Case study: Return-to-work program results in 49% reduction in lost time days

In one of the sessions of the virtual National Workers Compensation and Disability Conference, Sikorsky shared their return-to-work (RTW) program that significantly decreased an injured worker's disability duration period. When the company was acquired by Lockheed Martin (LM) in 2015, there was no clear RTW program and disability durations were significantly higher at Sikorsky than at other LM locations. There were many long-term employees, including those in their 70's and 80's.

After the acquisition, the companies evaluated their workers' compensation programs to find similarities, differences, and potential problem areas. Shoulder and knee injuries were especially prevalent at Sikorsky, as well as other business units at LM, but employees at LM had much quicker recoveries. They discovered that the physician's directives were not always clear to supervisors or employees. For example, "walking as tolerated" or "sedentary work."

As a result, the supervisor did not always understand the worker's physical capabilities, which created a risk of reinjury when the worker returned to work. Also, the worker's physician often relied on the injured worker to describe their job and did not fully understand the requirements and logistics of the job.

To address these issues, the new program included a job analysis database of more than 250 jobs, created in part with Genex, a medical managed care provider. The job analysis database is much more detailed than a job description. It contains information about the job, such as estimated amount of time sitting, standing, kneeling, and squatting, which provides physicians with a clearer understanding of the role and how to best physically care for the worker.

The job analysis not only helped physicians provide accurate medical restrictions but also helped identify light duty opportunities that focused on a work-conditioning approach.

In building the program, the company developed a matrix, focusing first on shoulder injuries, which were the costliest. The matrix compared ODG guidelines for treating these injuries with the protocols being used by providers treating Sikorsky's injured workers. Supervisors were asked questions such as if a worker had a rotator cuff injury and could only work with one arm, what could they do to assist people on the line? Team members then went back to physicians with these tasks and negotiated a shorter return to work. It was also important for supervisors to know that injured workers would only do particular light-duty tasks for short periods of time.

In addition to the supervisor, employee, and physician, team members included a Return-to-Work Specialist who continues creating modified tasks that recovered workers could perform when they return and a Case Manager who works with the injured worker on signing off on the light-duty tasks that will be performed, which is the first information a physician will see when meeting with the worker and ensures a smooth process until the worker is returned to full duty. Bayne Consulting oversees the entire program and ensures compliance with the matrix on a case-by-case basis.

The matrix created communication between the supervisor and physician and the job tasks ensured both were on the same page. The process led to the conclusion that meeting with a physician and shifting work positions every 3-4 weeks produced the most optimal outcome for a worker's return to work.

The procedure was published internally, outlining the roles and responsibilities of managers, employees, and others. The guiding message to employees is that they will return to work in some modified or transitional approach while continuing to receive the best medical care. A telephonic case manager discusses in detail what will happen. Physicians didn't want to tell workers that they were going back to work sooner than they liked, so the team communicated the intentions to the injured worker first, explaining the job tasks. When the employee signed it, it was sent to the doctor's office.

Within 6-9 months, the companies reported a positive shift within their process and were able to decrease disability duration by 49%. It is also very rare that an injured worker does not remain with their job after returning post-injury. The importance of consistent follow-ups with physicians and the ability to remain innovative when it comes to creating light-duty tasks are two cornerstones of its success.