Proactive Return to Work

Benefits of a Proactive Return-to-Work Program:

Reduces medical and indemnity payments. In addition to directly reducing wage loss payments, return-to-work programs accelerate rehabilitation. Research by the Menninger Foundation proves that employees who return to alternate duty heal faster and require fewer medical visits than those who are not supported by the program.

Reduces insurance costs. This program will lower loss costs that in turn will reduce future experience modifications. As a result of reduced future experience, standard workers’ compensation can be set at lower premiums. Premiums under loss-sensitive plans are directly reduced and provide an earlier payback.

Reduces malingerers. Questionable claims can be handled positively by offering productive alternate duty. Paid time off, which may be perceived as a benefit by some employees, is reduced. The employee’s capabilities become more apparent when he or she is at the workplace. System abusers can be identified when an employee is returned to work. This helps to encourage speedy claim management techniques to avoid abuse of the workers’ compensation System.

Promotes employee morale and security. Restore the employee’s sense of value to the company by recognizing their remaining abilities and maintaining positive communication.

Increases employee finances. Most often, take-home pay will be greater for the employee under alternate-duty pay than under WC wage loss benefits.

Minimizes litigation. Injured employees frequently contact lawyers because they are unsure of their rights or their failure to return to the workplace. Proactive return-to-work programs make employee opportunities clear.

Promotes safety. Promoting safety will open communication between the employee and management. This will reduce cover-ups and increase the likelihood for identifying the accident causes and corrective measures. The returning employee will serve as a physical reminder to others of the effects of hazards and individual errors.

Types of Alternate Duty:

Modified Duty. Modified work is the temporary placement of the injured employee in an existing position. This position is not as physically demanding as the employee’s normal position. The positions must accommodate any physical restrictions defined by the physician.

Restricted Duty. Restricted work is the placement of the injured employee back to their normal position but with some elements of the job removed. For example, a bench assembly worker can perform all aspects of the job except carrying tote bins to the workstation. It must be clear to all individuals involved that the restrictions are mandatory until clearance for expended duty is given by the physician.

Gradual Acclimation. Gradual acclimation is used when the employee is cleared to perform all duties of his or her normal position, but cannot sustain the exertion of a full workday. This is conceptually similar to work hardening at a physical therapist office. Note that professional work hardening will often still be needed. Gradual acclimation can be combined with other types of alternate duty to provide a full day’s work. If the employee is still overcome with hardship, then part time work may be suggested. Slowly, the number of hours can increase at the employee’s normal position until a full duty day is achieved.

Total Accommodation. Total accommodation is the identification of special duties, consistent with physical restrictions that are not done by the company on the typical workday. Examples could include special inventory projects, light painting, cleaning small equipment, and the like.

Careful: AD types of alternate duty should respect the dignity of the employee. Positions designed with punishment in mind are just as likely to increase claim management problems as they are to reduce costs.

Implementing a Proactive Return-to-Work Program:

• Identify key participants: top management, supervisors, employees and their representatives.
• Determine when and how each audience should be addressed. Plan to explain the intent of the program and the benefits to all involved.
• Obtain an agreement from each group to support the concepts of the program
• Identify a coordinator to facilitate communication between managers, injured employees and medical providers.

• Identify typical injuries/sources of loss.
• Identify existing positions that may be filled by employees with the anticipated injury types, one-handed work, light lifting, alternate seating/standing.
• Review existing positions to determine where gradual acclimation may be appropriate.
• Consider developing new positions to accommodate employees with restrictions. Enlist the supervisor’s assistance in developing a “wish list” of projects that may be appropriate for employees with restricted abilities.
• Develop written descriptions of the alternate-duty positions, focusing on physical demands. Pictures or videotape can support the descriptions.
• Consider the wage scale for the alternate-duty positions. Should wages for normal duty apply or is a special alternate- duty rate appropriate?

• Identify medical providers who can participate in the program.
• Meet with medical providers to discuss:
  • Company operations (a tour of the facility by providers is advisable).
  • The company philosophy on proactive return to work.
  • Existing alternate-duty opportunities and the willingness to be creative in responding to individual cases.
• Define communication procedures among the supervisors, return-to-work coordinator, medical provider, claims representative and injured employee. Including direct contact with the injured employee by the supervisor is advisable. Periodic case review triggers (time at or medical evaluation) should also be considered.
• Train supervisors in the management of the injured and alternate duty employees.
  • Positive and supportive contact with injured employees who have yet to return to work or who are temporarily working in another department.
  • Expect full performance of duties within the alternate job description.
  • Do not allow the employee to perform duties beyond the job description.
  • Consult with the internal coordinator or medical provider if the employee desires increased demands.