Early Return to Work: Benefits & Keys to Success

Saturday, January 15, 2005 | 0

By Robert Hall Ph.D., CRC, CDMS

This article is the first in a series of articles that will discuss Early Return-to-Work (RTW) Programs and how employers and employees can derive more value from those programs and provides an overview of the benefits employees, employers, and their partners derive from Early RTW programs and basic program elements that determine their success. Subsequent articles will focus on key program elements and resources that can help organizations move their Early RTW programs to the next level.

A BASIC MODEL FOR EARLY RETURN TO WORK PROGRAMS

Employers wishing to improve the return-to-work and job retention outcomes for their injured and ill employees need to develop a RTW program structure that effectively leverages internal and external resources with an eye on simplicity and "doing what works". Typically, establishing an Early Return-to-Work program includes accident prevention, an active safety program, ongoing review of workplace design and process, and proactive claims management [ ].

An injury may prevent a worker from returning to regular duties. Typically, injured workers remain out of work until 100% recovered. This leads to higher costs for the employer due to lost productivity, employee replacement and increased workers' compensation expenses. With an Early Return-to-Work program, the employer makes a special effort to bring an injured worker back to work in a job that the employee is medically able to sustain. Significant savings may be achieved with Early Return-to-Work by matching the injured employee to appropriate work assignments.

WHY HAVE AN EARLY RETURN-TO-WORK PROGRAM? Experience shows that injured workers recover faster when they return to work. The longer an injured worker remains away from work, the more difficult it is to return to gainful employment. Returning to regular work usually occurs more quickly when transitional or modified duty is offered to the injured employee.

Employers can cut costs by decreasing the amount of time that an injured worker remains out of work. Companies that have implemented Early Return-to-Work programs have seen savings of 20 to 40% or more in workers' compensation costs. According to the New York State Insurance Fund, these cost savings are achieved through the following steps [ ]:

* safety measures and the development of an Early Return-to-Work program may lower their experience rating, thereby reducing premium costs.
* when injured workers return to work, they are less likely to retain legal counsel, thereby lowering claims costs.
* everyone wins when people return to work. Injured workers are able to return to their livelihood; employers save money on hiring, retraining and workers' compensation costs.

KEYS TO A SUCCESSFUL EARLY RTW PROGRAM

Management Commitment
Commitment and support from an organization's management are keys to establishing an effective Early Return-to-Work program. Support for Early Return-to-Work and a fully integrated Risk Management program should be consistent and clearly communicated throughout the organization. The program will be more successful when managers, supervisors and workers clearly understand the program and work together.

Preparation
Careful planning and decision-making can lay the groundwork for the success of any program. Identify and involve key players early and provide them with training. Goals and policies should be established, along with appropriate forms and letters.

Training

Early Return-to-Work is more successful when all parties realize its value. Management, supervisors and employees will benefit from training that shows how this program works.

Communication
Policies and procedures relating to Early Return-to-Work should be carefully developed and made public throughout the organization. Maintain communication with injured workers, supervisors and medical care providers throughout the recovery process.

STEPS TO IMPLEMENTING EARLY RETURN-TO-WORK


Develop Clear Goals and Policies
Establishing an Early Return-to-Work program requires careful planning and decision making. Management must decide what outcomes are to be expected and what steps will be taken. Factors considered include existing company policies, collective bargaining agreements (if any) and the corporate culture of the organization.

First, identify employees who may be medically eligible to take part in the program. Alternative positions or accommodations can then be considered for those whose injuries will result in temporary or permanent impairment.

Indicate that modified duty assignments will be consistent with medical guidelines. Clarify time limits on transitional assignments. Specify that when such work is available, participation is mandatory. Where local statues and FMLA requirements may prevent mandatory participation, communication between the employee, manager, and others and flexibility is even more critical. Selling the health and economic advantages of Early RTW and flexibility in "how" it is offered and implemented can make the difference. Once goals and policies are agreed upon (include employees in this process, whether unions exist or not), written policy and procedures can be developed.

Designate a Program Coordinator
It is recommended that one individual, such as a safety manager, an HR or Benefits person, or even a Supervisor take the lead role in implementing the Early Return-to-Work program. This helps ensure consistent administration and accountability.

* Define the coordinator's responsibilities, which may include:
* Communicate program information to supervisors and workers;
* Monitor the recovery status of injured workers;
* Manage correspondence from injured workers, medical providers and the insurance carrier;
* Work with supervisors to ensure that consistent and appropriate communication with injured workers is ongoing and documented.

Identify Transitional Duty
In preparation for accommodating injured workers who cannot perform their usual jobs, transitional assignments should be identified. An important first step is performing job analyses on the various positions in your organization. The actual demands and essential functions of each position must be identified. This can be used for developing individual modified assignments. The key is to find ways to make use of the worker's skills and knowledge, rather than "make-work" assignments. Creativity in developing modified assignments enables the employee to be productive while meeting medical guidelines. Consider the following:

* Part-time employment
* Temporary jobs
* Alternative tasks
* Job sharing
* Jobs in other departments
* Transitioning through different jobs
* Job modification

Employers can accomplish the above with some minimal coordination, planning, and by looking at each situation individually. It is common for a returning worker to be able to handle all but one or two aspects of the job. In such cases, it often makes sense to explore job restructuring. This involves arranging for a co-worker to take on those aspects of the job that the recovering worker cannot perform. In return, the recovering worker takes on some of the tasks typically done by the co-worker. This may include jobs combining tasks from several workers. Small employers may even have an advantage in restructuring jobs as they typically have fewer union issues to work through.

Develop Standard Forms
Using standard forms and letters ensures consistency and helps supervisors gather and communicate essential information. Forms that are typically needed include:

* An Accident Report Form reporting an on-the- job injury.
* A Doctor Notification Letter informing the treating doctor of the organization's Early Return- to-Work policy.
* A Functional Capacities Form to be completed by the doctor, detailing the worker's capabilities (Note: dont forget the mental and/or cognitive demands of work for mental health issues).
* A Job Analysis Form detailing the physical capacities needed for the position.
* A Job Approval Letter requesting the doctor to approve a proposed return-to-work assignment.
* A Return-to-Work Availability Letter informing the injured worker of the position assignment.
* An Employee Injury Tracking Sheet to log all contacts and correspondence concerning the injured worker.

Provide Training
It is essential that supervisory staff and employees become fully trained in the principles and procedures of Early Return-to-Work.

Training topics should include:

* Accident reporting and investigation
* Need for early and ongoing communication
* Methods of documentation
* Job modifications and alternative assignments

Maintain Communications
Supervisors should regularly reach out to injured workers during recovery, showing the organization's concern and interest in having them return. The importance of this one process cannot be overestimated. It has much positive value in enhancing morale and encouraging an early return and again, small employers can do this! Maintaining contact with medical providers is important as well. Communicate your organization's policy and practice regarding return-to-work with the medical team. Communicate with co-workers also. It is important for morale and productivity to keep communication open with all affected co-workers.

SUMMARY

Organizations that invest in creating and maintaining Early RTW programs reap huge benefits to their bottom line and employee health and productivity. No Early RTW effort is perfect, but employers that make diligent efforts to follow the above steps will find success.

All programs must be accountable and continually strive to demonstrate their value over time. The next article in this series will focus on measures of return on investment (ROI) for Early RTW programs.

About the Author: Robert Hall Ph.D., CRC, CDMS is a Principal in AtWork Resources, Inc., an absence and disability management services and software firm based in La Mesa, Ca. The AtWork ManagerPlus is a powerful RTW Case Management application that provides the needed RTW program structure, resources, forms, and tracking tools / metrics to maximize effectiveness.

For more information, please contact AtWork Resources at 1-866-463-0562 or visit http://www.atworkresources.com.

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FOOTNOTES

. http://www.wcb.state.ny.us/content/main/Small_Business/sifrtw.htm

2. Supra note 26.

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The views and opinions expressed by the author are not necessarily those of workcompcentral.com, its editors or management.