Say NO to “No Work” Doctor Diagnosis in Workers Comp Claims

The treating physician is the “gatekeeper” to return to work.  An important part of transitional work programs is getting the injured employees’ treating physicians to agree to their patients’ participation.

 

  • The first step is to obtain an agreement from the treating physician not to prescribe “no work” for the employee without first discussing the matter with the employer. An injured employee may be able to function in a transitional work capacity much sooner if the employer is an active participant in the decision making process.

 

  • Secondly, employers should ensure their medical advisors or physician consultants remain in regular contact with all treating physicians. The company doctor should receive periodic reports on the patient’s progress, as well as proactively communicate with the treating physician transitional work job descriptions. The treating physician can determine if the patient is able to perform the tasks listed in the description, as well as whether the employee can work in any capacity.

 

Transitional work programs are common at employer work-sites. However, the simple existence of a transitional duty program does not mean it’s operating with maximum effectiveness or efficiency.

 

Employers who take a more active role in coordinating the activities of the injured employee and the treating physician will generate the expectation that the employee will return to work in some capacity within a specified period of time. This will result in shorter and less costly workers’ compensation claims costs.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Customize Return To Work Strategy For Employee Personalities

During the course of business, employers will find that all employees are not the same.  Speaking differently to each employee in order to get the same result is normal and necessary to keep business flowing steadily each day.  It only stands to reason that the same approach should hold true when working with employees to get them quickly and safely back to work after a worker’s compensation claim.

 

 

Return to Work Approach With Four Different Employee Personalities

 

There are many different return-to-work programs that can be utilized, but they should be matched with specific employees’ personalities to get the most successful results.  While one employee may respond well to several phone calls a week, another may find that to be too intrusive.  Finding the balance is the key to getting employees back to work.

 

There are primarily four different employee personality types ranging from fully satisfied to completely unsatisfied.  The four types of employees:

 

  • Satisfied-Active– one who is happy and needs no coercion or prodding to return to work.
  • Satisfied-Passive– one who is happy, but complacent with staying out of work.
  • Dissatisfied-Passive– one who is unhappy, but does not willfully concoct schemes to stay out of work. However, they may take advantage of the system to stay out longer.
  • Dissatisfied-Active– one who is very unhappy with his/her situation and will actively attempt to take advantage of the system.

 

The majority of employees will fall under one of these description categories and will respond similarly to different return-to-work strategies.  Handling each situation according to the personalities of the employees is the best tactic.

 

 

Suit The Personality Of The Employee

 

For example, a satisfied-active employee might be someone who has not missed a day of work in 10 years, plays on the company softball team, and is always looked to as a go-getter.  A workers comp claim might be perceived as a setback to this type of individual and little or no interaction from the employer will be necessary in order to get him to return to work. A recommended strategy is to send a get well card and provide a transitional duty position; activity such as aggressive surveillance can have the opposite effect and make the employee unwilling to return to work.

 

An active-dissatisfied employee in the same situation will take a completely different approach and most likely abuse the system.  Employers of active-dissatisfied employees will need to take a much more severe approach including implementing fraud prevention measures, hiring investigators, and having almost constant contact with the employee in order to get him back to work.

 

Without using a different return to work approach to suit the personality of the employee, the employer can inadvertently stall the process.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment.

Contact: mstack@reduceyourworkerscomp.com

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

The Employee’s Role In Return To Work

To successfully carry out transitional work programs, risk managers must convince employees of the benefits of these programs. The most critical element in any return-to-work program is keeping the disabled employee actively involved in the workplace.

 

When a worker is injured, the employer must maintain contact with the employee throughout the recovery period so he or she does not become “psychologically disemployed.” The phenomenon of “psychological disemployment” occurs when employees are away from the work environment for an extended period. During this period, employees begin to perceive themselves as having become “distanced” from the company — that is, the same company paying their workers’ compensation benefits.

 

 

Publicize Return To Work in Positive Manner

 

To gain employees’ acceptance, transitional work programs must be carried out properly. First, the company should publicize the program in a positive manner. This requires ensuring employees understand that transitional work programs will keep them productive during their recovery. Also, a company must apply its return-to-work policy equally to all employees.

 

 

Weekly Communication

 

Companies can take other steps to convince employees of the benefits of transitional work programs. For example, employers should schedule weekly meetings with the injured employee throughout the injury recovery period. These meetings are a good way to obtain an informal status report concerning the types of physical activities the employee is able to engage in; the treatments the employee’s physician has prescribed or any problems the employee may be encountering. This weekly contact underscores the company’s expectation that the employee will return to work in some capacity as an active part of the work-force. Weekly progress meetings allow the company to demonstrate its concern about the continued welfare of the employee. The company can also send the employee “Get Well” cards and other remembrances throughout transitional period.

 

 

Doctor – Doctor Communication

 

Employers should also ensure that the company doctor or physician consultant talks to the injured employee’s treating physician about initiating a return-to-work plan as early as possible. The physician consultant can telephone the treating doctor and discuss the status of an employee’s injury on a doctor-to-doctor basis. Often, treating physicians are more willing to discuss a patient’s progress with another physician. This allows the physician consultant to discuss the medical aspects of the employee’s claim, such as the diagnosis, prognosis and treatment plan and then work with the treating physician to establish an estimated return-to-work date. This information can then be communicated back to the injured employee to create a transitional duty position within their physical restrictions.

 

It is critically important return-to-work programs become part of the corporate culture supported 100% by management. Thus, it becomes part of employees’ expectations that if they “go out on workers’ compensation,” they will return to work shortly in some form of transitional work capacity.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

Leverage 3 Different Types of Transitional Work Programs

A successful transitional duty / return to work program is much more than having an injured employee answering the telephone or sweeping the floors.  Unfortunately, too many employers see a transitional duty program, also known as a return to work program as a “make work” situation for both the employer and the injured employee. This approach to a return to work program often ends in frustration for both employer and employee.

 

Having the right return to work attitude, as well as understanding the various transitional work programs are the first steps to a successful program.

 

 

Alternate or Light Duty Programs

 

Alternate or light duty programs allow employees to work at less demanding jobs until they are physically able to resume their original work duties. For example, an employee who normally does physically demanding labor could work in a more sedentary capacity, such as answering telephones or taking product inventories

 

 

Modified Duty Program

 

The second type of transitional work program is the modified duty program, where injured employees’ original jobs are modified through engineering alterations of the workstation. Employers use these programs to prevent aggravation of the injury. For example, an employer could install seats with added back supports and foot rests to relieve discomfort for an employee with an injured back.

 

 

Work Hardening

 

“Work hardening” is the third type of transitional work program. In these programs, employees perform their usual job-related tasks in steps of increasing difficulty until they regain the physical ability needed to perform their original jobs. This allows the injured employee to remain at work, although at reduced hours. Sometimes, employees in a work hardening program will be placed in a simulated off-site work environment. Here, they perform simulated assignments closely approximating the tasks they perform at their real jobs. Many vendors offer these work simulation programs.

 

 

Additional Return to Work Considerations

 

Transitional work positions can be located in the same or a different department, or even in another company or operating division. Some employees perform transitional work program duties in the community as a volunteer in an employer-sponsored volunteer activity, or in a commercial vocational rehabilitation return-to-work center.   In these instances, employers should provide transportation for the employee to the work facility to demonstrate continued involvement and concern for his or her recovery.

 

 

During the return-to-work process, companies need to consider the employee’s physical limitations. If injured workers exceed their physical abilities, they may experience a recurrence of the injury causing unnecessary pain and suffering for the employee and needless additional workers’ compensation costs for their employers. Also, although employers can use transitional work programs for temporary illnesses and injuries, it is important to remember all absence and disability programs must be integrated with the requirements of the Family and Medical Leave Act and the Americans with Disabilities Act..

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

Convince Your Employer Of Return To Work Benefits

Return to work and transitional duty are not new concepts in workers’ compensation.  Many companies are using transitional work programs to temporarily return injured employees to the workforce in a limited capacity until they are physically able to resume their original, full-time duties.

 

Benefits of Return to Work

Transitional work programs have the advantage of allowing injured employees to regard themselves as “actively employed” and thus productive and valuable members of the workforce. These programs are also financially beneficial for the company because keeping the employee at work helps the employer realizes significant workers’ compensation cost reductions.

In addition to reducing workers’ compensation costs, transitional work programs also help decrease short- and long-term disability insurance or wage continuation costs for non-occupational injuries. While employees in a transitional work program assignment may be less than 100 percent productive, having an injured employee working part-time in a limited capacity is more cost-effective than having one who does not work at all.

 

Many Companies Reluctant To Initiate Transitional Duty

Many companies, however, are reluctant to initiate transitional work programs. Some employers believe worker unions will not accept these programs, or the programs themselves will not be time- or cost-effective. However, evidence proves transitional work programs are very cost-effective, and a well-managed transitional work program can result in a return-to-work rate of up to 90 percent for injured employees returning to the job within four days after the injury. These significantly shortened workers’ compensation claims result in lowered indemnity costs and overall improvement in the company’s workers’ compensation loss experiences.

Reluctant employer concerns suggest the primary barriers to setting up transitional work programs are related to attitude toward return to work.  Therefore, successful implementation of return to work programs requires risk managers to convince their companies, employees, and treating physicians that transitional work programs are beneficial for all concerned.

 

Convincing Employers

To convince employers of the benefits of transitional work programs, risk managers should point out the key factors supporting their use. First, the risk manager can demonstrate how the company will realize significant financial savings if a return-to-work program is established. An employer can expect an average of 30 percent in savings for workers’ compensation costs for a well-managed return-to-work program.

To illustrate, consider this example. Suppose for every day an employee is brought back to work in a transitional duty capacity, a company realizes savings of $100 per day. If the employer has 50 workers on lost-time status who return to work in a transitional job assignment capacity one day earlier, the employer would realize savings of $5,000 per day. At a 5 percent profit margin, the return-to-work program would save the company $100,000. In other words, it would “cost” the company $100,000 to replace the $5,000 on the company’s bottom line (if the firm has a 5 percent profit margin.)

 

The risk manager can also point out how transitional work jobs can be as diverse and creative as the employer chooses. For example, employers can establish transitional work programs by gathering work “wish lists” from their managers. These lists could consist of the “to-do” tasks managers would like to accomplish but cannot due to time constraints and other more demanding work priorities. Perhaps one department needs inventory taken, another department requires updates to their database, or possibly someone to pay more attention to their social media presence.

 

Companies can have recuperating employees perform these tasks, thus helping to boost productivity. Companies should also attempt to make transitional work positions creative and productive. For example, by drawing from the “wish list,” employers can develop varied activities, thus keeping a recuperating employee gainfully occupied.

 

 

For additional information on workers’ compensation cost containment best practices, register as a guest for our next live stream training.

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

Return To Work Not As Hard With Work Hardening

work-hardeningThe majority of the employees who are injured will need only standard medical care to return to work.  Most of the employees who need rehabilitation will recover completely with physical therapy or occupational therapy.  However, some employees do not recover enough of their physical capabilities to return to work even though they have recovered from their injury. This is a result of the muscles becoming atrophic and the employee deconditioned due to lack of physical activities during the injury recovery time.  Work hardening is a comprehensive and systematic therapy plan created specifically for an injured employee to return him to the physical condition he was in prior to the injury.

 

 

Objective to Bring Skills Back to Prior Levels

 

The objective of work hardening is to return not only the employee’s physical ability but also to bring the employee’s functional, behavioral and vocational skills back to the skill level present prior to the injury. The therapist administering the work hardening program should be provided a detailed job description in order to tailor the work hardening program to the specific job requirements of the injured employee.  Occasionally, the employee who needs work hardening has attitude issues or chronic pain that has caused the employee to become severely deconditioned.

 

 

Program Involves Physician, Nurse Case Manager, and Therapists

 

For an injured employee to be in a work hardening program, the treating physician will make the request, normally a written prescription.  The nurse case manager should arrange the work hardening program with a physical therapy or occupational therapy facility that conducts work hardening programs on a regular basis.  The nurse case manager should stay actively involved with the treatment until it has been totally completed.

 

There can be significant variation in the work hardening treatment plans. There will be variations in the type and frequency of treatment and variations in the amount of time needed to complete the program.  The work hardening plan created for the particular employee will acknowledge and incorporate these factors in the individualized program design, as the goal of work hardening is to return the employee to work.

 

 

Optimize Work Capability of Employee

 

The work hardening program or plan designed for the employee will optimize the work capability of the employee while minimizing the employee’s risk of re-injury when the employee returns to work. Each individual plan may incorporate one or more of the following:

 

  1. Simulation of specific work tasks
  2. Simulation of general work tasks
  3. Physical reconditioning
  4. Training on how to prevent future injury
  5. Training on how to perform the work tasks to minimize pain
  6. Training on how to modify work tasks
  7. Training on how to modify daily living activities
  8. Psychological intervention to demonstrate to the employee that he is capable of returning to work

 

The employee who understands the reasoning for work hardening and wants to recover to the maximum from the injury will embrace the concept.  Often this is an employee who has been on modified duty and understands what is needed to return to work full duty.

 

However, if the employee has an attitude, behavioral issues, chronic pain or psychological issues interfering with a return to work, work hardening can be effective, if the therapist is aware of the issues that will interfere with the successful completion of the work hardening program.  The nurse case manager on the workers’ compensation claim should discuss these barriers with the therapist and agree on the treatment plan necessary overcome the barriers.

 

 

Success Measured in Several Areas

 

The success of the work hardening program can be measured in several different areas.  The therapist will report to the treating physician during the work hardening program and at the conclusion of the program.  Information the therapist will provide to the treating physician includes:

 

  1. Musculoskeletal improvement
  2. Cardiovascular status
  3. Motivation
  4. Attitude
  5. Behavior
  6. Vocational status (in relation to job specific requirements)
  7. Need for future accommodations

 

One mistake physicians and others make in the use of work hardening programs is to wait until the employee has totally recovered from the work related injury before starting work hardening.  If the employee has been off works for months, and the employer – adjuster – nurse case manager knows the employee will be returning to a physically demanding job, work hardening should be incorporated into the physical therapy program, and not as a subsequent program to the physical therapy.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

OLYMPIC Return To Work and Factors Causing Disability Extremes

Hello. Michael Stack here, Principal of Amaxx, founder of COMPClub and co-author of Your Ultimate Guide to Mastering Worker’s Comp Costs. Today I want to look at 2 extremes. One in the case of an Olympic return to work success, in comparison to a claim with the same injury that would cause a permanent disability and fall in the category of Workers’ Compensation of the 5% of claims that are causing 80% of the cost.

 

 

Identical Injury Can Cause Two Very Different Outcomes

 

Let’s take a look first at the success case. This was the story of Ellie Downie. She’s an Olympic gymnast on the Great Britain women’s gymnastics team. She was performing her floor exercise in the qualifying round, and through the course of her tumbling she over rotated and landed on the back of her neck. It looked like a very gruesome injury, but in true Olympic spirit Ellie tried to get up and continue her performance. She felt dizzy and had to leave the arena. I believe at that moment she believed that her Olympic dream was over. Only a few short hours later Ellie returned to the arena performed 2 vaults and helped Great Britain qualify for the team final.

 

In the Workers’ Compensation world we would qualify that as a tremendous return to work success following an injury. That’s the success story. There’s also a case where that same injury could lead to a permanent disability. ACOEM published a white paper called, “The Guide to Preventing Needless Work Disabilities.” In that paper they stated that only a small percentage of injuries actually by medical necessity need to be out of work. The vast majority of individuals who are injured can get back to work in some capacity, causing a much faster healing and recovering time. That’s the other extreme; the permanent disability side.

 

What are the elements that were involved in Ellie’s injury that she had over here that are not existent and maybe causing these problems that we can recognize in the Work Comp industry and then try to get ahead of those claims to prevent that small percentage of claims that cause the highest dollar amounts?

 

 

OLMYPIC Return To Work Success Factors

 

Let’s take a look at these factors that Ellie had. She had immediate medical attention. If you look at the footage here you can see that her training staff, the medical staff rushed to her aid. She had immediate medical attention. That was factor number 1. Factor number 2; she had tremendous support. She had support of her teammates, she had support of her family, she had support of her country, and she really had the support of the entire arena and the entire world that was watching that event, because we know the passion and preparation that goes into that and were rooting for her to get back to the arena. She had tremendous support. Third piece; she had personal skills. She was an Olympian. She had the Olympic spirit. She had the pain of training, the passion and dedication to get ready and prepare for that event. The same skills were able to let her handle the stress of that injury and have the motivation to get back to work.

 

 

Permanent Disability Factors

 

Now, the reality is when we’re watching the Olympic Games we realize that we’re not all Olympians and there are things that we can learn from that. Let’s take a look at this case where that same exact injury that happened to Ellie not in the context of the Olympics, but in the context of an everyday working Joe American. The same injury occurs and let’s look at what happens when these factors are not at play. Maybe that claim doesn’t get reported. Maybe the claim happens and that person feels like they’re a tough individual or maybe there’s some different elements at play in the workforce that they feel fearful to report the claim, so the claim goes unreported. There’s no medical attention at the time of injury. Both of these factors are not present; the claim is not reported and there’s no immediate medical attention.

 

 

Immediate Medical Attention

 

There was a story that was reported later that Ellie reported that she was actually a lot better than she thought, which allowed her to in order to come back to work, in order to perform that vault. That immediate medical attention, that fear, that anxiety that she felt even as an Olympian with all this stuff going for her, she still had that fear and anxiety that she would not be able to return. In the claim of a really standard American claim goes unreported that fear then accelerates; that anxiety accelerates and it’s not addressed in order to be able to get that injury going in the right direction.

 

 

Support

 

Next thing here; let’s take a look at support. I’m going to do this as transitional duty/work support and then family and friends. Ellie obviously had this in spades being an Olympian and having the support of her country and really of the entire world. From a transitional duty position maybe there’s no job available. Maybe someone at the employer has no injury response procedure. They had no communication plans in place. This person is left to be on their own and maybe they don’t have much family and maybe they don’t have many friends. These skills and the support system that enables an individual to recover and get back to work is nonexistent on this side.

 

 

Personal Skills

 

Then let’s talk about these personal skills and this motivation. Maybe this person doesn’t have this. Maybe there’s some depression, maybe there’s some anxiety, maybe there’s some psychiatric mental underlying mental conditions that are existent and present in this person’s life that are not addressed, that are left unnoticed. In this case tremendous system support, medical attention, and those personal skills in order to get back to work, in this case none of this is present. Leaving this claim now to be what could have been back to work in a matter of a few hours now leaves this person disabled for the rest of their life and now falls into that category of one of those a very small percentage of claims that cost the most amount of money years and years and becomes a permanent disability or a permanent partial disability claim costing hundreds of thousands of dollars that could have been prevented.

 

Prevent Needless Disability

 

When we look at this example, when we look at this case, and we look at both extremes of what was in play at that time of injury, putting these systems in place, getting those claims reported, having that transitional duty, putting that injury management process in place that I talk about on this blog, extraordinarily important to control your Workers’ Compensation cost and create the best Olympic outcomes.

 

Remember your success in Workers’ Compensation is defined by your integrity, So, be great!

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Re-Thinking Return-to-Work as Stay-At-Work

Implementing a successful return-to-work program requires employers to think outside the box.   This includes the interested stakeholders at the employer to explore the economic realities of implementing a program that includes discussion about the amount of premium paid to the workers’ compensation insurer, or if self-insured, the amount paid out in medical and indemnity benefits.

 

 

Thinking About Return-To-Work During Medical Recovery

 

The thought of return-to-work in most instances takes a narrow approach.  This includes failing to think about an employee’s return until they are nearing the end of the healing period, or final restrictions are being set.  Failing to do this can result in a loss of productivity, which is the primary indirect cost employers incur due to a job injury related absence.  This is due to many factors and includes:

 

  • Incurring the cost of health and other insurance premiums;
  • The accruing time for vacations, sick days and other employee benefits while the employee is off work; and
  • Overtime hours paid to other employees to make up part of the loss of productivity or time training a temporary or permanent replacement for the injured worker is also a part of the indirect cost.

 

By allowing an employee to return to work, even if they have restrictions, employers can receive the benefits and contributions that person has to offer.

 

In an effective program, employers can seek out opportunities from their disabled workforce.  One example of this altering their return to work programs to include stay at work.  In other cases, an employer can allow critically injured employees to perform modified duties, or even a totally new and different job.

 

 

Create a “Win-Win” with Return(Stay)-To(At)-Work

 

Return-to-work is really “Stay-At-Work.”  By keeping the injured worker within the labor market, they continue to be productive.  They also retain a sense of worth and dignity that is often missing in the adversarial workers’ compensation system.

 

In a Stay-At-Work program, the employer’s workers’ compensation coordinator is involved from the onset of an injury.  The workers’ compensation coordinator is involved in the medical aspects of the case and assists in understanding and coordinating with the medical provider issues concerning modified work duty within the employee’s medical restrictions.  This includes providing total sedentary work if needed.

 

Benefits of the Stay-At-Work concept are numerous.  Here are some of the benefits for each side of the equation in any workers’ compensation injury:

 

  • Employer
    • Develop defenses to future wage loss and medical benefits if the employee does not comply with offers of work;
    • Development of compassionate business practices that recognize each employee is valuable; and
    • Productive workforce that retains value and productivity.

 

  • Employee
    • Increased development of skills or vocational trade;
    • Gainful employment during the recovery process, which often leads to quicker recovery from an injury; and
    • Development of confidence in one’s self-worth.

 

 

Conclusions

 

The proper use of an integrated stay at work/return to work program lowers overhead cost and increases profitability by lowering the overall cost of workers’ compensation.  It also had a value add by reducing the mistrust that is often present in workers’ compensation cases.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

How To Develop A Temporary Transitional Duty Job

A risk manager or workers compensation coordinator understands the importance of bringing employees back to work as quickly as possible following an injury.  However, for the temporary duty job or for the modified duty job to be worthwhile to the employee and productive for the company, it needs to be more than having the employee to answer the phones or sweeping the floor.

 

 

Difference Between Temporary Duty & Modified Duty Job

 

There are differences between a temporary duty job and a modified duty job.  A temporary duty job is a regular job within the company that the injured employee is assigned to on a temporary basis.  A modified duty job is the employee’s regular job with aspects of it changed or removed to accommodate the physical restrictions of the injured employee.

 

 

The challenge is to place the employee in a temporary duty job that will match the restrictions placed on the employee’s work by the medical provider while producing a benefit for the employer. The physical demands of the employee’s regular position are often such that if lifting, standing, and bending are eliminated, there is nothing left in the injured employee’s regular job, and a temporary duty job is necessary to return the injured employee to work.

 

 

For the purposes of this article, we are assuming there is a written job description for each and every position that is more detailed than “makes stuff”.  If not the human resources department can have a job description designed to use each time they are recruiting to fill a position.

 

 

Conduct Assessment of Worker Similar To Time Of Hire

 

To determine what type of temporary job the injured employee can do, conduct an assessment of the employee just like hiring the employee for the first time. If the injured employee’s job skills are subtracted from those skills he is unable to do due to his injury, what is left is a fairly good rendition of the type of temporary job the employee can do.

 

 

To assess the injured employee’s capabilities to do a temporary duty job, use the following for each job considered for the employee’s placement.

 

What are the physical demands of the temporary duty job being considered?  [If the employee cannot meet the physical demands of the temporary duty job, the temporary duty job can be eliminated from further consideration and a different job should be considered.]

 

  • List the essential requirements of the temporary duty job.
  • List the major responsibilities of the person in the temporary duty job.
  • Does the job require any particular educational background?
  • Does the job require any particular training?
  • Does the employee have the technical skill necessary for the job?
  • Will all the necessary tools and equipment for the job be available to the employee?
  • Are language skills, or bi-lingual skills necessary in the temporary job?
  • Are mathematical skills necessary in the temporary job?
  • Does the temporary job require strong reasoning abilities or the ability to make quick decisions?
  • Does the job require any travel that could interfere with his medical care?
  • Will the work environment of the temporary job conform to the employee’s restrictions?

 

 

Once each aspect is considered, the list of potential jobs is shortened to an essential few.  If you have more than one job to place the injured employee in, then consider where the employee would provide the most benefit to the company, or which job needs that worker the most.  If there are not any jobs to accommodate the employee’s abilities and skills, then consider which job will need the least modification or adaptation for the employee to perform the job.

 

 

Temporary Job Placement Will Save The Employer Money

 

While on the surface this might seem like a lot of work to place the employee back at work for 15, 30, or 60 days before being recovered enough to assume prior job duties, keep in mind the employees who are placed back to work are paid less in indemnity benefits while recovering faster than peers at home unable to return to work.

 

 

Temporary job placement and modified duty will save the employer money through increased production and lower workers’ compensation cost.  We strongly recommend providing the injured worker a job within physical restrictions as soon as possible after the injury.

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Vocational Rehab Returns Seriously Injured To Work

Vocational rehabilitation is for the purpose of returning the seriously injured employee to:

 

  1. The prior job with the employer or,
  2. A new job with the employer or,
  3. A new job with another employer.

 

Most jurisdictions have a section within their workers’ compensation statutes mandating vocational rehabilitation for the injured workers who need it.

 

 

Vocational Rehabilitation Starts with Job Restrictions

 

When the treating physician determines the employee has reached maximum medical improvement, the employee is then released from further medical care. However, if the employee’s functional ability is below what the employee was able to accomplish prior to the work comp injury, the treating physician may determine the employee needs restrictions on future work activities to prevent the employee from a re-injury.

 

In a typical claim of this type, for instance a back injury, the treating physician assigns an impairment rating to the employee. For example, the employee had back surgery and the physician determines the employee has 20% permanent disability to the back. For the employee’s safety, the physician releases the employee to return to work with a restriction stating the employee is not to lift more than 25 pounds at one time. However the employee’s job routinely requires the employee to lift 25 pounds or more. This is the typical vocational rehabilitation case.

 

 

Start Vocational Rehabilitation Timely

 

Experienced work comp claims adjusters know the earlier the injured worker is started in vocational rehabilitation, the higher the probability of success. The success rate is also higher for workers who return to work with the same employer. When the status of the work comp claim is such that the adjuster knows from the medical records that an impairment rating is probable, the adjuster should start then with vocational rehabilitation to return the worker to the former job.

 

 

Primary Vocational Rehabilitation Activities

 

A trained vocational rehabilitation counselor works with the treating physician to establish the course of action necessary to minimize the employee’s limitations on returning to work. Three areas the physician and the vocational rehabilitation counselor normally consider are:

 

  1. Work hardening programs.
  2. Functional capacity evaluations.
  3. Ergonomic work station assessments.

 

The work hardening program prepares the employee for the physical requirements of the former job. The employee who for months has had no physical activity is not physically able to do the labor done before the injury, even if the employee was not injured. The work hardening program is physical exercise that mimics the work the employee did before. It is designed to gradually build up the employee’s strength and endurance so that s/he can lift, pull, push or drag weight similar to what s/he was doing prior to the injury. The work hardening program can go on for weeks as the employee rebuilds physical endurance.

 

A functional capacity evaluation is a one-time evaluation performed by a physical therapist after the employee completes all physical therapy treatments. During a functional capacity evaluation the employee is evaluated doing simulated work. The therapist observes and scores the employee’s ability to complete task similar to what the employee would do on the job. The purpose of the functional capacity evaluation is to give the insurer or the employer information on the employee’s ability to do the work. The vocational rehabilitation counselor in conjunction with the therapist can make recommendations on modifying the employee job and work environment to accommodate the employee’s limitations.

 

An ergonomic assessment is used to prevent the employee from re-injury by improper lifting techniques or improper placed equipment. The vocational rehabilitation counselor inspects the work site and makes recommendations to protect the employee from re-injury. For example, the vocational rehabilitation counselor may recommend objects the employee might lift to be placed on a table rather than on the floor at the employee work site. Another recommendation might be for the employee to be accommodated with a stool to sit on while working rather than standing all day.

 

 

Other Vocational Rehabilitation Services

 

If the employee’s injury is such that regardless of the efforts of the vocational rehabilitation counselor, the employee cannot return to the prior employment, then other vocational rehabilitation services may be needed. Other services that can be provided include:

 

  1. Counseling the employee in selecting a job suitable for them.
  2. Labor market surveys and job search assistance.
  3. Instructions in job-search techniques.
  4. Vocational assessments to evaluate the employee’s aptitudes, skills, interest and physical capabilities.
  5. Job training in a new vocation.
  6. American with Disabilities Act accommodation assistance.

 

Summary

 

Some employers take the position that vocational rehabilitation for the employee is expensive. It is. However, vocational rehabilitation is far less expensive than paying life time disability benefits to the injured worker who never returns to work. Properly utilized vocational rehabilitation can significantly reduce the cost of the larger work comp indemnity claims by returning the injured worker to a productive role.

 

 

 

Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.

 

 

©2016 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

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