Returning to Work After Sexual Violence: When the Workplace is Part of the Injury 

Safety at Work

Returning an injured worker to work is usually framed around function. What can the person safely lift, carry, stand, reach, tolerate, or perform while recovery continues? Workplace sexual violence complicates that model because the work environment itself may be connected to the injury. The building, shift, supervisor, patient, coworker, customer, hotel room, or work assignment may carry meaning that did not exist before the event. A medically appropriate return to work therefore requires more than determining whether someone is physically capable of performing a job. 

Research on sexual trauma helps explain why. Post-traumatic stress can involve heightened arousal, intrusive memories, avoidance, changes in mood, and increased sensitivity to reminders associated with the original event. Dworkin and colleagues found substantial PTSD symptoms among many sexual assault survivors shortly after an assault, with considerable recovery occurring during the first several months and persistent symptoms for some individuals. That variability matters because there is no universal timeline for when someone should be ready to return to a particular environment. Two workers with similar physical injuries may respond very differently to the circumstances surrounding those injuries. Return-to-work planning should account for the worker’s functional abilities and the conditions capable of affecting recovery. 

The economic pressure to return can be significant. Research examining violence against women at work has identified subsequent job loss, fewer working hours, lower earnings, and reduced job retention. Loya’s research on the economic consequences of sexual violence similarly documented missed work, impaired performance, job disruption, and periods when survivors were unable to work. These consequences can continue well beyond the initial medical response to an assault. Losing employment can compound the financial effects of an injury at the same time treatment, legal proceedings, and recovery are demanding additional time and resources. Successful return to work can therefore be enormously valuable, but speed alone is a poor measure of success. 

One of the most important questions is what the injured worker is being asked to return to. If the alleged perpetrator remains in the workplace, shares a supervisor, works the same shift, or continues to interact with the worker, returning to the original job may recreate conditions associated with the injury. The same concern can arise when the assault involved a patient, resident, customer, or other third party and the worker is expected to resume identical assignments without additional safeguards. Different shifts, work locations, reporting relationships, assignments, or contact arrangements may need to be considered as part of the return-to-work process. Modified duty should address relevant risk and function rather than merely producing a job description the worker can technically perform. 

This becomes particularly important when organizations unintentionally place the burden of workplace separation on the injured worker. Moving the injured employee while leaving every other condition unchanged may preserve operational convenience while creating professional, financial, or psychological consequences for the person who reported the assault. A different assignment may carry fewer hours, reduced visibility, less opportunity, an undesirable schedule, or isolation from a previously supportive team. Employers therefore need to look beyond whether a modification exists and examine what the modification actually does. A return-to-work plan can satisfy a logistical requirement and still create barriers to sustainable recovery. The goal should be a workable arrangement that addresses safety without unnecessarily disadvantaging the injured worker. 

Research on workplace violence also suggests that organizational responses can affect people beyond the individual directly involved. Adams, Huttunen, Nix, and Zhang found meaningful employment consequences following violence against women at work and observed differences in what happened after workplace assaults depending on organizational response. Workplaces that retained perpetrators could experience the departure of other women employees as well. That finding matters for workers’ compensation because the consequences of an occupational assault may extend into retention, trust, workforce behavior, and organizational culture. Employees observe how organizations respond when something serious happens to someone around them. The handling of one injury can therefore influence how safe other employees perceive the workplace to be. 

Communication between the employer, clinician, claims professional, and injured worker also requires discipline. Treatment providers may understand which environmental conditions or interactions are affecting symptoms, while claims professionals need enough information to coordinate benefits and work capacity. Employers need functional information necessary to develop appropriate work options without receiving every clinical detail discussed in treatment. This creates an important boundary between coordinating recovery and unnecessarily expanding access to highly personal information. Claims professionals can help maintain that boundary by requesting information relevant to treatment, causation, restrictions, and work capacity rather than collecting detail simply because it exists. Thoughtful information management can support both accurate decision-making and the worker’s dignity. 

The return-to-work conversation should also recognize that recovery rarely occurs in isolation from other obligations. An injured worker may be attending medical appointments, therapy, legal meetings, interviews, or proceedings while simultaneously trying to resume employment. Some of those demands may occur during ordinary working hours and may continue after the worker has regained much of their physical capacity. Fatigue, disrupted sleep, concentration difficulties, and anxiety may also affect work even when the individual appears physically recovered. Coordination among the worker, treating clinician, employer, and claims team can help identify which barriers are temporary and which workplace conditions require adjustment. A sustainable return is more valuable than a rapid return followed by another absence. 

Workers’ compensation has spent decades improving return-to-work practices through modified duty, transitional work, functional restrictions, and communication between employers and medical providers. Workplace sexual violence asks us to apply those same principles with a broader understanding of what function and safety can mean after trauma. The question cannot stop at whether an injured worker is capable of coming back to work. We also need to examine what environment we are returning that person to, whether workplace conditions remain connected to the injury, and whether the proposed plan supports recovery or introduces another barrier to it. Return to work remains an important goal. For some injuries, however, where someone returns may matter just as much as when. 

Research Referenced 

Adams, A., Huttunen, K., Nix, E., & Zhang, N. Research on violence against women at work and employment outcomes. 

Dworkin, E. R., et al. (2017; 2023). Research on psychological outcomes and PTSD trajectories following sexual assault. 

Loya, R. M. (2015). Rape as an Economic Crime. 

Substance Abuse and Mental Health Services Administration. Trauma-informed care principles. 

Equal Employment Opportunity Commission. Guidance related to workplace harassment and minimizing burdens placed on individuals reporting harassment. 

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