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					       Fire Department
Early Return-to-Work Program
Fire Department Workers’ Compensation
               Program
   In FY 2010-11, 1383 workers’ compensation claims were opened on the
    Fire Department Program.

   Traditionally, the Fire Department frequency rate exceeds 30% (30
    reported injuries per 100 employees).

   In FY 2010-11, Fire Department workers’ compensation expenses were
    $42.3 M with another $20.3 M paid in salary continuation and LC 4850
    benefit expenses.
    What can be done to reduce intractable
     workers’ compensation expenses?
    Safety and Loss Control Efforts.
    Leverage and improve workers’ compensation processes to promote the
     expedient delivery of quality medical care and facilitate early and
     sustainable return to work efforts.
    Improve communication between system stakeholders (injured worker,
     department management, department RTW staff, workers’ compensation
     third party administrator, and treating physician).
    Evaluate and expand an organization’s ability to provide timely and
     meaningful temporary alternate duty (light duty) assignments (ERTW).
     The premise of such a proposal is that organizational effectiveness is
     improved by transitioning absent unproductive employees to present
     productive employees.
    Better the experience of our injured workers during the complex and often
     confusing workers’ compensation claim process.
      The Injured Worker's Experience
   "No one gives you the full story, only parts."
   "When you want to go through the process, no one gives you a hand as
    to what to do . . . . [You're] completely on your own."
   "They only saw me as a number, they did not care about me as an
    individual.”
   "They catch some guy playing tennis on film. It's like 'Oh, all
    employees are lying.”
   "Everyone wants a piece of the case, and he who least benefits is the
    worker.”
   "It's really dehumanizing to have your fate decided by so many
    outside forces.”
   "Initially, when I got hurt on the job, the supervisor took no notes, did
    nothing, and progressively I was getting lame."
   "It starts with the human factor, first of all--train people or the
    counselors or people in insurance to treat you as a human being."
          Fire Department Early
              RTW Program
   Program overview:
       Phase 1- Strengthen communication
       Phase II - Initial Treatment Center’s
       Phase III - Orthopedic Facilities
       Phase IV- Modified/Alternative work
            Fire Department Early
                RTW Program
   Phase 1: Strengthen Communication
       RTW Supervisor contacts an employee within 24 hours.
           Assess employee medical needs
           Clarify work status
           Provide contact letter (RTW and Intercare contact numbers)
       RTW Regional Coordinator follow-up contact within 3
        days
           RTW Coordinators assigned to specific Bureaus within
            Emergency and Business operations
           Increased communication results in better case management
             Fire Department Early
                 RTW Program
   Phase 1: Strengthen Communication
       Workers’ Compensation TPA makes 24 hours.
           Assess employee medical needs
           Clarify work status
           Provide employee with WC TPA contact information
           Facilitate medical appointment and/or diagnostic testing
            Fire Department Early
                RTW Program
   Phase II: Initial Treatment Centers (ITC’s)
       Provide appropriate quality care for non-life threatening
        injuries/illnesses.
       Fitness for Life medical facilities
           County Contracted facilities
           Familiarity with Department personnel because of providing
            annual medical exams for the last 10 years
           Cost savings due to high cost associated with Emergency Room
            visits for non-life threatening injuries/illnesses
            Fire Department Early
                RTW Program
   Phase III - Orthopedic Facilities
      Kerlan & Jobe
     Southern California Orthopedic Institute (SCOI)
     California Orthopaedic Specialist
   Facilitate timely scheduling of Initial and follow-up
    appointments of orthopedic injuries
     Authorization of medical treatment
           MRI, Physical Therapy and Chiropractor services approved
            within 24 hours
           Reduce or have no loss time from work while receiving
            orthopedic intervention
               i.e. reduce cost associated with 4850 and salary continuation
          Fire Department Early
              RTW Program
   Phase IV: Early Return-to-Work Program
       Develop and provide reasonable accommodations to
        employees that have a physical or mental condition,
        regardless if Industrial or Non-industrial
      Development of a Early
         RTW Program

   The department is in the process of establishing a
    detailed Modified and Alternative work program
    for employees that are medically disabled from an
    Industrial or Non-Industrial injury or illness. The
    intent of this program is to utilize our injured
    workers knowledge, skills and abilities in a
    temporary position other than their usual and
    customary job
        Development of an Early
            RTW Program
   Benefits:
       The prevention of de-conditioning, psychological
        sequels of prolonged time off work, and
        maintenance of employment benefits.
        A reduction in workers’ compensation time-loss
        costs and improved organizational effectiveness.
           Clearly, improved outcomes are dependent on the
            communication between and the cooperation of the
            Employee, Employer, Third Party Administrator
            and the Treating Physician.
         Development of an Early
             RTW Program
   Process:
       Physician spells out an employee work restrictions
       RTW Regional Coordinator, Intercare, HR or ESS is
        notified of temporary work restrictions
       Anyone of the above Section notifies ERTW Assignment
        Desk
       ERTW Assignment Desk has list of all Department
        administrative vacancies as well as Emergency Operations
       ERTW Desk assigns employee based on current work
        restrictions and Knowledge, Skills and Ability
  Workers’ Compensation
Communication Flow (ERTW)
Expanded ERTW Option
LA County Fire Dept. Limited
   Duty Assignment Desk




                               16
          LA County Fire Dept. Limited
            Duty Assignment Desk


   Support employee and department when work
    accommodations are requested

   Centralized location for tracking, assigning,
    and obtaining limited duty assignments

   Generate monthly reports with pertinent
                                                    17
    limited duty data
      Limited Duty Assignment Pool
             Obtained From
   Monthly vacancy reports

   Section Supervisors, Regional Captains,
    B.C.s, & Assistant Chiefs

   Special projects for Administrative Staff

   Department training/continuing education    18
Why Limited Duty Is So Advantageous

   Saves sick or 4850 time
   Maintain regular pay and benefits
   Create flexible work hours
   Place them close to their home/treatment facilities
   Allow reasonable time for doctors appointments/
    rehabilitation
   Allows employee to stay current on training
   Keep employee involved/maintains self worth

                                                      19
    Assigning Limited Duty Personnel

   Contact the employee
   Confirm limited duty and work restrictions
   Utilize injured workers knowledge, skills and
    abilities in determining placement
   Contact position supervisor to review/confirm
    reasonable accommodations
   Tailor fit assignment around work restrictions:
     Work hours Location Accommodation
                  Skills and abilities
                                                      20
    Employees Tracked And Monitored During
           Limited Duty Assignment
   All employees seeking limited duty funneled
    to assignment desk
   Monitored and tracked during assignment
   Keeps track of doctor’s appointments in
    relation to status
   Ensures proper forms are distributed for
    completion

                                                  21
Limited Duty Assignment Desk Data
            Tracking




                                    22
Limited Duty Assignment Desk Data
            Tracking




                                    23
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Thank you!

				
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