Employer approaches to recognizing and managing intermittent work capacity

• DOI: https://doi.org/10.1108/EDI-02-2021-0046
• Published date: 28 January 2022
• Date: 28 January 2022
• Pages: 739-759
• Subject Matter: HR & organizational behaviour,Employment law,Diversity,equality,inclusion
• Author: Rosemary Lysaght,Terry Krupa,Allan W. Gregory

Employer approaches to

recognizing and managing

intermittent work capacity

Rosemary Lysaght and Terry Krupa

School of Rehabilitation Therapy, Queen’s University, Kingston, Canada, and

Allan W. Gregory

Economics Department, Queen’s University, Kingston, Canada

Abstract

Purpose –This study explored how intermittent work capacity (IWC) presents in workplaces in order to

advance conceptual understanding of this phenomenon and establish a set of initial principles to assist in its

management.

Design/methodology/approach –The study followed a grounded theory approach in a multi-stage data

collection process. In total, 25 employers representing diverse employment sectors were recruited with a goal of

exploring their experiences with IWC. The first phase of the study comprised individual interviews with all

employers. A subset of these employers later participated in two focus groups organized by company size.

Finally, in-depth case studies were conducted with two information rich organizations to understand their

approaches to managing IWC. Analysis methods consistent with grounded theory were used.

Findings –Although employers have a variety of positive motivations for supporting employees with IWC,

they are challenged by the uncertainty arising from the unpredictable work patterns associated with IWC. Five

distinct expressions of uncertaintywere identified. Negotiation of this uncertainty involves attention to a range

of factors, including i ntrapersonal factor s, workplace relation s and morale, specific jo b demands,

communication processes, and structural and organizational factors.

Research limitations/implications –Thefindings of this study advanceunderstanding ofthe expression of

IWC, and factorsthat influence its impact.This paper presents a seriesof workplace strategies thatboth enable

thewell-being and capabilitiesof employeeswho experience IWC,and ensure productiveand diverse workplaces.

Originality/value –The findings of this study advance understanding of the expression of IWC, and factors

that influence its impact. This paper presents a series of workplace strategies that both enable the well-being

and capabilities of employees who experience IWC, and ensure productive and diverse workplaces.

Keywords Employment, Chronic conditions, Episodic disability, Disabled workers, Organizational culture

Paper type Research paper

Introduction

A diverse workforce is broadly acknowledged to hold a number of advantages and is an

unavoidable reality due to changing demographics in most modern societies (van

Knippenberg and Mell, 2016;Yadav and Lenka, 2020). The changing demographics in

many businesses and industries of all sizes demands assertive actions by employers to

manage diversity well (Yadav and Lenka, 2020), yet many social identity groups, including

people with disabilities, continue to experience discrimination and exclusion (Shore et al.,

2018). Several authors note that diversity and inclusion in the workplace are not synonymous

Intermittent

work capacity

739

This research was funded through a grant from Human Resource and Skills Development Canada

(HRSDC Contract No. 7616-09-0016/00). The authors wish to thank Elizabeth Cahill and other HRSDC

staff for their support and commitment to this work. The authors would also like to acknowledge the

contributions of Susan Barham, Mariam Baig and Rivka Birkam and Carrie Anne Marshall to

components of the project.

Ethics approval: Ethical clearance for this study was received from the Queen’s University, Canada,

General Research Ethics Board, Reference number 6005443. Informed consent was received from all

parties prior to their participation in this study.

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/2040-7149.htm

Received 16 February 2021

Revised 27 September 2021

21 December 2021

Accepted 7 January 2022

Equality, Diversity and Inclusion:

An International Journal

Vol. 41 No. 5, 2022

pp. 739-759

© Emerald Publishing Limited

2040-7149

DOI 10.1108/EDI-02-2021-0046

concepts; however, while diversity focuses on issues of workplace entry for those in

marginalized groups, inclusion addresses issues related to involvement in meaningful

participation, decision-making and career development (Mor Barak et al., 2001;Shore et al.,

2018). Failure to address either of these issues risks a number of damaging outcomes,

including reduced cohesion in the workforce, high rates of turnover and overall reduced

organizational performance (Shore et al., 2018).

Disability as a unique identity group has received limited attention in the research

literature (Yadav and Lenka, 2020) despite its growing relevance. The Centre for Disease

Control in the US reports that 90% of that country’s $3.5tn in healthcare expenditures relates

to services provided to people with chronic physical and mental health conditions (National

Centre for Chronic Disease Prevention and Health Promotion, 2021), and statistics of this type

are emerging worldwide (Chronic Disease Prevention Alliance of Canada, 2017;Hajat and

Stein, 2018). Beyond healthcare costs, the economic burden of chronic disease is also reflected

in workplace productivity losses, making this a broad social concern. For example, a 2014

international study calculated the direct costs of disability or illness in the United States at

8.1% of payroll and the cost of overtime and replacement workers to compensate for absence

at 7.3% (Society for Human Resource Management, 2014).

There is growing evidence that workers with disabilities bring many advantages to

workplaces. Past studies have demonstrated productivity benefits, as well as reductions in

absenteeism, contributions to workplace cohesion and reputational benefits (Kalargyrou,

2014). This is true for workers with physical and intellectual disabilities (e.g. Lysaght et al.,

2011), cognitive or sensory disabilities (Fisher and Connelly, 2020), as well as mental health

disability (Gewurtz et al., 2018). A resounding message in all related research is the need for

appropriate accommodations, and efforts to create a welcoming workplace in terms of

psychological and physical safety (Kalargyrou, 2014).

Working age peoplewith chronic conditions who presentwith intermittent work capacity

(IWC), sometimesreferred to as episodic disability,are particularly challenged with respect to

maintainingtheir attachmentto a workplace. StatisticsCanada data showthat 61% of the 6.2 m

adults with disabilities in Canada experience dynamic patterns of activitylimitation. Further,

individuals with fluctuating and progressive limitations are less likely to be employed than

those with continuous or recurrent limitations (Morris et al.,2019). For them, the workplace

transactionregarding disabilityadds a level of complexitybeyond that experiencedby persons

with more static conditions. Similarly, employers face a unique challenge in attempting to

effectivelymanage the needs of workerswho may present with varyinglevels of capacity over

the course of their employment and to keep them attached to the workforce.

IWC is a distinct situation among working age adults with chronic conditions that

involves periodically diminished capacity relative to usual or expected workload. It may also

involve frequent or extended workplace absences because of a disability or chronic health

condition (Fowler, 2011). IWC is associated with a variety of physical and mental health

conditions, and wide ranging patterns of exacerbation and remission (Solomon et al., 2018).

The list of episodic health conditions is long and diverse; 27 different episodic health

conditions have been identified (Furrie, 2010), including a broad spectrum of chronic diseases

such as arthritis, diabetes and mental health disabilities, as well as conditions such as cancer

and HIV-AIDs that may persist for an extensive portion of adult life. While some distinct

patterns of IWC might be associated with certain health conditions, broad variations in how

health disruptions emerge and the complexity of the contemporary workplace make IWC a

particular challenge for all stakeholders (Gignac et al., 2021a).

Presenteeism, defined as either the behaviour of attending work while ill, or the lost

workplace productivity associated with those who present for work while ill (Gosselin and

Corneil, 2013), is a highly relevant concept due to its frequent association with reduced work

capacity. Presenteeism is also associated with substantial financial loss to industry, often

EDI

41,5

740