This publication is provided to assist in the development of a Return To Work Program. The information contained herein has been derived from sources believed to be accurate. The Covenant Group does not warrant nor guarantee that every possible consideration has been made or that the information provided is applicable to every type or classification of business or service operation, nor that the information contained herein is applicable to every situation.

The implementation and maintenance of any Return To Work Program is solely the responsibility of the employer. Federal, State, and local laws and regulations concerning Return to Work Programs should be investigated. It may be advisable to consult with competent legal counsel prior to implementing Return To Work program provisions.

• Return-to-Work Overview
• Return-to-Work Programs
• Implementing a R-T-W Program
• Sample Policy
• Sample Corporate Policy

Workers’ compensation insurance has become a very expensive form of disability insurance. Contributing factors include:

• Increasing benefits for lost time injuries.

• Upwardly spiraling medical costs

• Regulatory control with its increasing paperwork and case complexity brought about by increasing regulatory control.

When considering the above factors, it is easy to see how many tend to feel that workers’ compensation is another form of liability coverage. Culturally, many feel that workers’ compensation’s sole purpose is to protect the employer against claims of the injured employee. To the contrary, workers’ compensation is a form of social insurance designed to:

• Help the injured employee return to work.

• Provide appropriate medical treatment while minimizing any disability resulting from the injury.

• Furnish rehabilitation when needed.

• Return the injured worker to the same job, or to a position which meets any new physical limitations.

• Prompt payment of benefits.

When we fail in providing the above, litigation often follows. The attitude of the injured employee and the entire atmosphere of how he/she perceives their injuries is determined by what happens in the first few days. Litigation of claims only results in higher costs. The only person who benefits is the attorney—not the employee, not the employer, not the insurance company.

In reality, there are only two ways to obtain final disposition of a claim:

1. Settle the claim.
1. Return the employee to work.

Return to work is an important factor in controlling workers’ compensation costs. The need for a return to work attitude does not begin when the doctor releases the injured employee for work. Every employer should have a corporate culture that starts a return to work program from the first day of disability.

• Minimizes Temporary Total Disability benefits for lost time.

• Minimizes Permanent Partial Impairment (Disability) cases, caused by injury.

When an employee cannot be returned to work, compensation laws award this employee for permanent total disability. Injured employees are well informed. They receive information form public sources on workers’ compensation claims that tell them their rights and benefits. Lawyers actively seek, and advertise for, such workers’ compensation cases.

Return to work programs stress support for the injured employee. Such support will lift the employee’s attitude and positively impact the recovery process This support is a clear message to other workers that you, as the employer, care about them as an employee. Employee relations are closely tied to reducing claims and litigation costs.

Society, through governmental legislation and public opinion, is demanding meaningful employment for the handicapped. Employment for those disabled workers from work related injuries is a natural extension. The courts, and society in general hold little sympathy for an employer who says he can’t find a job for a worker who was disabled while working for the employer.

Additionally, federal Americans With Disabilities (ADA) legislation enables disabled persons to sue employers who fail to make "reasonable accommodation" to their disability, to allow the disabled person to work. Courts would likely be more prone to punish an employer whose workplace has disabled the worker, then failed to make an effort to find work for the disabled worker.

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An active return to work program enhances the psychological and physical healing of a work-disabled employee. An employee who has been off work for an extended period of time loses interest in the job. They become accustomed to living on the budget imposed by workers’ compensation benefits. At a given point in time, the disabled employee would rather stay home than come back to work. Life is simpler, economic adjustments will have been made, and the interest in work has subsided.

An active return to work program gets the employee back to an environment that is stimulating and productive. This productive employee demonstrates psychological and mental behavior that is much more beneficial to the company and to the individual than one of a nonproductive, disabled person. An employee who remains at home has the opportunity to become preoccupied with their injuries which has a tendency to magnify physical pain. At work, the employee is buys, productive, and in an atmosphere that fosters positive thoughts.

There are three variations to this specific theme:

• Modified Work Programs

• Restricted Work Programs

• Light Duty or Total Accommodation Programs

Any variation or combination of the three is effective in most workplace settings.

This program exists where an existing job can be modified to meet job restrictions placed on the injured employee by the attending physician. This temporary placement must meet the physical restrictions imposed by the physician. This type of program is considered to be not as physically taxing or demanding as the normal job the employee was performing prior to the injury.

This program incorporates most of the functions of the normal job the employee was performing with specific restrictions assigned by the physician. The employee, the supervisor, and fellow employees must be made aware of these restrictions and help the employee perform those tasks that have been restricted.

Under this program, positions are specifically created which will accommodate the restrictions of any injured employee. These positions may already exist, or may have to be created as specific restrictions to injuries dictate.

In relatively few, rare cases, the injured employee is not motivated, either psychologically, or economically, to return to work. At that point, the company has the option to take further action.

First and foremost, a forced return to work should be supported by the physician, the company, and the workers’ compensation insurance company’s claims examiner. This type of program generally involves the discontinuing of disability payments. It is extremely important to have all the facts in order. Specifics concerning the work assignment and supervision must be exacting in these forced return to work programs. Though considered much more tedious, these types of situations have generally been considered positive either in returning a malingerer to a productive status, or removing them from the payroll.

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• Policy Statement

• Reduced Claim Cost Dollars

For years, employees on long-term disability were viewed as "losses" by their employers. Companies simply footed the bills for their disabilities (with generous assistance from their insurance carriers and state workers’ compensation benefits). Conventional wisdom suggested that there was no reason to encourage disabled employees to return to work, since they could probably never return to their old jobs and be as productive as they had been in the past. Also, few companies kept in touch with disabled workers, and they did not realize the psychological trauma disabled employees experienced because they could not work.

Fortunately, attitudes are changing. Encouraged by motivations such as The Americans With Disabilities Act (ADA), employers, insurance carriers, physicians, private rehabilitation companies, and the disabled employees themselves are now making efforts to return supposedly permanently disabled workers, and temporarily disabled workers to the job more quickly than in the past. These workers are returning to their same jobs with limited duty, or to completely different jobs for which they are qualified, or can be trained.

Some special steps are required to get injured workers back on the job safely and productively. Managers and supervisors must be trained to treat an injured employee with care and concern at the time of the injury, during recovery, and when the employee eventually returns to work.

There seems to be a tradition of sympathy for employees injured "off-the-job" but such concern is often lacking for employees injured on the job. Often, management feels that an employee’s claim is fraudulent, or he/she was injured as the result of an unsafe act, and therefore does not deserve sympathy. If an employee was injured as a result of company negligence, management feels guilty and embarrassed. And if the company doesn’t expect the employee to return to work, there seems to be no need to keep in touch. Finally, many supervisors seem to feel that their only responsibility is to productive employees on the job. If and when an injured employee returns to a productive capacity, the supervisor will resume interest.

These are all just excuses.

A designated employee, generally in Human Resources, should be given the responsibility of coordinating the Return to Work Program. This role involves the coordination of the program between personnel, the production manager, the supervisor, the medical care provider(s), and the insurance carrier. The responsibility for directing this program should be considered a function of a specific individual within your company.

Physicians play a vital role in both rehabilitation and the decision to return to work. Encourage the employee to see a physician who is well versed in rehabilitation efforts, and who believes in the value of on-the-job rehabilitation. Many physicians, for whatever reason, have little interest in rehabilitation, and are content to have an injured employee who could be rehabilitated and returned to work, remain on permanent disability. Still other physicians have an inordinate interest and often a financial stake in "professional rehabilitation" delivered by providers in whom the physician has a financial interest, and little or no interest in returning the employee to work. This is a disservice to the employee, to the employer, to the insurance carrier, and to society. Good physicians will, whenever possible, assure injured employees that they can eventually return to work, and will recommend that they do so. Under workers;’ compensation statues, employers have a valuable tool in their ability to guide employees (direct them, in some jurisdictions) to physicians who will embrace the concept of return to work.

There’s more to a cooperative physician relationship than making recommendations to employees, however. Discuss the company work setting with the physician. Use your "Critical Work Function" documentation (ADA) to help the physician understand your workplace. Explain what kinds of work are available, and what these jobs entail. You might even make a video tape of the employees performing the kinds of work you think might be suited to an injured employee, and show the video tape to the physician.

Barring the above, seek positions in other departments that the employee might be qualified for, and physically capable of performing. If there are positions available for the employee that they can physically perform, but are not qualified for, train them in those positions, if possible. Returning employees to work in some capacity is acceptable. They don’t need to return to a position where they’re required to perform at full capacity.

The safety director/manager can be instrumental in helping to redesign jobs to suit an employee’s abilities and/or selecting less demanding jobs that the employee can perform. For instance, he/she may find a job that is well suited to an employee’s abilities, except for one specific task. It might be desirable to have the employee take that position, but make a coworker responsible for the one task the injured employee cannot perform. There are many ways to be creative and still ensure the safety and health of all concerned.

The company, especially the employee’s supervisor, should make a special effort to maintain regular contact with an injured employee during recuperation. Besides being the humanitarian thing to do, maintaining contact keeps the employee informed about what’s going on at work, and helps the employee realize that the people there are still maintaining an interest, which can boost morals, and possibly speed recovery. Also, this approach may state off an otherwise angry decision to contact an attorney and file a lawsuit.

Supervisors or a representative of management, should visit the employee in the hospital, and follow up with visits at home. These personal visits can be interspersed with phone calls, notes, and other correspondence. Ideally, someone from the company should accompany the employee to the physician’s office, therapy sessions, etc. Supervisors should also encourage fellow employees to visit injured employees and reassure them that "the team" needs them back.

Working closely with your workers’ compensation insurance carrier claims examiner is a crucial element of successful rehabilitation efforts. Frequent, regular contact between all interested parties expedites recovery and proper handling of the claim. Unless there’s a compelling reason, such as medical confidentiality, or similar concern to do otherwise, all parties should share information to the extent that each of the parties always know what the others know. Report injuries, status changes, and other information promptly and assist in follow-up investigations. Don’t be afraid to ask questions. In many, perhaps most cases where a claim ends up as a lawsuit, the problem has been a misunderstanding, or a communication failure, that could have been headed off, if proper coordination had been maintained.

The Supervisor is the key to keeping company contact with an injured employee. The Return-To-Work Coordinator can assist the supervisor in maintaining contact while the employee is off work. The following represents typical duties of a supervisor in maintaining contact:

1. A supervisor should take an active role immediately following an injury.

• Take time to investigate and properly handle the injury.

• Request or authorize the necessary medical attention immediately.

• Trust your employee. Until proven otherwise, give them benefit of any doubt. Avoid projecting suspicion of fraud.

• Complete the First Report of Injury promptly and completely.

• Properly Investigate the accident and record all pertinent information.

2. Supervisors play an important role in bringing injured employees back to work.

• Plan time to visit the employee at home or in the hospital. Encourage coworkers to do the same.

• Stay on top of the employee’s progress.

• Reassure the employee that the team needs him/her.

3. A supervisor’s approach and attitude can make an employee’s return to work successful.

• Make the employee feel welcome and glad to be back to work.

• Research and provide temporary modified duties that have been approved by the doctor.

• Explain the duties clearly and emphasize the importance of the temporary job.

• Point out any new safety precautions, or reinforce old ones that the employee may have forgotten.

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RETURN TO WORK

SAMPLE POLICY STATEMENT

The health and well being of every employee is of vital importance. The active participation of the company and all its employees is necessary to make occupational health and safety programs of this type a success.

The company’s primary goal is to decrease the number of safety and health related accidents, injuries, and losses.

The health and safety director will work closely with employees through appropriate channels to develop more effective and efficient programs.

The return to work program is designed to discover better ways to protect the safety and promote the health of employees that have been injured on the job.

The company recognizes the economic impact of health and safety policies. It’s believed that a return to work program of this type will improve overall health and safety records while promoting improved earnings.

To this end, it is the responsibility of each department to provide the Human Resources Manager with jobs or functions within the department which can be performed by a person with some degree of work-related disability. It is the responsibility of the HR Manager working with the employees immediate supervisor and with the supervisor of the department in which work is to be performed, to arrange such assignments.

The entire program for restricted work assignments can be found in the company manual.

One of the keys to the success of this program is proper selection of a physician or clinic. One should be chosen for the treatment of injured employees that has complete facilities and industrial experience. It is equally important that a good working relationship be developed. By choosing an individual physician or clinic based on experience and relationship, the program can insure the best treatment for injured employees is an understanding of the company’s return to work program.

The physician/clinic should be made aware of specific physical requirements of both regular and light duty positions. Job descriptions or video tapes of proposed light duty positions should be provided. Such efforts will ensure proper decisions regarding return to work and temporary total disability determinations.

Periodic visits to the physician or clinic should be made. Likewise, these personnel should be invited to visit the facility on a regular basis to insure a responsible relationship between both parties.

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RETURN TO WORK

SAMPLE CORPORATE POLICY

SCOPE:

Generally, compensible injuries and illnesses are those that "arise out of and in the course of employment." Initially, workers’ compensation laws covered only injuries. (sudden impairments) Now all state laws also cover occupationally related illnesses caused by exposure to chemicals, radiation, repetitive motion, and other hazards.

Most states set compensation at two-thirds of a covered employee’s average wages except in the case of death, when benefits range from 25 to 200%, depending on the number of dependents. States also have different time limitations for payments. Maximum range from forth weeks to the full period of disability.

Most states require employees to wait between two and seven days before receiving disability benefits (Hospital and other medical costs are covered immediately) However, once disability benefits begin, most states make them retroactive to the date of injury if the disability continues for a certain length of time.

PURPOSE:

To provide guidelines for administering work assignments and/or work status for employees who have sustained an industrial injury of occupational illness, the result of which precludes their performing any, or something less than, normal work assignments.

PROCEDURE:

As injuries or illnesses sustained in the workplace result in varying degrees of disability, the administration of the employees’ return to work program must key on both the degree of disability and the nature of the restricted work assignment in question. For those reasons, this program provides the following levels of administration:

Temporary Partial Disability—Employees can eventually return to their former capacities, but for a period of time they cannot perform at all or can only do limited types of work or work for a limited time.

Temporary Total Disability—Employees cannot work but can eventually return to work with full or partial recovery.

Permanent Partial Disability—There is a maximum possible improvement with out full recovery. Some aspect of the employee’s ability to perform his former job is permanently lost.

Permanent Total Disability—Similar to Permanent Partial Disability except that the employees are permanently and totally disabled. For all practical purposes, the employee will never be able to perform any substantial aspect of his former job.

Many states provide for payment of Permanent Total Disability Benefits for the entire period of disability, but some states reduce payments after a specific number of weeks. Other states, however, impose time and/or dollar limits.

Management should determine, based on the capabilities of the injured employee and the work available, if a restricted, light duty assignment is available and if the employee is capable of returning to do the specific type of work. The company reserves the right to assign and transfer these injured employees to different jobs, and will use the following guidelines to determining pay based on the work being performed.

• If the nature of the work related disability is such that the employee can perform, to the company’s satisfaction, his or her normal job assignment, the employee will be returned to that assignment and receive their normal rate of compensation.

• Should the nature of the work related disability be such that the employee cannot perform his normal job assignments satisfactorily, but can perform other predetermined jobs, they will be paid at an appropriate rate which is not greater than their normal rate; not more than incumbents in that job, and not less than 10% more paid under provisions of the workers’ compensation act.

• If the nature of the work related disability is such that the employee cannot perform the duties of a classified position, but can be assigned tasks such as sweeping, filing, folding, and other clerical functions, they will be paid at a rate which is $10.00 per week in excess of what they would normally be paid under the provision of the workers’ compensation act.

When an employee is placed on a restricted duty assignment, as described above, the position he or she occupied prior to the disabling accident or illness may be assigned on a temporary basis. If at the conclusion of 60 working days from the date of the work related disability, the employee cannot return to his normal job assignment, the position may be posted as a permanent position through the job opportunity program.

When the employee is released by a physician to return to full time, full duty, they shall return to any available position that, at the discretion of the company, they are able to perform in a satisfactory manner.

When work related injuries result in an injury or illness that precludes the employee from performing any work as deemed by a physician, the employee will be placed on workers’ compensation benefits and deemed a "total disability case." The employee will remain as a total disability case until his condition is such that he can be returned to full time and full duty, or restricted light duty employment.

Should, in the employee’s absence, the job he normally performs be deemed mission critical, the position may be assigned to another employee as a temporary position. If after 60 working days following the date of work-related disability, the employee cannot return to that specific job on a full time, full duty basis, the position may be posted as a permanent position opportunity.

When the employee is released by a physician to return to full time, full duty, they may return to a position that is available that they can perform in a satisfactory manner. The rate of compensation may be adjusted based on the prevailing wage range for the position, the employee’s previous level of compensation, the employee’s demonstrated skills in the particular position, or by existing collective bargaining agreements.

The company reserves the right to assign, or not assign, a restricted duty position. It is understood that this authority lies solely at the discretion of the company and one or more restricted duty assignments are not intended to be long term, or consecutive in nature. Need, not seniority, nor other considerations, will be used in determining assignments and their availability.

The company retains the right to require an employee on total disability to submit to a second opinion examination when circumstances, in the opinion of the company, warrant such a request. In the event the employee refuses to perform a restricted duty assignment or to submit to a second opinion evaluation, the company will contact the workers’ compensation insurance carrier and cease all forthcoming benefits, insofar as law allows.

Administration of the return to work program lies solely within the company’s management function. All decisions involving the program will be in concert with appropriate management personnel. The administration of the program will be in accordance with all federal, state, and local requirements.

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