Return-To-Work Program Considerations

Overview Of Program Benefits

A transitional duty or return-to-work program is an important feature in controlling workers’ compensation costs. An employer can effectively use a transitional duty program to permit an injured employee, who is still recuperating, to return to gainful employment in a productive manner before resuming full duty work. Benefits of returning the employee to work include:

• Encouraging inclusion of the employee in the workforce
• Reducing extended periods of idle time spent at home
• Offering activity levels that strengthen and enhance the employee’s physical recovery
• Reduction in the number of OSHA reportable lost time days
• Reducing the indemnity payments made under workers’ compensation
• Increasing the employee’s total earning capacity.

These physical, mental and financial motivators should be designed so that an employee is more willing to return to work and is capable of performing meaningful tasks that result in greater financial rewards for working. A transitional duty program should be temporary in duration and transitional so that an employee “passes through” the program, thereby opening positions for other injured employees.

Evaluating All Of The Possibilities

Evaluating potential transitional duty jobs to assist an injured employee coming back to work is a challenging task, but it can play an important role in the success of a return to work program. A thorough review of all of the possibilities is important in uncovering the real potential for formulating productive transitional jobs for employees.

Supervisors usually have a list of tasks and activities that they would like to get done but never seem to have time to accomplish. By reviewing the supervisor’s list of needs, some meaningful modified duty jobs may be identified. Being able to assemble these unattended tasks into a job will benefit the supervisor, and enable the employee returning to work to feel that their contributions are valuable, not just “make work” assignments. Additionally, evaluating what tasks and services are currently subcontracted will help to identify opportunities to reduce outsourcing expenses while still getting the job done in-house.

Responsibilities

To prepare for the likelihood of returning injured employees to jobs that best accommodates their restrictions, an employer should classify a number of jobs as “temporary modified duty” positions. If an employee has been out for an extended period of time, the employer can contact the employee’s health care provider and suggest various light-duty jobs the employee might be able to perform safely.

For musculoskeletal disorder claims (back, wrist, shoulder), an ergonomist or other qualified person should analyze the physical procedures used in the performance of each job, including lifting requirements, postures, hand grips and frequency of motion. The ergonomist should develop a list and description of jobs with the lowest ergonomic risk. This information will assist health care providers in recommending assignments to light or restricted duty jobs. The light duty job should therefore not increase ergonomic stress on the same muscle-tendon group.

Department managers should identify essential transitional duty job functions/positions within their respective departments. Multiple transitional duty functions can be combined to create a temporary transitional duty position. This can be achieved through the effective assistance of a vocational expert or occupational or physical therapist. Once such job functions or transitional duty positions are identified, an accurate job description can be drafted and/or videotaped. Next, the transitional duty job descriptions are distributed to the designated physicians who appear on the employer’s posted list for treatment of work injuries. These physicians, through the use of videotapes or medical provider tours, can be made familiar with the available transitional duty functions/positions within all of the employer’s departments.

Timing And Duration Of The Transition

The transitional duty program should be limited to 90 days or less for a medically disabled/impaired individual to participate. Within the first 90 days, written confirmation of the injured employee’s ability to perform a transitional duty position should be obtained from the physician who already is familiar with the employer’s transitional duty program. A written job offer of transitional duties is then made to the injured employee with a return-to-work date given.

Prior to an employee returning to work, an evaluation of the temporary position work environment should be performed to ensure that the conditions support whatever restrictions the employee may have. The employer should allow an extended time period, such as three months, to allow employees to ease back into their normal job requirements. During this period, a monthly safety follow-up should be conducted. If it is determined that the employee can no longer perform their previous job tasks, the employer should work with the employee to find another job within the company if possible.

Through close coordination with the medical provider, the employer should make a determination whether to offer an injured employee transitional duty based on the type of injury sustained. Transitional duty positions can be offered to those employees who sustain disabling injuries from which they could likely medically recover within 90 days. Because the program by definition is transitional and temporary, the employees who fall within the protected class of the Americans with Disabilities Act would not be eligible to participate.

The transitional duty program should continue for the maximum of 90 days or whenever the employee is medically released to return to regular duty, whichever comes first. The employer’s panel physician or another physician of the employer’s choosing should then evaluate the individual working in a transitional duty program to update and define any continuing medical restrictions.

In some states, when an injured employee refuses to return to transitional duty work, consideration can be given to denying the claim and stopping the payment of compensation benefits. However, should the injured employee return to the transitional duty work that is offered to him or her, the employer may continue to pay compensation. Successful denial of compensation claims depends on accurate and timely communication among the employer, claims adjuster, and involved medical professionals.

Funding Alternatives

The funding for the transitional duty program may include innovative concepts to encourage active participation by department managers. For example, a department that develops and accepts employees may receive a financial credit from a lost time injury “fund.” At the same time, the department benefits from increased productivity during the time that an employee is on transitional duty.

XL Environmental • Risk Control Division • 520 Eagleview Boulevard, PO Box 636, Exton, PA 19341 • Phone: 800-327-1414 • Fax: 610-458-7285 • xlenvironmental.com

XL Environmental is a division of XL Specialty Insurance Company.