How to Reduce Costs with a Return to Work Program

Sunday, September 14, 2003 | 0

This is the first in a two-part series reviewing the elements for implementing a successful return to work (RTW) program.

The 2002 Workers' Compensation Reform Act AB 749 mandated that beginning 7-2004 that the Administrative Director will establish a Return to Work Program in order to promote the early and sustained return to work of the employees following a work related injury or illness.

If an employer meets specific criteria relating to the program participation, they may be entitled to reimbursement of expenses up to $1250.00 to accommodate the employee's return to work or modified duty and up to $2500.00 to accommodate each permanently disabled worker who is a Qualified Injured Worker (QIW).

More than 40% of large U.S. companies have no RTW program. Most employers have adopted a passive role in returning disabled employees to work. Skyrocketing W/C costs, legislative changes, increases in litigation expenses and the economic need to reduce costs in order to stay competitive, all have worked together to encourage employers to take a closer look at their disability related policies & procedures.

Research has shown that proactive RTW programs are more cost effective than other options, including managed care. This has lead many companies to investigate the feasibility of a formal RTW program. Yet the shear variety of programs and varying levels of corporate support has made it relatively impossible for a company to do direct, apples to apples comparison. Attempting to do so with limited information has lead to misconceptions within the industry as to the true benefits & pitfalls of RTW programs.

To determine if a Return to Work Program is feasible for your company, you should look at the following points:

Eligibility

- The RTW program should be open to all employees with a work related illness or injury.
- Must have been released by a treating physician to some form of modified work.
- Participation is mandatory for employees who meet the program criteria.

Program Criteria

Employees will be approved for the program if the following criteria are met:

- A treating physician must release employees to modified duty, with a maximum of 90 calendar days duration.
- A suitable position must be identified that is within the injured workers' medical restrictions. The work should be meaningful.
- A suitable position must comply with the Collective Bargaining Agreement terms, if applicable.
- The employee's salary should remain the same during the transitional duty period (90 days).

Program Coordination

- The doctor should be aware of the RTW program.
- The treating physician initially identifies candidates.
- Job duties on a day-to-day basis.
- Abilities, not disabilities.

Initiation of the Process

One of the following individuals would be responsible for relaying the information on the potential candidate to the Transitional Duty Coordinator:

- WC Examiner
- LTD Adjuster
- Medical dept.
- Medical case manager
- Medical consultants

Training & Education

- Best RTW programs provide training for employees and supervisors on what to expect if a worker gets injured.
- Everyone has the same goals.
- Communication an ongoing activity.
- The following groups need to be trained and educated on the program:
Management:
* Focus on cost savings,
* Altruistic benefits,
* Compliance under ADA.
Supervisors:
* Focus on advantages to departments by participating in the program.
Employees:
* Benefit to return to work.
* Company wide benefit program.
Medical community:
* Focus on increased awareness that Company provides early & modified duty.
Bargaining Unit Contract:
* Transitional duty program will be implemented after approval by Company administration and official representatives from the Bargaining Units.
* A Memo of understanding included as part of the Bargaining Unit contract.

The next article in this series will review the balance of an RTW program, including case management, duration, incentives, and financial considerations.

If you are interested in a Return to Work Program and would like to have more information, please fee free to contact Cyndi Robinson, CM Claims Management @ 909.920.4159 or email cmclaimsmgt@msn.com.