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

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 a 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

Development of an EarlyRTW Program

Workers’ Compensation Communication Flow (ERTW)

Expanded ERTW Option

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Support employee and department when work accommodations are requested

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

Generate monthly reports with pertinent limited duty data

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Monthly vacancy reports

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

Special projects for Administrative Staff

Department training/continuing education 18

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

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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 abilities20

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

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Thank you!