What Is It?

A Return-To-Work (RTW) Program is an organized plan to get injured employees back to productive employment as soon as medically possible. The program provides for temporary modified or alternative duty as a way to return the injured employee to work as early as possible. It is an effective cost containment program that can reduce the high cost of "time loss" (indemnity) injuries and control your workers' compensation costs. Crucial to its success is establishing effective relationships between the employer, injured employee, insurer, and medical treatment facility.

Why Return-To-Work?

• Maintains work ethic -- the employee who continues to go to work each day will not develop lifestyles which inhibit return to regular work after recovery is achieved

• Improves physical condition -- physical activity is necessary for recovery from most injuries and illnesses. Going to work and performing normal functions maintains physical conditioning, hastens healing and reduces potential for permanent impairment.

• Avoids disability syndrome -- workers who experience disruption of their normal, daily living activities and who are placed in a disabled category adjust to their new status in about four to six weeks. The disabled lifestyles and behavior patterns are then comfortable and difficult to change.

• Lessens economic fears -- disability compensation may be close to take-home pay, but it usually isn't total replacement and has a termination point. Continuing to be a valued employee increases economic security.

• Increases employee morale -- the company's willingness to reasonably accommodate injured and ill employees through modified or transitional work improves the morale of all employees.

• Lessens dependence -- the positive support provided to ill and injured workers by family members, friends, the medical community and coworkers is beneficial, however, unintentional reinforcement of a "can't do" or "shouldn't do" mindset can prolong or increase the period of disability. Sharing an expectation of full recovery and return to life activities fosters early and total recovery.

• Enhances self esteem -- an individual's identity, sense of worth and belonging is derived in large part from their work contribution. When this is diminished, anxiety and depression which inhibit recovery usually occur.

• Helps manage production costs -- the operation will achieve higher quality at acceptable production levels when employees are required to return to work as early as safely possible. The costs of training, replacement personnel, and subsequent errors are lowered. The supervisor's time and attention are properly focused on the team's production. Absent employees, escalating costs and lower morale detract from a manager's personal effectiveness and the unit's financial success.

• Reduces Workers' Compensation costs -- temporary disability costs are minimized, thus reducing the 3 - year impact on experience modification and reducing Workers' Compensation premiums.

• Protects company assets -- our assets cannot earn returns for the company without healthy and energized employees to produce goods and services. Our human resources are our most valuable assets. An effective RTW program demonstrates respect and commitment to our employees.

• Reduces fraudulent claim potential -- knowing that company efforts will be made to return an employee rapidly lessens the chances for claims being filed to get time off.

• Discourages litigation -- reduces exposure to medical/legal commercials and possible spontaneous litigation.

How Does It Work?

The employer develops a statement of policy relating to RTW (sample policy attached) and designates a RTW coordinator. An effective RTW program requires a designated coordinator with managerial support and commitment. The coordinator should have knowledge of company job tasks, the authority to develop and implement on-going training of supervisors and the ability to coordinate the sometimes conflicting interests of employer, employee, medical provider and insurance carrier. Responsibilities should include:

• working with insurance carrier (Risk Control and Claims) to develop opportunities for modified or alternate ("light duty") jobs,

• working with insurance carrier case managers and adjusters to establish a rapport and relationship with a medical provider who understands the intent of the RTW program and is committed to working closely with the employer to ensure the best options for the employee,

• acting as liaison between employer, employee, medical provider and insurance carrier,

• training supervisors in the importance of RTW and their roles in accommodating injured employees,

• developing possible modified / alternate duty options with the medical provider as soon as an injured employee goes to the medical provider for treatment

• maintaining contact with the medical provider and the injured employee to ensure close monitoring.

The medical provider determines the employee's restrictions and estimated recovery period.

The employer, medical provider, claims adjuster and employee develop a plan to return the employee to productive (modified / alternate duty or full duty) employment within medical restrictions. The program is intended for temporary accommodations during an employee's recovery from a work related injury and should typically only involve 2 to 3 weeks. After 2-3 weeks, permanent employment should be appropriate or the plan should be re-evaluated.

• Written descriptions of essential job functions provide the basis for determining job placement for a returning employee. Descriptions should be specific.

• A Physical Capacity Evaluation should be completed by the treating physician to determine the employee's physical capability. This evaluation initiates action on the part of the RTW Coordinator to match capabilities to available tasks.

• A written job offer should be made in all modified / alternate work cases . This establishes a record of the company's desire to assist the employees in returning to work.

• The receiving supervisor and/or manager should be notified of the employee's start date and all specifics associated with needed job accommodations.

• Acceptance by the employee should not be optional. All reasonable efforts have been made to expedite the employee's recovery and return him or her to a normal, productive life. A rejection of the assignment should be handled as would any other refusal of a reasonable request. Action should be taken within local Workers' Compensation laws to address the refusal issue (including suspension of benefits if appropriate).

What Are The Benefits of a Return-To-Work Program?

• Reduces the costs of injury (medical & indemnity)

• Speeds up recovery

• Reduces the direct costs of disability absence

• Cuts the indirect costs to company

• Reduces litigation and system abuse

• Improves employee morale and security

• Positively affects company's bottom line & profitability

Steps To Success

Be creative. Brainstorm with the employee and supervisor. Establish a list of alternative accommodations from which injured workers can return to work. The following are some possibilities:

• Modify the essential functions of their regular job

• Temporarily modifying the position's incidental functions

• Reassignment to alternate position

• Refer for help in planning accommodations, outside the company

• Place employee in alternate position

• Contact Job Accommodation Network (JAN) for helping employees return to work

Promote good communication. Worker awareness of RTW should begin on the first day of employment. Some employees may perceive RTW as a benefit to them and a reflection of a proactive and caring employer; others may perceive RTW as a deterrent to fraudulent claims.

Respond promptly to injuries. Call employees or their families the next day, or even sooner, if appropriate. Attend to the immediate needs of the family of the injured employee. The investment of a little personal attention early in the process may yield significant benefits as the case develops.

Stay in touch with injured workers. The longer workers are absent, the less likely they are to return.

Work closely with medical providers.

Show care and compassion to the injured employee. Reassure them that their job remains available and encourage their return to productive status.