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17 steps for implementing a successful Return-to-Work program


Every employee injured at work is at risk of having an extended, costly absence. For employers, it can mean higher workers' compensation costs, lower productivity, increased training or overtime costs, possible litigation, and an adverse effect on employee morale. In some cases, $5,000 in medical expenses can add up to as much as $30,000 when lost time, retraining, and other often-overlooked costs are included. For employees, an extended absence can lead to a disability mindset and a lack of motivation for returning to work.

Return-to-Work (RTW) programs provide paths to bring injured workers back to light-duty or transitional work quickly and safely and are considered a cornerstone to a well-run workers' comp program. The sooner the injured worker is back to work, the better, even if in a limited capacity position.

Here are 17 steps recommended by the Institute of WorkComp Professionals to implement a successful RTW program:

  1. Learn state laws about returning injured employees to work especially as it relates to what benefits can be provided once the injured employee has been released to temporary alternative duties.
  2. Distribute copies of your Recovery @ Work policy and continuously reinforce it.
  3. Explain employee rights, roles, and responsibilities.
  4. Do not violate union contracts. Contact unions to discuss Recovery @ Work programs before injuries occur. Maintain contact with union representatives throughout the process.
  5. Ask your adjuster if they have a 'preferred' job description format available that follows the requirements of your state's WC Law.
  6. Creatively identify temporary alternative jobs. Appoint an employee/management committee to create temporary alternative jobs. Consider off-site, work hardening temporary alternative jobs if you don't have any at your workplace. Injured employee jobs should be meaningful, not demeaning or demoralizing, and certainly not punitive.
  7. Visit worksites to determine tasks similar to the employee's existing job.
  8. Provide treating medical providers with job descriptions for both the temporary alternative duty job and the regular duty jobs for injured employees.
  9. Get medical restrictions from treating medical providers even if the injured employee isn't quite ready to return to work. Be proactive and prepared for the release. Don't wait to have the release in hand before you begin your process. A delay of even a few days costs you money.
  10. Encourage treating medical providers to approve temporary alternative duty for injured employees.
  11. Offers of temporary alternative duty should be mailed first class certified, and include a confirmation receipt with a stamped, self-addressed envelope for returning.
  12. Communicate regularly (at least once a week) with injured employees returning to work for a temporary alternative duty position. (During this time therapy and treatment may still continue.)
  13. Remind Recovery @ Work Coordinator and supervisors of the injured employee's physical limitations. Re-enforce that they are NOT to push the injured employee to exceed the limitations prescribed. If you fail to closely follow the physician's limitations, you could damage your credibility with the physician and increase the length of future disability and your overall costs.
  14. Train the employee in the new position, if necessary.
  15. Continue to pay the injured employee at their regular rate of pay. Consider doing so even if the employee is working partial hours. This will help you avoid paying lost wage benefits and, in many states, reduce future settlements. (Be sure to advise your third-party administrator, if applicable.)
  16. Ask injured employees for continual feedback on the temporary alternative duty positions starting with the first week after your first offer of temporary alternative duty work. Attempt to identify any obstacles to remaining in position through 'care-phrased' questions.
  17. Provide feed-back to the physician regarding the progress the injured employee is making at the temporary alternative duty position to make sure the physician is getting both sides of the 'story'. It also conveys the concern you have for your injured employees.

The basic tenets of a RTW program are that employees will recover faster, return to their full-duty jobs sooner, and have a sense of stability and security, which will lead to improved morale, higher productivity and lower premium rates for employers. Offers to return to temporary alternate work have an even bigger potential for cost savings in states that allow an Experience Rating Adjustment (ERA) when claims are medical-only and include no lost time. Even if a claim has a very small amount of indemnity (lost wages) as compared to medical, the full amount of the loss will count against the experience mod. However, in many states an injured employee has a window of time in which to return to work before the claim negatively affects the experience modification factor. The ERA calls for each medical-only loss in the experience period to be reduced by 70% for the purpose of the mod calculation. Knowing each state's wage waiting period (usually 3-7 days) is very important to effectively manage return-to-work and lost-time claims.

States that have NOT approved ERA are: California, Colorado, Delaware, Massachusetts, Missouri, New Jersey, New York, North Dakota, Oregon, Ohio, Pennsylvania, Washington, Wyoming and Texas.