Work Ability vs. Disability: Holistic Strategies for Supporting Employees with Disabilities

Employees with disabilities are shaped by more than just their individual health needs. Work demands, environmental factors, and the skills and attitudes they bring to work all create a picture of how an employee might experience or overcome barriers at work. Understanding how these factors interact can allow employers to view disability through a broader lens and approach efforts proactively and holistically.

The Work Ability House Model, developed by Juhani Ilmarinen, acts as a framework to understand how different systems interconnect. Employers who address each level of the framework can take meaningful steps toward creating an ability-focused workforce that enables employees to work at their best.

What is “Work Ability”?

“Work ability” is a concept that emphasizes an individual’s capacity to perform their job duties by balancing personal resources, job demands, and broader contextual factors.¹ Unlike traditional "disability management," which often focuses on addressing limitations and challenges, work ability emphasizes strengths, resources, and the overall potential of employees to succeed in their roles.

This concept is illustrated in the Work Ability House Model, visualized as a house with four interacting floors.

An illustration of the work ability house model taken from the latest published version [51]. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

• The first three floors are built on personal resources, including health and functional abilities, education and competence, and values and attitudes.
• The top fourth floor addresses workplace factors, including work demands, work environment, work community, and leadership, which may include the manager’s role and ability to provide resources.
• Surrounding the house are contextual factors, such as social networks, family support, and societal, legislative, and technological factors.

Applying Work Ability: A Case Study

We can see how each level of the house impacts disability by looking at research on chronic musculoskeletal disorders (CMSDs) in older employees. A 2022 study by Skamagki et al. explored the sustainable employability of employees over the age of 50 who had experienced a CMSD for 12 weeks or more. Using the Work Ability Model as a framework, the study revealed unique challenges for employees, beyond the health condition itself.

Researchers found that key factors influencing work ability included the following:

• Anxiety and depression – not directly due to their condition, but because of uncertainties about employment and perceived declines in work performance
• A lack of social support and empathy for disclosure and management of the health condition
• Presenteeism, especially in workplaces with poor communication, limited sick pay, or a culture of long working hours
• Failure from employers to connect employees to relevant healthcare professionals or occupational health services
• Services that supported employees’ efforts to self-manage their condition at work

Understanding how personal and work factors interacted, the study suggested that increased education, training opportunities, collaboration with healthcare professionals, and a more flexible, empathetic, and resourceful work environment is needed to sustain employability in an ageing workforce.

How to Provide Holistic Support Using Occupational Therapy

By applying the Work Ability model, employers can create a structured approach to removing barriers and building an ability-focused workforce. Occupational Therapists are uniquely positioned to help employers address needs at every level of the framework because of their holistic perspective. Here are some strategies for organizations to consider:

First Floor: Health and Functional Capacities

• Provide workplace accommodations: Engage an Occupational Therapist to assess employee function, work demands, and the work environment. Strategies and recommendations tailored to individual needs can help employees with disabilities succeed.
• Facilitate return-to-work: Partner with healthcare providers and Occupational Therapists to design gradual reintegration plans after illness or injury.

Second Floor: Competence

• Offer skill development opportunities: Help employees face workplace challenges by helping them gain skills to communicate, manage workload, give and receive feedback, and more. Success coaching provides employees with the tools to implement new strategies at work.
• Ensure skills align with job roles: Conduct a Job Demands Analysis to evaluate the physical, cognitive, and emotional requirements of a role so you can ensure they align with an employee’s skills and abilities. This can help employers identify potential mismatches and areas where adjustments or additional training may be needed. An individual's skills and abilities can be determined through an accommodation assessment, which can help facilitate creative solutions to ensure the employee is able to meet the demands of the job.

Third Floor: Values, Attitudes, and Motivation

• Promote a culture of inclusivity: Conduct regular diversity and sensitivity training for all employees, ensuring that managers and colleagues understand how to work collaboratively and respectfully with people with disabilities.

Fourth Floor: Work, Community, and Leadership

• Provide supportive leadership: Train managers to practice empathy, recognize employee challenges, and identify appropriate workplace solutions. Training such as Manager Mental Health Training can be effective for leadership teams.
• Cultivate team inclusion: Train employees on neurodiversity, mental health, and disability, with a focus on inclusive practices to ensure all employees feel safe and supported at work.

How Can Gowan Consulting Help?

Not sure where to start? Contact us with a question, a referral, or a workplace problem, and we’ll work with you to find the right solution for your business.

Resources

[1] Ilmarinen, J. (2009). Work ability—a comprehensive concept for occupational health research and prevention. Scandinavian Journal of Work, Environment & Health, 35(1), 1–5. http://www.jstor.org/stable/40967749