*4.3. Implications for Supporting Disabled Workers during the Pandemic*

Workers who are disabled because of an accident or disease at work are most concerned about their quality of life and their ability to work again after the injury. In order to protect workers from this risk, some countries include occupational injury insurance in their social security programs. Moreover, a study on rural–urban migrants in China highlights the challenges they faced during the COVID-19 pandemic including housing evictions and difficulties with travel [19]. This sheds light on how disabled people, as another disadvantaged population group, may also be impacted by similar issues, and highlights the need for policies to address the needs of various disadvantaged groups. Policy instruments such as occupational health and safety initiatives are necessary to facilitate the work resumption of disadvantaged workers during COVID-19, however, more comprehensive evaluations and implementation details are needed to determine their effectiveness [20]. The implementation of coverage under occupational injury insurance has taken the shape of a case management system which is the Return to Work program [21–25]. Despite the fact that during the pandemic, the state of employment in temporary contracts was related to enhanced well-being and increased performance, the research found that they were also associated with decreased job security [13].

Workers who have been disabled due to an accident or disease might have their dignity restored and their chances of returning to work improved by RTW programs [26]. This is in line with the journey of businesses taking part in the RTW assistance program offered by BPJS Ketenagakerjaan, Indonesia. In addition, there has been an increase in the promotion of career options for those who are either disabled or have a permanent complete handicap. Workers regain their productivity when employers invest in their education and re-entry into the workforce, putting them in a position to compete for better job prospects and, on a larger scale, become one of the elements contributing to good economic development [27]. The success of the RTW program will increase the number of workers engaging in the labor market. The effective management of a disabled workforce can play a critical role in promoting the participation of disabled workers who have suffered from occupational injuries in the labor market. The RTW program supports disabled workers returning to the workforce, promoting their participation in the labor market and effectively managing disabilities. By providing support and accommodation, RTW programs help address the challenges faced by disabled workers. RTW programs are essential for effectively managing disabilities and supporting the workforce [28,29]. This, in turn, will increase the output level, affecting the economy's status in Indonesia.

Our study found that the variable of working period was significantly related to the preference for participating in the return to work (RTW) program, with a *p*-value of 0.000 for the Chi-square test and a *p*-value of 0.000 in the multivariate logistic regression. This suggests that the length of time an individual has been out of work plays a significant role in their preference for participating in a RTW program. Additionally, we found that the category of working period among workers in the RTW group was dominantly 10–14 years (69 ± 30.10%). In the non RTW group, the dominant category was 5–9 years (69 ± 30.10%). These findings suggest that those who have been out of work for a longer period of time are more likely to prefer the support and resources provided by the RTW program in order to return to work.

It is important to consider the potential implications of these findings for policy and practice. Employers and policy-makers may wish to consider implementing RTW programs that are targeted toward those who have been out of work for longer periods of time, as they may be more likely to benefit from the support and resources provided. Additionally, further research is needed to understand the specific factors that influence an individual's preference for participating in a RTW program such as personal and professional goals, job availability, and health and wellness.

This study shows an identical outcome to a study carried out in Malaysia [22,30] that demonstrated that the outcomes of RTW had a significant correlation with the physical health domain of workers who participated in RTW programs. Under certain situations to turn for equating with a study that followed that sequence, this study shows the results. Research with the same questionnaire was also undertaken for people with disabilities [31], and the results indicated that all means of QOL domains were accordingly lower than this report revealed. Furthermore, this study's setting differed significantly from other studies. Moreover, this research analyzed how the RTW program's comprehensive rehabilitation affects the quality of life for persons with disabilities. It would seem that the RTW program beneficially impacts the practical approach during the COVID-19 pandemic to improve the quality of life among disabled workers.

In addition, regarding the work ability index, this investigation used the work ability index questionnaire developed by the Finnish Institute of Occupational Health [32]. This tool describes the respondents' current work capabilities while also allowing for projections of the health concerns they experience. The results may mean that the category is poor if the score is between 7 and 27 points, and the category is moderate if the result is between 28 and 36 points. In this case, the category is considered good if the score is between 37 and 43 points and excellent if it is between 44 and 49 points. The questionnaire is an instrument for self-evaluation, and its purpose is to determine an individual's job competence by analyzing how that person interacts with the environment in which they are employed. It is flexible enough to be utilized by individual workers and teams [32,33].

The work ability index results classified all participants in a range from moderate to excellent. The broad range of WAI scores in this study ranged from 29 to 49. The results of this study should therefore be seen as a response to specific previous findings [16]. There is some evidence to suggest that there may be a correlation between the WAI and age and working period. Some studies have found that older workers and those with longer working periods tend to have lower WAI scores, while younger workers and those with shorter working periods tend to have higher WAI scores [34]. This may be due to the increased physical and mental demands of work as well as the accumulation of health problems over time.

The purpose of occupational health management that may be achieved by implementing WAI is to consider maintaining and making efforts to improve the quality of work for an inclusive society that includes people with disabilities in accordance with the UN's Sustainable Development Goals (SDGs). It has been revealed that 54.2% (n = 84) of the total number of disabled workers who participated in the RTW program significantly improved their working abilities due to their participation. During the COVID-19 outbreak in Indonesia, it was observed that 27.3% (n = 42) of employees fell into the moderate group, while 18.2% (n = 28) had an exceptionally excellent work ability index.
