Transitional Return-to-Work

1. Transitional Return-to-Work Presented by QBE Loss Control Services

2. What is a Transitional Return-to-Work (TRTW) Program? A program to enhance the injured employee’s rehabilitation and facilitate their return to normal job duties by providing temporary modified work

3. What is TRTW? Plan for dealing with return-to-work issues before an injury occurs

4. TRTW “You do not get injured workers well to put them back to work. You put them back to work to get them well.” Richard Pimentral The Return to Work Process: A Case Management Approach

5. Injury Results Injury Occurrence Stress Physical, Emotional, Social Increased Medical Procedures, Therapy/rehab/Surgical Costs

6. Employee Benefits of TRTW • Generally gets employees back to work 50% faster • Speeds recovery up to 3 times • Reduces vocational rehab • Reduces degree of permanent partial disability • Reduces possibility of re-injury upon return • Employee’s wage loss minimized

7. Employer Benefits of TRTW • Helps control medical costs by as much as 70% • Reduces indemnity costs • Less abuse of Worker’s Compensation system • Improves moral/employee relations • Improved work ethic • Enhanced company image • Less litigation

8. Litigation “People sue because no-one cares more often than because they felt they were wrongly injured.”

9. Litigation • 80% of claims involving litigation result in higher settlements • Contacting the injured employee within 1 week of injury reduces chances of litigation by 50%

10. Employer Benefits of TRTW • Eliminate repeaters & malingerers • Reduced turnover • Reduces hiring & retraining costs • Maintains company productivity • Employer is in charge rather than employee

11. Important Considerations • The longer an employee is off work, the more difficult it is to get the employee to return to work. (Disability Syndrome) • The longer an employee is off work, the larger the disability awarded at hearing.

12. Absenteeism • 20% of employees account for 80% of employee absence costs • Red Flag- Absenteeism problems

13. Effective TRTW Programs • Identification of potential jobs for modified duty • Early reporting of injuries and illnesses • Accident investigation program • Communications- employee/employer/medical/WC carrier • Education of staff

14. A Hard Look at Lost Time • Lost time typically constitutes 60% of Worker’s Compensation costs • For each 1$ paid out by the insurance carrier, there may be as much as $2 in increased workers comp premium costs to the employer

15. TRTW Vs. No Program Example: Employee with one hand duty for 8 weeks wage $500/week WC pays 66.67% of wages. No TRTWWith TRTW $500 x 8 x 0.67 = $2,680 $0 3-Year Cost in Increased WC Premiums due to Indemnity $2,680- $5,360 $0

16. Claims Costs Crawford & Company 1995

17. TRTW Benefits According to the Washington Business Group on Health there is a $8-$10 return on every $1 invested in a TRTW program

18. TRTW Team • Injured employee • Upper management • Return-to-work coordinator • Front line supervisor • Physician/Medical provider • Worker’s Comp. provider

19. Management • Commitment to TRTW • Develop TRTW policy • Develop TRTW team • Communicate

20. Return-to-Work Coordinator • Develop/implement/coordinate program • Direct injury management • Maintain contact with injured employee • Communicate with QBE/medical provider and Management

21. Return-to-Work Coordinator • Coordinate with medical providers • Maintain records • Report to management • Provide training • Establish a plan for each injured employee

22. Supervisor’s Role in TRTW • The greatest road block to an effective TRTW program is supervisor attitude. • Program support

23. Supervisor’s Role in TRTW • Get employee prompt medical attention • Promptly report to management • Complete accident investigation • Respond positively • Assist in job evaluations

24. Supervisor’s Role in TRTW • Keep in contact with employee • Make employee feel welcome • Identify light duty jobs • Never allow employee to work outside restrictions

25. Injured Employee • Financial concerns • Health concerns • Advise from friends, neighbors, etc. • Attorneys

26. Injured Employee Responsibilities • Follow safety policies and rules • Promptly report injuries • Complete paperwork • Maintain contact with employer when off work • Provide updates on medical condition

27. Injured Employee Responsibilities • Follow medical recommendations • Do not work outside restrictions

28. Physician/Medical Provider • Make medical determination • Be familiar with employee’s job functions and the jobs physical requirements • Determine work restrictions • Work with TRTW coordinator & QBE or case nurse

29. Medical Considerations • Develop relationships with medical providers • Give medical providers tours of facility

30. General Information for Medical Provider • Job descriptions • Job function analyses • List of transitional work activities • Written TRTW program • Videotapes of jobs

31. Specific Information to Medical Provider • Job function analysis of injured employee’s job • Descriptions of available jobs that fit restrictions • Physical capabilities form

32. Job Function Analysis • Job title • Describe job tasks • Equipment used • Physical demands • PPE needed • Other hazardous conditions

33. Job Function Analysis Example: An employee may tell the medical provider they lift 50 lbs. The missing information is that they lift 50 lbs. once per week!

34. Physical Demands • Standing/walking • Sitting • Lifting/carrying • Pushing/pulling • Bending • Twisting • Kneeling/crawling • Reaching

35. Types of Work • Modified Work- Regular job with modifications to accommodate restrictions • Alternate Work- A temporary assignment until worker is able to perform regular job

36. Modified Duty Jobs • Try to return to same job first • See what regular activities fall outside restrictions • Evaluate ways to reorganize job to accommodate restrictions • Separate jobs tasks into essential and non-essential

37. Alternate Work • Should be identified before injury occurs • Should be meaningful and productive • Develop a list of possible alternate jobs • Look for things that never seem to get done- inventory, painting, cleaning, organizing, sorting, paperwork, labeling, etc.

38. On the Day of Injury • Get injured employee medical attention • Send physical capabilities form and notice of temporary modified duty availability and job function analysis to medical provider • Contact QBE Claims Dept. • Complete First Report of Injury • Start accident investigation

39. Within 3 Days of Injury • Send employee get well card • Have supervisor contact employee • Contact physician and discuss TRTW issues • Develop specific TRTW program for employee

40. Complete Every Week Until Release • Contact or visit employee • Contact physician after each medical exam • Continue to work with physician, QBE and employee until restricted or modified duty provided

41. Written TRTW Program • Policy statement • Roles & responsibilities • Procedures • List of job descriptions with physical requirements • List of modified duty jobs • Should be reviewed by company attorney

42. ADA and TRTW 1. Determine if there is impairment 2. Determine if the employee can still work within the scope of their original job 3. If they can’t work within the scope of the original job, can reasonable accommodations be made 4. If reasonable accommodations can’t be made is there another job the employee can perform

43. Coordinating ADA & Workers Compensation • Objective is to prevent employees from getting a WC settlement and then arguing they are able to return to work to pursue an ADA claim • Employers often make the mistake of resolving a WC claim and then try and determine employment status

44. Coordinating ADA & Workers Compensation • Do not allow an employee to remain off work indefinitely or leave the employee indefinitely in a light duty job • Make sure an employee returns to work before resolving a WC case • Employers should work closely with a qualified attorney