Fire Department Early Return-to-Work Program

1. Fire Department Early Return-to-Work Program

2. Fire Department Workers’ Compensation Program • In FY 2010-11, 1383 workers’ compensation claims were opened on the Fire Department Program. • Traditionally, the Fire Department frequency rate exceeds 30% (30 reported injuries per 100 employees). • In FY 2010-11, Fire Department workers’ compensation expenses were $42.3 M with another $20.3 M paid in salary continuation and LC 4850 benefit expenses.

3. What can be done to reduce intractable workers’ compensation expenses? • Safety and Loss Control Efforts. • Leverage and improve workers’ compensation processes to promote the expedient delivery of quality medical care and facilitate early and sustainable return to work efforts. • Improve communication between system stakeholders (injured worker, department management, department RTW staff, workers’ compensation third party administrator, and treating physician). • Evaluate and expand an organization’s ability to provide timely and meaningful temporary alternate duty (light duty) assignments (ERTW). The premise of such a proposal is that organizational effectiveness is improved by transitioning absent unproductive employees to present productive employees. • Better the experience of our injured workers during the complex and often confusing workers’ compensation claim process.

4. The Injured Worker's Experience • "No one gives you the full story, only parts." • "When you want to go through the process, no one gives you a hand as to what to do . . . . [You're] completely on your own." • "They only saw me as a number, they did not care about me as an individual.” • "They catch some guy playing tennis on film. It's like 'Oh, all employees are lying.” • "Everyone wants a piece of the case, and he who least benefits is the worker.” • "It's really dehumanizing to have your fate decided by so many outside forces.” • "Initially, when I got hurt on the job, the supervisor took no notes, did nothing, and progressively I was getting lame." • "It starts with the human factor, first of all--train people or the counselors or people in insurance to treat you as a human being."

5. Fire Department Early RTW Program • Program overview: • Phase 1- Strengthen communication • Phase II - Initial Treatment Center’s • Phase III - Orthopedic Facilities • Phase IV- Modified/Alternative work

6. Fire Department Early RTW Program • Phase 1: Strengthen Communication • RTW Supervisor contacts an employee within 24 hours. • Assess employee medical needs • Clarify work status • Provide contact letter (RTW and Intercare contact numbers) • RTW Regional Coordinator follow-up contact within 3 days • RTW Coordinators assigned to specific Bureaus within Emergency and Business operations • Increased communication results in better case management

7. Fire Department Early RTW Program • Phase 1: Strengthen Communication • Workers’ Compensation TPA makes 24 hours. • Assess employee medical needs • Clarify work status • Provide employee with WC TPA contact information • Facilitate medical appointment and/or diagnostic testing

8. Fire Department Early RTW Program • Phase II: Initial Treatment Centers (ITC’s) • Provide appropriate quality care for non-life threatening injuries/illnesses. • Fitness for Life medical facilities • County Contracted facilities • Familiarity with Department personnel because of providing annual medical exams for the last 10 years • Cost savings due to high cost associated with Emergency Room visits for non-life threatening injuries/illnesses

9. Fire Department Early RTW Program • Phase III - Orthopedic Facilities • Kerlan & Jobe • Southern California Orthopedic Institute (SCOI) • California Orthopaedic Specialist • Facilitate timely scheduling of Initial and follow-up appointments of orthopedic injuries • Authorization of medical treatment • MRI, Physical Therapy and Chiropractor services approved within 24 hours • Reduce or have no loss time from work while receiving orthopedic intervention • i.e. reduce cost associated with 4850 and salary continuation

10. Fire Department Early RTW Program • Phase IV: Early Return-to-Work Program • Develop and provide reasonable accommodations to employees that have a physical or mental condition, regardless if Industrial or Non-industrial

11. Development of a Early RTW Program • The department is in the process of establishing a detailed Modified and Alternative work program for employees that are medically disabled from an Industrial or Non-Industrial injury or illness. The intent of this program is to utilize our injured workers knowledge, skills and abilities in a temporary position other than their usual and customary job

12. Development of an Early RTW Program • Benefits: • The prevention of de-conditioning, psychological sequels of prolonged time off work, and maintenance of employment benefits. • A reduction in workers’ compensation time-loss costs and improved organizational effectiveness. • Clearly, improved outcomes are dependent on the communication between and the cooperation of the Employee, Employer, Third Party Administrator and the Treating Physician.

13. Development of an EarlyRTW Program • Process: • Physician spells out an employee work restrictions • RTW Regional Coordinator, Intercare, HR or ESS is notified of temporary work restrictions • Anyone of the above Section notifies ERTW Assignment Desk • ERTW Assignment Desk has list of all Department administrative vacancies as well as Emergency Operations • ERTW Desk assigns employee based on current work restrictions and Knowledge, Skills and Ability

14. Workers’ Compensation Communication Flow (ERTW)

15. Expanded ERTW Option

16. LA County Fire Dept. Limited Duty Assignment Desk

17. LA County Fire Dept. Limited Duty Assignment Desk • Support employee and department when work accommodations are requested • Centralized location for tracking, assigning, and obtaining limited duty assignments • Generate monthly reports with pertinent limited duty data

18. Limited Duty Assignment PoolObtained From • Monthly vacancy reports • Section Supervisors, Regional Captains, B.C.s, & Assistant Chiefs • Special projects for Administrative Staff • Department training/continuing education

19. Why Limited Duty Is So Advantageous • Saves sick or 4850 time • Maintain regular pay and benefits • Create flexible work hours • Place them close to their home/treatment facilities • Allow reasonable time for doctors appointments/ rehabilitation • Allows employee to stay current on training • Keep employee involved/maintains self worth

20. Assigning Limited Duty Personnel • Contact the employee • Confirm limited duty and work restrictions • Utilize injured workers knowledge, skills and abilities in determining placement • Contact position supervisor to review/confirm reasonable accommodations • Tailor fit assignment around work restrictions: Work hours Location Accommodation Skills and abilities

21. Employees Tracked And Monitored During Limited Duty Assignment • All employees seeking limited duty funneled to assignment desk • Monitored and tracked during assignment • Keeps track of doctor’s appointments in relation to status • Ensures proper forms are distributed for completion

22. Limited Duty Assignment Desk Data Tracking

23. Limited Duty Assignment Desk Data Tracking

26. Thank you!