Journal of Occupational Rehabilitation

, Volume 25, Issue 2, pp 357–367 | Cite as

Barriers to Return-to-Work for Linguistic Minorities in Ontario: An Analysis of Narratives from Appeal Decisions

  • Stephanie Premji


Purpose Previous research has shown that linguistic minorities have inferior workers’ compensation experiences and outcomes; however little information exists on the structural barriers they face in relation to return-to-work (RTW). We sought to address this gap by describing barriers to RTW for linguistic minorities in Ontario using narratives from appeal decisions. Methods We examined decisions by the Ontario Workplace Safety and Insurance Appeals Tribunal. We searched the full text of decisions rendered between October 1, 2010 and September 30, 2011 for the keyword “English”. A total of 378 decisions were generated. After eliminating decisions that did not involve linguistic minorities we retained half (189) for analysis. We summarized the issues around language for each decision and identified broad themes across decisions. Results We found that linguistic minorities’ limitations with regards to communication and power left them vulnerable to abuse, incomprehension and misperception by employers, care providers and adjudicators. In addition, specific RTW policies and practices failed to properly consider or mitigate their lack of English proficiency. These interpersonal and structural barriers negatively impacted linguistic minorities’ eligibility to benefits and services and the appropriateness thereof, as well as their eventual return to work. Conclusions Our research highlights the need to move beyond efforts to improve the linguistic competence of compensation boards to target the structural factors that impede equal access at every stage of the process.


Language Workers’ compensation Return to work Disparities 



This study was funded by Research Grants from McMaster University’s School of Labour Studies and McMaster University Arts Research Board. The author wishes to thank Alicia Shaw for her assistance with researching the appeal decisions and Joel Schwartz for his helpful comments on this manuscript.

Conflict of interest

Author Stephanie Premji declares that she has no conflict of interest.


  1. 1.
    Statistics Canada. Canada Year Book 2011. Ottawa; 2011.Google Scholar
  2. 2.
    Statistics Canada. Population by knowledge of official language, by province and territory (2006 Census). Ottawa; 2007.Google Scholar
  3. 3.
    Statistics Canada. Knowledge of official languages by mother tongue, Ontario, 2006. Ottawa; 2011.Google Scholar
  4. 4.
    Asanin J, Wilson K. “I spent nine years looking for a doctor”: exploring access to health care among immigrants in Mississauga, Ontario, Canada. Soc Sci Med. 2008;66:1271–83.CrossRefPubMedGoogle Scholar
  5. 5.
    King G, Lindsay S, Klassen A, Esses V, Mesterman R. Barriers to health service utilization by immigrant families raising a disabled child: unmet needs and the role of discrimination. Ontario: Citizenship and Immigration Canada; 2011.Google Scholar
  6. 6.
    Corbeil J-P, Lafrenière S. Portrait of official-language minorities in Canada: francophones in Ontario. Ottawa: Statistics Canada; 2010.Google Scholar
  7. 7.
    Villeneuve MJ. Healthcare, race and diversity: time to act. Healthc Q. 2002;6:67–73.CrossRefGoogle Scholar
  8. 8.
    Ricento T, Cervatiuc A. Language minority rights and educational policy in Canada. In: Pretovic JE, editor. International perspectives on bilingual education: policy, practice, and controversy. Charlotte, NC: Information Age Publishing Inc.; 2010. p. 21–42.Google Scholar
  9. 9.
    Duff PA, Li D. Indigenous, minority, and heritage language education in Canada: policies, contexts, and issues. Can Mod Lang Rev. 2009;66:1–8.CrossRefGoogle Scholar
  10. 10.
    Premji S, Krause N. Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners. Am J Ind Med. 2010;53:960–75.CrossRefPubMedGoogle Scholar
  11. 11.
    Sears JM, Bowman SM, Adams D, Silverstein BA. Who pays for work-related traumatic injuries? payer distribution in Washington State by ethnicity, injury severity, and year (1998–2008). Am J Ind Med. 2013;56:742–54.CrossRefPubMedGoogle Scholar
  12. 12.
    Smith PM, Kosny AA, Mustard CA. Differences in access to wage replacement benefits for absences due to work-related injury or illness in Canada. Am J Ind Med. 2009;52:341–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Premji S, Duguay P, Messing K, Lippel K. Are immigrants, ethnic and linguistic minorities over-represented in jobs with a high level of compensated risk? Results from a Montreal, Canada study using census and workers’ compensation data. Am J Ind Med. 2010;53:875–85.CrossRefPubMedGoogle Scholar
  14. 14.
    Gravel S, Vissandjée B, Lippel K, Brodeur J-M, Patry L, Champagne F. Ethics and the compensation of immigrant workers for work-related injuries and illnesses. J Immigr Minor Health. 2010;12:707–14.CrossRefPubMedGoogle Scholar
  15. 15.
    Kosny A, MacEachen E, Lifshen M, Smith P, Jafri GJ, Neilson C, et al. Delicate dances: immigrant workers’ experiences of injury reporting and claim filing. Ethn Health. 2012;17:267–90.CrossRefPubMedGoogle Scholar
  16. 16.
    Bonauto DK, Smith CK, Adams DA, Fan ZJ, Silverstein BA, Foley MP. Language preference and non traumatic low back disorders in washington state workers’ compensation. Am J Ind Med. 2010;53:204–15.CrossRefPubMedGoogle Scholar
  17. 17.
    Burgel BJ, Lashuay N, Israel L, Harrison R. Garment workers in California: health outcomes of the Asian Immigrant Women Workers Clinic. AAOHN J. 2004;52:465–75.PubMedGoogle Scholar
  18. 18.
    Lashuay N, Harrison R. Barriers to occupational health services for low-wage workers in California. A report to the Commission on Health and Safety and Workers’ Compensation, California Department of Industrial Relations. San Francisco: University of California, San Francisco; 2006.Google Scholar
  19. 19.
    Pransky G, Moshenberg D, Benjamin K, Portillo S, Thackrey JL, Hill-Fotouhi C. Occupational risks and injuries in non-agricultural immigrant latino workers. Am J Ind Med. 2002;42:117–23.CrossRefPubMedGoogle Scholar
  20. 20.
    de la Hoz RE, Hill S, Chasan R, Bienenfeld LA, Afilaka AA, Wilk-Rivard E, et al. Health care and social issues of immigrant rescue and recovery workers at the World Trade Center site. J Occup Environ Med. 2008;50:1329.CrossRefPubMedGoogle Scholar
  21. 21.
    Scherzer T, Wolfe N. Barriers to workers’ compensation and medical care for injured Personal Assistance Services workers. Home Health Care Serv Q. 2008;27:37–58.CrossRefPubMedGoogle Scholar
  22. 22.
    de Castro AB, Fujishiro K, Sweitzer E, Oliva J. How immigrant workers experience workplace problems. A qualitative study. Arch Environ Occup Health. 2006;61:249–58.CrossRefPubMedGoogle Scholar
  23. 23.
    MacEachen E, Kosny A, Ferrier S, Chambers L. The, “toxic dose” of system problems: why some injured workers don’t return to work as expected. J Occup Rehabil. 2010;20:349–66.CrossRefPubMedGoogle Scholar
  24. 24.
    Côté D. Intercultural communication in health care: challenges and solutions in work rehabilitation practices and training: a comprehensive review. Disabil Rehabil. 2013;35:153–63.CrossRefPubMedGoogle Scholar
  25. 25.
    Dressler D, Pils P. A qualitative study on cross-cultural communication in post-accident in-patient rehabilitation of migrant and ethnic minority patients in Austria. Disabil Rehabil. 2009;31:1181–90.CrossRefPubMedGoogle Scholar
  26. 26.
    Workplace Safety and Insurance Board. Strategic plan 2012–2016: strategic direction. Toronto: WSIB; 2012.Google Scholar
  27. 27.
    Gravel S, Brodeur J-M, Vissandjée B, Champagne F, Lippel K. Incompréhension des travailleurs immigrants victimes de lésions professionnelles de leurs difficultés d’accéder à l’indemnisation. Migration et Santé. 2007;131:1–42.Google Scholar
  28. 28.
    Canadian Heritage. Official language majorities and minorities: an overview. Gatineau: Government of Canada; 2012.Google Scholar
  29. 29.
    Association of Workers’ Compensation Boards of Canada. Key statistical measures—history/background. 2011. Accessed 15 Sept 2013.
  30. 30.
    MacEachen E, Ferrier S, Kosny A, Chambers L. A deliberation on’hurt versus harm’logic in early-return-to-work policy. PPHS. 2007;5:41–62.Google Scholar
  31. 31.
    Miles MB, Huberman AM. Qualitative data analysis. A sourcebook of new methods. Beverly Hills: SAGE Publications; 1984.Google Scholar
  32. 32.
    Lippel K. Preserving workers’ dignity in workers’ compensation systems: an international perspective. Am J Ind Med. 2012;55:519–36.CrossRefPubMedGoogle Scholar
  33. 33.
    Soklaridis S, Ammendolia C, Cassidy D. Looking upstream to understand low back pain and return to work: psychosocial factors as the product of system issues. Soc Sci Med. 2010;71:1557–66.CrossRefPubMedGoogle Scholar
  34. 34.
    Friesen MN, Yassi A, Cooper J. Return-to-work: the importance of human interactions and organizational structures. Work. 2001;17:11–22.PubMedGoogle Scholar
  35. 35.
    Brines J, Salazar M, Graham K, Pergola T. Return to work experience of injured workers in a case management program. AAOHN J. 1999;47:365.PubMedGoogle Scholar
  36. 36.
    Kirsh B, McKee P. The needs and experiences of injured workers: a participatory research study. Work. 2003;21:221–31.PubMedGoogle Scholar
  37. 37.
    MacEachen E, Clarke J, Franche R-L, Irvin E. Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health. 2006;32:257–69.CrossRefPubMedGoogle Scholar
  38. 38.
    MacEachen E, Kosny A, Ferrier S, Lippel K, Neilson C, Franche R, et al. The ‘ability’paradigm in vocational rehabilitation: challenges in an Ontario injured worker retraining program. J Occup Rehabil. 2012;22:105–17.CrossRefPubMedGoogle Scholar
  39. 39.
    Lynoe N, Wessel M, Olsson D, Alexanderson K, Helgesson G. Does feeling respected influence return to work? Cross-sectional study on sick-listed patients’ experiences of encounters with social insurance office staff. BMC Public Health. 2013;13:1–8.Google Scholar
  40. 40.
    Roberts-Yates C. The concerns and issues of injured workers in relation to claims/injury management and rehabilitation: the need for new operational frameworks. Disabil Rehabil. 2003;25:898–907.CrossRefPubMedGoogle Scholar
  41. 41.
    Butterwick S. Life skills training: Open for discussion. In: Cohen MG, editor. Training the excluded for work: access and equity for women, immigrants, first nations, youth and people with low income. Vancouver: UBC Press; 2003.Google Scholar
  42. 42.
    Ontario Network of Injured Workers Groups. Injured workers and poverty survey. Toronto: Ontario Network of Injured Workers Groups; 2010.Google Scholar
  43. 43.
    Li PS. Deconstructing Canada’s discourse of immigrant integration. J Int Migr Integr. 2003;4:315–33.CrossRefGoogle Scholar
  44. 44.
    Boyd M. Immigration trends, language skills and the labour market integration of recent immigrants. Metropolis Conference, “Language Matters” symposium; Ottawa; 2009.Google Scholar
  45. 45.
    Wayland SV. Unsettled: legal and policy barriers for newcomers to Canada. Ottawa: Law Commission of Canada; 2006.Google Scholar
  46. 46.
    Office of the Worker Adviser. Returning to work. Ontario; 2013. Accessed Feb 26 2014.
  47. 47.
    MacEachen E, Kosny A, Ferrier S, Lippel K, Neilson C, Franche R-L, et al. The ideal of consumer choice in social services: challenges with implementation in an Ontario injured worker vocational retraining programme. Disabil Rehabil. 2013;35:2171–9.CrossRefPubMedGoogle Scholar
  48. 48.
    Allan K. Skilling the self: the communicability of immigrants as flexible labour. In: Duchêne A, Moyer M, Roberts C, editors. Language, migration and social (In)equality. A critical sociolinguistic perspective on institutions and work. Toronto: Multilingual Matters; 2010.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Health, Aging and Society, School of Labour StudiesMcMaster UniversityHamiltonCanada

Personalised recommendations