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Return-to-Work: Do’s and Don’ts of Transitional Work Assignments

Early return to work following an injury helps control costs directly related to the injury and reduces the potential impact on the business as well as on the injured employee’s life. Consider the employee who injured his back while loading and unloading a truck. Sitting at home he is probably thinking about how terrible he feels or worse, how his predicament is YOUR fault.

A much better solution is to get the employee back to work in a modified, transitional position that matches his medical capabilities. Studies show that injured workers who are allowed to return to productive work as early as possible following an injury heal faster and better than those injured workers who remain off work.

Developing and integrating an early return-to-work program into routine business operations is a “win-win” situation for employers and employees. It prepares everyone ahead of time as to what will happen in the event of an injury and becomes an expectation of both employers and employees.

A key element of a successful return-to-work program is the availability of transitional work assignments: temporary work assignments, not jobs, that are intended to facilitate the transition from temporary medical restrictions to the resumption of full duty in the usual job. They are designed to address the needs of employees who have temporary impairments that can be resolved within a limited period of time, often defined as a maximum of 90 days. Here are some do’s and don’ts:

Do's
  • Work with supervisors and employees to develop a list of tasks that can be performed by injured workers as temporary assignments. Tasks should be meaningful and productive. Consider jobs or tasks that should get done, but are rarely done due to lack of time; tasks that will help other employees work more efficiently; and jobs that are presently outsourced.
  • Have the treating doctor provide a Work Status Report. Then match the transitional assignment that has duties within the employee’s work abilities as determined by the employee’s treating physician.
  • Make the offer of modified duty in writing. The offer should include a copy of the Work Status Report; the location at which the employee will be working; the work schedule; the wages that will be paid; a description of the physical and time requirements that the position will entail; and a statement that the employer will assign tasks consistent with the employee’s physical abilities, knowledge and skills and will provide training if necessary.
  • Be sure that both supervisor and employee understand the injured employee’s temporary medical restrictions and see that they are not exceeded.
  • Ensure that all transitional work is temporary. Utilize evidenced-based standards of disability duration and communicate an expected start and end date of the transitional assignment to the employee, the treating physician, and the supervisor prior to beginning the assignment.
  • Monitor progress. Follow up with the treating physician; get feedback from the employee and the supervisor. Transitional work assignments are progressive and should be adjusted in line with medically documented changes in the employee’s ability.
  • Since the transitional assignment is short-term in nature, do not reduce the employee’s pay. While the employer may have the right to reduce pay, the best results come from employers who do not do so. Reducing pay can have a negative effect on the employee’s attitude and if reduced too much could mean some indemnity would have to be paid.
  • Let injured workers know how pleased you are that they are back to work and ask often how they are feeling.
  • Make participation mandatory. Have a clearly written policy that explains the consequences if an employee refuses a transitional assignment that is consistent with the physician’s instructions. Be sure the policy complies with all state and federal statutes.

Don'ts
  • Allow workers in transitional assignments to exceed their medical restrictions.
  • Be deterred from setting up transitional assignments because the employee “may get hurt again.” This of course is a risk, but an even greater risk is having the employee stay at home and develop a “disability attitude” that extends the absence and drives up costs. Be sure job assignments meet the medical restrictions set by the treating physician and stay in touch with the employees as to their comfort level with the assignment.
  • Offer demeaning or “make-work” assignments that will make workers feel badly and/or be viewed as punishment.
  • Change expectations of punctuality, attendance, proper notification for time off for medical appointments, etc. The employer’s policies and work rules should apply to employees who are performing transitional work assignments.
  • Consider yourself “too small” for such a program. Finding appropriate transitional work is not as difficult as it may seem and return-to-work programs can reduce the cost of claims significantly.
  • Neglect to let the treating physicians know about your program. Do engage them in helping to identify transitional assignments that are appropriate for the injured employee.
  • Administer the program inconsistently. Clear standards and policies need to be in place to ensure that all employees are treated fairly and consistently.
  • Allow transitional assignments to continue indefinitely. Set clear expectations of time frames. If an employee is unable to return to their permanent job in a time frame consistent with evidenced based guidelines, there are probably underlying issues that need to be addressed.
  • Allow a worker to remain in a transitional assignment after being released to full duty by the physician.