INJURED FIREFIGHTERS RETURN TO WORK GUIDE

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects.

The job is part of who they are. They thrive when they are with their crew.

They train to keep their skills.They live to serve.

So when they get hurt, they need to get back to work.

WHEN FIREFIGHTERS GET HURT ON

THE JOB.....

THEY HAVE A NEED TO GET BACK TO WORK.

Losing firefighter shifts to injury means losing expertise, institutional knowledge, and team cohesion.

Department budgets can be effected when overtime is needed to fill injured firefighters shifts. After only a few days of a lost time injury, Worker’s Compensation rates start to rise for the department and the rate for all firefighters and departments across the state.

THEIR DEPARTMENTS DEPEND ON THEM. STATISTICAL REVIEW

Departments are facing budget short-falls as the firefighter rates for Worker’s Compensation are steadily increasing. Below are the last five year 6904 code rates based on FTE (1,920 hours) with an experience factor of 1.0.

2017

2015

2013

2016

2014

Percentage of Fire Districts statewide participating in the Stay at Work Program, receiving over $693K in payments.

66%88%

18%

Percentage of districts surveyed who have a firefighter return to work after a severe or moderate injury.*

Percentage that work-man’s comp rates have increased since 2013, due to lost time days off work and other claim costs in the fire service.

THEIR FAMILIES NEED THEM ON THE JOB TOO. The longer an injured worker is gone from work, the more likely they will never work again.

Studies show time off work can cause emotional distress, increased stress, negative impacts on family relationships, and lower self esteem.

It can also reduce the long-term financial security of the families of injured workers.

$3,860

Premium per FTE

10%$4,232

13%

$3,425 20%

$2,846 10%

$2,579 9%

Increase

A STEADY RISE IN WORKER’S COMPENSATION INSURANCE RATES

An early return to work program can significantly reduce rates for participating departments and ulitmately the experience rate for Washington firefighters.

41%Percentage of fire districts with NO pre-defined light duty job descriptions.*

Percentage of injuries caused by over- exertion and strains in the Fire Service in Washington State. 52%

* May 2017 Survey, Washington Chief’s Conference

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DEVELOP A LIGHT DUTY JOB ANALYSIS

This form is a line item analysis of light duty depart-ment tasks in a “weight and motion” format. Typically prepared by a Vocational Rehabilitation Counselor, this document helps healthcare providers, including primary care, physical therapists, and occupational therapists quantify specific appropriate tasks for temporary light duty jobs.

Focus on light duty assignments that are meaningful to the injured firefighter and beneficial to the department.

This combination makes for successful return to work programs. A sample Light Duty Job Analysis is available through the WFC Return to Work program website.

DEVELOP A FULL DUTY JOB ANALYSIS

Typically prepared by a Vocational Rehabilitation Counselor, thisdocument helps healthcare providers, including primary care, physical therapists, and occupational therapists understand the needed functional capacity of their injured firefighter/EMS patient. It can serve as a detailed rehabilitation goal for all parties.

A sample Full Duty Job Analysis is available through the WFC Return to work program website.

A PROACTIVE APPROACHDEVELOP RELATIONSHIPS WITH MEDICAL PROVIDERS

Fire departments can do much to improve the care provided to their firefighters and decrease time out of work by developing relationships with health care providers.

Innovative departments have partnered with clinics, physical and occupational therapists, Chiropractors, massage therapists, and other health care providers to form a network of care that givesinjured firefighters priority in care.

These programs reduce wait time for visits, procedures, and ultimately reduces time lost on the job.

Quickly filing and actively working with your Labor and Industries claims manager may also reduce total time to treatment and return to work.

DEVELOP A WELLNESS PROGRAM TO ADDRESS THE CAUSES OF INJURIES

Overexertion and strains make up the majority of the causes of injuries on the fire ground.

Vibrant wellness programs that focus on long term physical fitness are key to avoiding an injury that could result in lost time.

Firefighters who currently smoke lose their presumption of occupational disease designation. ( RCW 51.32.185 ) Departments should encourage a non-smoking policy for both career and volunteer firefighters.

Implementing best practices that reduce the risk of cancer is one of the most important approaches a department can take for firefighter wellness.

Have firefighters on light duty update your wellness program.

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DEVELOP A RE-ENTRY PROGRAM

To help firefighters comfortably return to full duty after a prolonged absence, some departments have developed a re-entry program that involves specific evolutions that closely resemble actual job demands. An example of a re-entry set of evolutions includes:

• Donning full PPE in a SCBA quarterly skills evaluation.

• Taking a hydrant and 2 1/2” charged hose line advance evolution.

• Search and rescue evolution with patient extrication.

• Forcible entry evolution requiring striking of door or jamb.

• Extrication evolution with use of hydraulic cutting or lifting equipment.

• Stair or standpipe evolution with multiple-story hose carry.

• Ladder use in a vent, enter, isolate, search evolution.

Successful re-entry programs do not need to resemble firefighter testing for employment or skills stations, rather they are a tool to over come skill degrada-tion and make sure firefighters can safely perform their assigned duties. Consider un-timed or team evolutions for your re-entry program.

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DEFINE MEANINGFUL LIGHT DUTY JOBS

ADMIN PROJECTSUpgrade maps, and enter data into reporting software. Write and submit grant applications.

EQUIPMENT INVENTORYOrganize and inventory department supplies and equipment. Upgrade to barcode systems.

SCBA RELATED TASKSSet up a mobile unit to perform fit testing. Perform SCBA maintenance, battery maintenance and minor pack repairs.

PPE INSPECTIONPerform required gear inspection as a qualified person. Receive free PPE inspection training at www.lionfireacademy.com.

TOOL EQUIPMENT REPAIRPerform routine and required tool repair and maintenance for tools and equipment.

COMMUNITY OUTREACH Provide school and nursing home presentations, bike rodeos, and fire alarm battery re-placement drives. Community out-reach is a powerful tool to help the firefighter heal.

L&I’S STAY AT WORK MODIFICATION EXPENSE REIMBURSEMENTS

Departments are eligible for reimburse-ments of up to $2,500 for equipment purchased to facilitate light duty work.

Examples are:Sit-stand stations - Support back injuries in light duty admin, inventory and office work.

Lift tables - Assist injured firefighters with weight restrictions on small equipment repair.

Laptops and Tablets - Assist firefighters in mobile inventory, equipment testing, and public outreach activities.

Bar Code Printers and Scanning Guns - Assist in inventory functions for tools and equipment.

Equipment purchased must have a writtenrationale for reimbursement and be reasonably used to accommodate an injured worker’s needs. Equipment may require pre-approval from the Stay at Work program to receive funding.

COMMAND SUPPORTAssist command by driving, perform accountability functions and planning activities on scene.

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TRAINING DIVISION SUPPORTParticipate in training and education support tasks, such as teaching classes, setting up training evolutions, and building props.

“Though light duty is beneficial, it has to be worthwhile for the employee.” - Bill Dicken, Central Pierce Fire and Rescue

DEFINE PROGRAM SUCCESSDevelop an Early Return to Work Packet for your Department:

Put a return to work program package together and cover the steps of what to do if a firefighter is injured on the job (see back page of guide for sample document links).

Departments should develop a Standard Operating Procedure (SOP) or a Standard Operating Guideline (SOG) that outlines light duty job descriptions, forms, and require-ments for return to work, such as a re-entry program.

Most importantly, train your staff about the program, so if a firefighter is injured, everyone knows their role in getting the firefighter back to work as safely and quickly as possible. Make early return to work have a positive impact on your department. Actively look for buy-in and suggestions for the program from your firefighters.

Labor Contracts: Departments should make sure any light duty provisions agree with negotiated labor contracts. For a Stay at Work program to be successful it needs support from all parties involved.

Have a well-defined, fair and consistent process of re-integrating firefighters to full duty.

Reduced Costs: Departments need to “do the math” and see the actual costs of firefighters being off work and the associated Worker’s Compensation rate increases, staffing overtime rates increases, and retraining costs compared to light duty costs. Stay at Work reim-bursements for light duty wages are added incentives and can be weighed in the equa-tion.

ULTIMATELY, SUCCESS IS SAFELY AND QUICKLY GETTING

FIREFIGHTERS BACK TO FULL DUTY!

4.

2. ACTIVITY PRESCRIPTION FORM (F242-385-000) - This standard medical provider form allows a worker to return to work after an injury. May include mandatory time off, weight and motion restrictions, or release to full duty.

3. EMPLOYERS JOB DESCRIPTION AND RELEASE FORM- LIGHT DUTY (WFC 252-040-000-LD). OPTIONAL: JOB ANALYSIS - LIGHT DUTY (WFC 252-072-000-LD) This form is a summary of Light Duty tasks firefighter will perform. The WFC version can also serve as an Employee offer and acceptance of Light Duty Work. This form may be used as by the health care provider to release a firefighter for light duty for day or 24 shifts.

4. STAY AT WORK WAGE REIMBURSEMENT APPLICATION FOR EMPLOYERS (F243-001-000): Fire Departments must also include: • Timecards and Payroll Stubs • Activity Prescription Form • Employer Description of Job Full Duty Form WFC 252-040-000-FD. • Employer Description of Job and Light Duty Job Offer Form WFC 252-040-000-LD.

5. STAY AT WORK EXPENSE FORM (F243-003-000): Form used to request reimbursement of up to $2500 per injured worker for equipment used for light duty modifications. Must be submitted with : • Receipt for Equipment Purchased • Brief Rational of Purchase for Injured Worker

ADDITIONAL INCENTIVES

WITH L&I’S STAY AT WORK

PROGRAM

Financial Incentives: On top of reduced workman’s comp rates, L&I’s Stay at Work Program provides wage and ex-pense reimbursements for light duty jobs.

Wages: For up to 66 days in which work was performed, 50% of wages paid, up to $10,000, may be reimbursed for light duty work. Fire Departments have up to 12 months from the date that their employee was prescribed light duty to apply for reimbursement for wages.

Expenses: Up to $2500 per injured worker for equipment used for light duty modifications may be reimbursed to Departments up to 12 months from date of purchase.

Training: Up to $1000 for tuition, books, training, and materials to recoverying firefighters in the Stay at Work program.

REQUIRED FORMS FOR STAY AT WORK FUNDING

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1. ACCESS THE PROGRAM ONLINE - Use your existing Secure Access Washington account and log in through the My L&I Portal. At your ‘Dashboard’ screen, choose Request Light Duty Wage Reimbursement to start the process and follow up on dollars requested and received.

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Firefighter promptly reports injury to Chief, officer or human resource department to start the return to work process.

L&I or self insurance claim is generated and accident report form is filled out using lni.wa.gov/filefast or by department policy. A claim number is usually generated.

Chief or Officer sends firefighter to health care provider with a return to work package.

This usually includes the department’s SOG or SOP with return to work instructions, Job Analysis and Job Description forms for both Full and Light Duty.

After examination, the Health Care Provider signs an Activity Prescription Form for:

A) Release for full duty based on the Full Duty Job Description Form.

B) Release for Light duty on Light Duty Job Description form.

C) Injured firefighter is not released for any work at the time.

Physical and occupational therapists work with occupational athletes to ensure they will be able to perform the job essential functions as presented in the Full Duty Job Analysis.

Along with physical and occupational therapy, firefighters may need a work hardening or conditioning program to get them fit for duty.

Firefighter is offered a light duty position which must be approved by his or her Health Care Provider on the Light Duty Job Description Form or by letter.

The Stay at Work Program may reimburse departments for up to 50% of light duty wages paid for up to 66 days ($10,000 maximum).

Chief or Officer monitors recovery and light duty plan for injured firefighter.

After a period of recovery time, firefighter is reassessed by Health Care Provider and the assessment in step 3 is repeated.

If cleared to return to work, Firefighter is released on Full Duty Job Description Form.

PHYSICAL THERAPISTS AND OCCUPATIONAL

THERAPISTSROLE

If injury caused an extended absence, Training Officer has firefighter complete re-entry program and verifies full duty readiness.

The program is designed to make the transition back to full duty and reduce skill degradation.

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Human Resources Manager makes an application for reimbursement from the Stay at Work Program and other expenses that may also be reimbursed.

Vocational Rehabilitation Counselor serves as a Liaison between the Fire Department, Medical Providers and Labor and Industries to help injured workers identify essential skills and related jobs.

Labor and Industries Claim Manager facilitates payment to health care professionals for services to injured worker.

AFTER THE INJURY: STEPS TO RETURN

OTHER RETURN TO WORK

CONTRIBUTERS

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FIREFIGHTER IS RETURNED

TO FULL DUTY!

Washington State Fire Chiefs www.washingtonfirechiefs.comWayne Senter, Executive Director

Return to Work Tool KitUse the links and forms below to build your department’s custom return to work program at www.washingtonfirechiefs.com/Resources/TimelossResources.aspx

Pro-Active Links Sample Return to Work ProgramWellness Initiative

Return to Work FormsReport of Accident Formhttp://www.lni.wa.gov/ORLI/ECS/FileFast.aspActivity Prescription FormLight Duty Job Analysis FormLight Duty Job Description Offer of Light Duty FormFull Duty Job Analysis FormFull Duty Job Description and Release Form

L&I Stay at Work Formslni.wa.gov/Main/StayAtWork/ApplicationApplication for Reimbursement of WagesApplication for Reimbursement of Expenses

Stakeholders and Project ProfessionalsSteve Haskey OTRL, Peoples Injury Network Northwest Barbara Berndt M.Ed, CRC, CDMS, CCM, D-ABVE, Industrial Rehabilitation ConsultantsKris Alberti, CEO Forum Consulting Karmen Schuemann, Forum Consulting, Technical Support Mary E Stevens, HR, South King Fire & Rescue Chief Harold D Scoggins, City of Seattle Fire DepartmentAndrew Schaffron, President WSFFADennis Lawson, President WSCFFJoyce Allen, Return-to-Work Outreach Specialist, Department of Labor & IndustriesKathleen Harmon, WFC, Return to Work Grant Coordinator Jessi Souza, WFC General SupportJim Jacques and Doug Walker, East Pierce Fire and RescueJake Friesen, Forum Consulting

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects.