Transitional Return to Work by zhangyun



Presented by QBE the Americas
Loss Control Services
What is a Transitional Return-to-Work
         (TRTW) Program?

A program to enhance
the injured employee’s
rehabilitation and
facilitate their return to
normal job duties by
providing temporary
modified work
    What is TRTW?

Plan for dealing with
return-to-work issues
before an injury occurs

“You do not get injured workers
  well to put them back to work.
  You put them back to work to
  get them well.”
                Richard Pimentral

           The Return to Work Process: A Case Management Approach
       Injury Results
      Injury Occurrence

 Physical, Emotional, Social

Increased Medical Procedures,
  Therapy/rehab/Surgical Costs
Employee Benefits of TRTW
• Generally gets employees back to work
  50% faster
• Speeds recovery up to 3 times
• Reduces vocational rehab
• Reduces degree of permanent partial
• Reduces possibility of re-injury upon
• Employee’s wage loss minimized
Employer Benefits of TRTW
• Helps control medical costs by as much
  as 70%
• Reduces indemnity costs
• Less abuse of Worker’s Compensation
• Improves moral/employee relations
• Improved work ethic
• Enhanced company image
• Less litigation

“People sue because no-
 one cares more often than
 because they felt they were
 wrongly injured.”
• 80% of claims involving
  litigation result in higher
• Contacting the injured
  employee within 1 week of
  injury reduces chances of
  litigation by 50%
    Employer Benefits of TRTW
•   Eliminate repeaters & malingerers
•   Reduced turnover
•   Reduces hiring & retraining costs
•   Maintains company productivity
•   Employer is in charge rather than
Important Considerations
• The longer an employee is off
  work, the more difficult it is to
  get the employee to return to
  work. (Disability Syndrome)
• The longer an employee is off
  work, the larger the disability
  awarded at hearing.

• 20% of employees account for
  80% of employee absence
• Red Flag- Absenteeism
 Effective TRTW Programs
• Identification of potential jobs for
  modified duty
• Early reporting of injuries and illnesses
• Accident investigation program
• Communications-
  employee/employer/medical/WC carrier
• Education of staff
  A Hard Look at Lost Time
• Lost time typically constitutes 60%
  of Worker’s Compensation costs
• For each 1$ paid out by the
  insurance carrier, there may be as
  much as $2 in increased workers
  comp premium costs to the
    TRTW Vs. No Program
Example: Employee with one hand duty for
8 weeks wage $500/week WC pays 66.67%
of wages.
No TRTW                    With TRTW
$500 x 8 x 0.67 = $2,680        $0

3-Year Cost in Increased WC Premiums
 due to Indemnity
$2,680- $5,360             $0
  Claims Costs

Without                           $15,720
TRTW            $2,224

  With                  $6,120
 TRTW          $1,097

          $0            $10,000   $20,000

                                            Crawford & Company 1995
     TRTW Benefits

According to the Washington
Business Group on Health
there is a $8-$10 return on
every $1 invested in a TRTW
          TRTW Team
•   Injured employee
•   Upper management
•   Return-to-work coordinator
•   Front line supervisor
•   Physician/Medical provider
•   Worker’s Comp. provider
•   Commitment to TRTW
•   Develop TRTW policy
•   Develop TRTW team
•   Communicate
Return-to-Work Coordinator
• Develop/implement/coordinate
• Direct injury management
• Maintain contact with injured
• Communicate with General
  Casualty/medical provider and
 Return-to-Work Coordinator
• Coordinate with medical
• Maintain records
• Report to management
• Provide training
• Establish a plan for each injured
Supervisor’s Role in TRTW
• The greatest road block to
  an effective TRTW
  program is supervisor
• Program support
 Supervisor’s Role in TRTW
• Get employee prompt medical
• Promptly report to management
• Complete accident investigation
• Respond positively
• Assist in job evaluations
    Supervisor’s Role in TRTW
•   Keep in contact with employee
•   Make employee feel welcome
•   Identify light duty jobs
•   Never allow employee to work
    outside restrictions
       Injured Employee
• Financial concerns
• Health concerns
• Advise from friends,
  neighbors, etc.
• Attorneys
Injured Employee Responsibilities
  • Follow safety policies and rules
  • Promptly report injuries
  • Complete paperwork
  • Maintain contact with employer
    when off work
  • Provide updates on medical
Injured Employee Responsibilities
 • Follow medical recommendations
 • Do not work outside restrictions
 Physician/Medical Provider
• Make medical determination
• Be familiar with employee’s job
  functions and the jobs physical
• Determine work restrictions
• Work with TRTW coordinator &
  QBE or case nurse
  Medical Considerations
• Develop relationships with
  medical providers
• Give medical providers tours
  of facility
General Information for Medical Provider

 •   Job descriptions
 •   Job function analyses
 •   List of transitional work activities
 •   Written TRTW program
 •   Videotapes of jobs
 Specific Information to Medical Provider

• Job function analysis of injured
  employee’s job
• Descriptions of available jobs
  that fit restrictions
• Physical capabilities form
     Job Function Analysis
•   Job title
•   Describe job tasks
•   Equipment used
•   Physical demands
•   PPE needed
•   Other hazardous conditions
    Job Function Analysis

  An employee may tell the
 medical provider they lift 50
 lbs. The missing information
 is that they lift 50 lbs. once
 per week!
        Physical Demands
•   Standing/walking
•   Sitting
•   Lifting/carrying
•   Pushing/pulling
•   Bending
•   Twisting
•   Kneeling/crawling
•   Reaching
       Types of Work
• Modified Work- Regular job with
  modifications to accommodate
• Alternate Work- A temporary
  assignment until worker is able
  to perform regular job
      Modified Duty Jobs
• Try to return to same job first
• See what regular activities fall
  outside restrictions
• Evaluate ways to reorganize
  job to accommodate
• Separate jobs tasks into
  essential and non-essential
     Alternate Work
• Should be identified before injury
• Should be meaningful and productive
• Develop a list of possible alternate jobs
• Look for things that never seem to get
  done- inventory, painting, cleaning,
  organizing, sorting, paperwork,
  labeling, etc.
  On the Day of Injury
• Get injured employee medical attention
• Send physical capabilities form and
  notice of temporary modified duty
  availability and job function analysis to
  medical provider
• Contact General Casualty Claims Dept.
• Complete First Report of Injury
• Start accident investigation
 Within 3 Days of Injury
• Send employee get well card
• Have supervisor contact
• Contact physician and discuss
  TRTW issues
• Develop specific TRTW program
  for employee
Complete Every Week Until Release

• Contact or visit employee
• Contact physician after each
  medical exam
• Continue to work with
  physician, QBE and employee
  until restricted or modified duty
    Written TRTW Program
• Policy statement
• Roles & responsibilities
• Procedures
• List of job descriptions with
  physical requirements
• List of modified duty jobs
• Should be reviewed by company
    ADA and TRTW
1. Determine if there is impairment
2. Determine if the employee can still work
  within the scope of their original job
3. If they can’t work within the scope of the
  original job, can reasonable
  accommodations be made
4. If reasonable accommodations can’t be
  made is there another job the employee
  can perform
Coordinating ADA & Workers Compensation

   • Objective is to prevent employees from
     getting a WC settlement and then
     arguing they are able to return to work
     to pursue an ADA claim
   • Employers often make the mistake of
     resolving a WC claim and then try and
     determine employment status
Coordinating ADA & Workers Compensation
   • Do not allow an employee to remain off
     work indefinitely or leave the employee
     indefinitely in a light duty job
   • Make sure an employee returns to work
     before resolving a WC case
   • Employers should work closely with a
     qualified attorney

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