How Adjusters Can Speed Return to Work

Statistics prove   time and time again, the longer an employee is out of work following a work injury, the more unlikely it is he or she will ever return to work and the more expensive the claim costs. Prompt return to work therefore is very important.

Employers must  have a well-administered, strong early return-to-work program in place. “Light” jobs and tasks are identified in advance for those employees unable to return to full duty jobs following a work injury. In jurisdictions where possible, occupational physicians utilized by your company should be aware of these jobs and tasks so the physician is able to release the employee to specific work after the initial visit. This will alleviate a potentially lengthy exchange between the physician, adjuster and insured to clarify what the physician meant by “light duty.” The employee may be able to do 80% of his or her regular work and require only 20% in modified tasks. 

If an employee  is taken out of work entirely or has restrictions and there is no modified duty, the adjuster confirms a follow-up medical appointment is scheduled and notes the date. If the physician schedules a one- week follow up, make sure the appointment IS in one week and not a week and a half or two weeks later. OR, better yet — make SURE the employee has a form to collect restrictions during the first medical visit, not a week or two later, but DURING the first medical visit. Employers or insurance companies that do not have work ability forms are almost certainly turning the claim into a lost time claim instead of a medical only claim.

The adjuster  also makes sure the treating physician has a copy of the employee’s full duty, quantified job description for a clear understanding of what the employee does. Leaving up to the employee to communicate to the physician may not be a good idea and providing a quantified job description removes subjectivity from the decision-making process.

Provide modified duty job  descriptions to the doctor and suggest the possibility of a modified schedule. A release to work 50% of the time is better than being out of work completely.   The adjuster speaks with the employee and/or physician immediately after each medical appointment to stay on top of any changes in restrictions or abilities and act accordingly and also to be certain a follow up was scheduled. If the length of disability is disproportionate to normal expectations,  consider an exam (IME) with an independent doctor. (workersxzcompxzkit)

Adjusters closely  manage claims with current lost time and mitigate the length of disability to the extent possible by making sure injured employees are is examined in a timely way for follow up visits and provide the physician with full and modified job descriptions for consideration. 

 

Site-less workplaces  might need specialist to find jobs for employees that are unable to return to work. Companies such as trucking or contractors, might not have a site on which to place a modified duty position, and some employers may just not want such a program not matter how much the potential savings, so adjusters should be sensitive to that need also and use companies that locate jobs at other locations.