Office of Risk Management Annual Conference TRANSITIONAL DUTY EMPLOYMENT A RETURN-TO-WORK CONCEPT...

Office of Risk Management Annual Conference

TRANSITIONAL DUTY EMPLOYMENTTRANSITIONAL DUTY EMPLOYMENT

A RETURN-TO-WORK CONCEPT FORA RETURN-TO-WORK CONCEPT FOR

WORKERS’ COMPENSATION COSTWORKERS’ COMPENSATION COST

CONTAINMENTCONTAINMENT


Transitional Duty EmploymentTransitional Duty Employment

A process that facilitates returning injured A process that facilitates returning injured

employees back into the workforce in a employees back into the workforce in a safe safe

and timely manner after a work-related and timely manner after a work-related injury.injury.



Injured employees are returned to workInjured employees are returned to work

to perform meaningful, productive work to perform meaningful, productive work andand

within safe parameters of his or her within safe parameters of his or her physical capabilities.physical capabilities.


Goal of Transitional Duty EmploymentGoal of Transitional Duty Employment

TemporaryTemporary transitional employment transitional employment options options

that fit the injured employee’s specific that fit the injured employee’s specific

capabilities.capabilities.


Objectives of Transitional Duty Objectives of Transitional Duty EmploymentEmployment

Manage workplace injuries.Manage workplace injuries. TemporarilyTemporarily modify the employee’s position or modify the employee’s position or

job description to accommodate physical job description to accommodate physical restrictions identified by the treating physician.restrictions identified by the treating physician.

Reduce workers’ compensation costs.Reduce workers’ compensation costs. Make workers’ compensation more effective.Make workers’ compensation more effective.


State of LouisianaState of Louisiana

Approximately 89,000 employees. Approximately 89,000 employees. 4400 active workers’ compensation claims.4400 active workers’ compensation claims. 960 of these paid compensation benefits on 960 of these paid compensation benefits on

regular basis. regular basis.

$55 mil spent on workers’ compensation. $55 mil spent on workers’ compensation. Money comes directly from agency budgets. Money comes directly from agency budgets.


State of LouisianaState of LouisianaPrior to 1999Prior to 1999

Injured workers cannot return to work unless they can Injured workers cannot return to work unless they can perform full duty. perform full duty.

Civil Service won’t allow injured workers to return to Civil Service won’t allow injured workers to return to work unless they are at 100% full duty.work unless they are at 100% full duty.



ORM had to get legislative authority just to ORM had to get legislative authority just to write write

a policy on return to work.a policy on return to work.



To make the legislative argument, ORM first worked a pilot program To make the legislative argument, ORM first worked a pilot program

of Transitional Duty Employment at Pinecrest Developmental of Transitional Duty Employment at Pinecrest Developmental Center.Center.

A vocational rehabilitation counselorA vocational rehabilitation counselor h helped Pinecrest develop elped Pinecrest develop

transitional duty policy. transitional duty policy.

The pilot was worked for one year.The pilot was worked for one year.



Pinecrest was selected for the pilot program Pinecrest was selected for the pilot program because:because:

They had the highest volume of workers’ They had the highest volume of workers’

compensation lost time claims. compensation lost time claims. They had the highest workers’ compensation They had the highest workers’ compensation

premiums. premiums.



Before the pilot program…Before the pilot program…

Pinecrest employees had accepted the fact that Pinecrest employees had accepted the fact that they they

would not be allowed back to work.would not be allowed back to work.



After the pilot was worked, Pinecrest employees After the pilot was worked, Pinecrest employees were were

allowed to return to work, limited duty. allowed to return to work, limited duty.



In the first six (6) months of the In the first six (6) months of the transitionaltransitional

duty pilot, Pinecrest saw a duty pilot, Pinecrest saw a 15%15% reduction reduction of itsof its

monthly indemnity pay-out. monthly indemnity pay-out.



At the end of one year of the transitional duty pilot, At the end of one year of the transitional duty pilot,

Pinecrest saw a Pinecrest saw a 36%36% reduction of its indemnity reduction of its indemnity

pay-out.pay-out.


Statutory Authority for TDEStatutory Authority for TDE

R. S. 23:1547R. S. 23:1547

In 1999, the legislature passed In 1999, the legislature passed Senate bill 689 Senate bill 689 which giveswhich gives

ORM the authority to develop and administer a ORM the authority to develop and administer a transitionaltransitional

duty program for State employees.duty program for State employees.


Case Study Case Study

INJURED WORKERINJURED WORKER


Case StudyCase Study

Injured Worker got hurt on the job.Injured Worker got hurt on the job.

She received conservative treatment with She received conservative treatment with Dr. Mild for 2 months. Dr. Mild for 2 months.

Now Dr. Mild feels like Injured Worker can Now Dr. Mild feels like Injured Worker can do something.do something.

Dr. Mild releases Injured Worker to return to Dr. Mild releases Injured Worker to return to work except… she can’t lift over 25 pounds.work except… she can’t lift over 25 pounds.



Injured WorkerInjured Worker is so happy she can go back to is so happy she can go back to

work.work.



Injured Worker’s supervisor does not allow Injured Worker’s supervisor does not allow her to return to work because she is not her to return to work because she is not

released to return to work full duty.released to return to work full duty.



Injured WorkerInjured Worker just doesn’t know what to just doesn’t know what to do…do…



Injured Worker gives the bad news to her Injured Worker gives the bad news to her adjuster: “Keep sending me my checks!” adjuster: “Keep sending me my checks!”

Develops renewed interest in: Develops renewed interest in:

Dr. PhilDr. Phil

The Biggest LoserThe Biggest Loser

Casino GamingCasino Gaming



Because Injured Worker is not allowed to work, Because Injured Worker is not allowed to work, restricted duty --restricted duty --

Compensation benefits continue to be paid.Compensation benefits continue to be paid.



Injured Worker’s doctor doesn’t see what Injured Worker’s doctor doesn’t see what the big deal is. the big deal is.

As her doctor, he knows Injured Worker As her doctor, he knows Injured Worker can work.can work.



Injured Worker doesn’t see what the big deal is Injured Worker doesn’t see what the big deal is either,either,

she knows she can work.she knows she can work.

She can do everything her job requires her to do She can do everything her job requires her to do except the lifting.except the lifting.



Sadly enough, Injured Worker’s supervisor Sadly enough, Injured Worker’s supervisor doesn’t doesn’t

see what the big deal is, either.see what the big deal is, either.

After all, Injured Worker is being paid workers’ After all, Injured Worker is being paid workers’

comp benefits anyway, rightcomp benefits anyway, right??

What’s the big deal?!What’s the big deal?!


Case StudyCase StudyThe big deal is: The big deal is:

Workers’ compensation benefits continue until the Workers’ compensation benefits continue until the injured worker returns to work, injured worker returns to work, oror

The injured worker is released to return to work The injured worker is released to return to work regular duties by a treating physician.regular duties by a treating physician.


THE ECONOMICS THE ECONOMICS

OF OF

RETURN TO WORKRETURN TO WORK


The Economics of Return to WorkThe Economics of Return to Work

A claim for a health care worker who hurts her back lifting A claim for a health care worker who hurts her back lifting a a

patient will cost the employer patient will cost the employer $5,150 $5,150 with a return to with a return to work work

program.program.

Without a return to work program the same claim will cost Without a return to work program the same claim will cost

$29,250$29,250..

This is a This is a 72%72% difference. difference.



If Injured Worker is unable to return to her previous work earning the If Injured Worker is unable to return to her previous work earning the same wages orsame wages or

If she is unable to earn 90% or greater of her pre-injury wage...If she is unable to earn 90% or greater of her pre-injury wage...

R. S. 23:1226 requires Injured Worker’s employer to provide rehabilitative R. S. 23:1226 requires Injured Worker’s employer to provide rehabilitative services: services:

Job placement RetrainingJob placement Retraining



Rehabilitation of injured workers Rehabilitation of injured workers automatically adds $5,000 - $7,500 to automatically adds $5,000 - $7,500 to

value of a claim.value of a claim.

Benefits continue to be paid during the Benefits continue to be paid during the rehabilitation process.rehabilitation process.



At the end of the rehabilitation process, if the At the end of the rehabilitation process, if the

injured worker is unable to earn wages equal injured worker is unable to earn wages equal

to 90% or greater of pre-injury wage, she is to 90% or greater of pre-injury wage, she is

entitled to supplemental earnings benefits or entitled to supplemental earnings benefits or

SEB.SEB.



SEB is based on 66 2/3 of the difference SEB is based on 66 2/3 of the difference between: between:

the pre-injury wage andthe pre-injury wage and

what the employee is now capable of what the employee is now capable of earning.earning.



While this reduces benefits, benefits are still While this reduces benefits, benefits are still being being

paid.paid.



As long as an injured worker is off work, As long as an injured worker is off work, indemnity andindemnity and

medical benefits continue to be paid.medical benefits continue to be paid.

These affect premiums.These affect premiums.



If the claim is settled, another $30,000 – If the claim is settled, another $30,000 – $50,000 $50,000

is added to value of the claim.is added to value of the claim.



If a claim is settled, in most cases, If a claim is settled, in most cases, consideration consideration

must now to be given to a must now to be given to a Medicare Set Medicare Set Aside Aside

which will significantly increase the settlement which will significantly increase the settlement

amount. amount.



The only way to stop indemnity payments The only way to stop indemnity payments altogether …altogether …



Return injured workers to work with the Return injured workers to work with the employeremployer

of injury on transitional duty.of injury on transitional duty.


BENEFITS OF RETURN TO BENEFITS OF RETURN TO WORKWORK

To the EmployerTo the Employer


Benefits of Return to WorkBenefits of Return to Work

Keep workers’ compensation costs down.Keep workers’ compensation costs down.

Productivity increases and human resources Productivity increases and human resources are used to the maximum extent.are used to the maximum extent.

Manage impact of workers’ compensation Manage impact of workers’ compensation claims on premiums.claims on premiums.

Reduce the fiscal impact of workplace Reduce the fiscal impact of workplace absences.absences.



Wage costs for substitute employees Wage costs for substitute employees are saved.are saved.

Work delays and business interruption Work delays and business interruption are eliminated when an experienced are eliminated when an experienced employee returns to work.employee returns to work.

Creates goodwill and positive image Creates goodwill and positive image with the public and employees.with the public and employees.



When an injured worker is sitting home When an injured worker is sitting home watching watching Dr. Phil …Dr. Phil …



A commercial comes on that says: “Have A commercial comes on that says: “Have you been hurt on the job? Call me, I’m a you been hurt on the job? Call me, I’m a

lawyer, I can help. I can get you top $$ for lawyer, I can help. I can get you top $$ for your claim.” your claim.”



This is how he does it and employers help This is how he does it and employers help the injured worker’s attorney by not the injured worker’s attorney by not

returning injured workers back to work returning injured workers back to work light duty.light duty.



Transitional Duty Transitional Duty

Light Duty Light Duty

Restricted DutyRestricted Duty

Modified Duty Modified Duty

Temporary Assignment of Duties.Temporary Assignment of Duties.



Whatever you call it, justWhatever you call it, just get ‘em back to get ‘em back to work!work!



Transitional Duty Employment is an absolute Transitional Duty Employment is an absolute must must

for keeping workers’ compensation costs down.for keeping workers’ compensation costs down.


Think About It Think About It

Would you like for your employee to sit Would you like for your employee to sit here?here?


Think About ItThink About It

Or here?Or here?



When an employee is sitting home When an employee is sitting home collecting a comp check -collecting a comp check -



The work piles up!!!The work piles up!!!

Somebody’s gotta do it or it doesn’t get done.Somebody’s gotta do it or it doesn’t get done.



To the Employee….To the Employee….



Return to work is an employee benefit.Return to work is an employee benefit.

Employees see workplace involvement in their Employees see workplace involvement in their recovery as an indication that the employer recovery as an indication that the employer cares about their well-being and wants to get cares about their well-being and wants to get them back to work.them back to work.

Transitional Duty speeds up recovery time and Transitional Duty speeds up recovery time and helps to boost the employee’s self-esteem. helps to boost the employee’s self-esteem.



Injured workers receive their regular pay instead Injured workers receive their regular pay instead of 2/3% of average weekly wage.of 2/3% of average weekly wage.

Return to work programs help reduce depression Return to work programs help reduce depression and alleviate emotional stress.and alleviate emotional stress.

Maintain physical conditioning through work life Maintain physical conditioning through work life discipline.discipline.

Most employees want to be a part of the Most employees want to be a part of the productivity of the company they work for.productivity of the company they work for.


Successful TransitionalSuccessful Transitional DutyDuty



Focus on what the injured worker Focus on what the injured worker CANCAN do. do.



Do not focus on what the injured worker Do not focus on what the injured worker cannot do. cannot do.



Transitional Duty Employment doesn’t Transitional Duty Employment doesn’t have to be nicest, coolest, best job you have to be nicest, coolest, best job you

have to offer.have to offer.



Create a return to work policy.Create a return to work policy. Announce the policy.Announce the policy. Sell the policy as an employee benefit.Sell the policy as an employee benefit. Include policy in personnel manuals and new Include policy in personnel manuals and new

employee orientation.employee orientation. Make policy accessible to employees through Make policy accessible to employees through

newsletters, etc.newsletters, etc.



Designate one person to manage the Designate one person to manage the program.program.

Injured employees need to know that someone is Injured employees need to know that someone is in charge of return to work at the employer.in charge of return to work at the employer.

Give the return to work coordinator the Give the return to work coordinator the appropriate authority to administer job duties.appropriate authority to administer job duties.



Adopt an Empathy Program.Adopt an Empathy Program.

Frequent contact with the injured worker helps to Frequent contact with the injured worker helps to facilitate early return to work.facilitate early return to work.

Contact them within 24 hours and once weekly.Contact them within 24 hours and once weekly.

Assure employees they are missed and explain their Assure employees they are missed and explain their benefits so they will know they will be taken care of.benefits so they will know they will be taken care of.

These courtesies promote rapid return to work and These courtesies promote rapid return to work and countercounter

negative feelings.negative feelings.



Establish a guaranteed transitional duty Establish a guaranteed transitional duty period.period.

Guarantee transitional duty for a set period of Guarantee transitional duty for a set period of time.time.

Alter length of time to conform to average Alter length of time to conform to average diagnostic recovery time.diagnostic recovery time.



Establish a guaranteed transitional duty Establish a guaranteed transitional duty period.period.

The job should be open and available when the The job should be open and available when the injured injured employee employee returns to work.returns to work.

Make sure ADA and FMLA guidelines are met if Make sure ADA and FMLA guidelines are met if the injured employee is unable to return to the injured employee is unable to return to work.work.



Stipulate the goals of the transitional duty.Stipulate the goals of the transitional duty.

Transitional duty should have agreed upon Transitional duty should have agreed upon therapeutic goals.therapeutic goals.

Treating physician can help define the Treating physician can help define the employee’s abilities to make sure tasks are employee’s abilities to make sure tasks are meaningful and promote recovery.meaningful and promote recovery.



Stipulate the goals of the transitional duty.Stipulate the goals of the transitional duty.

Both the employer and the employee must Both the employer and the employee must adhere to any physical restrictions.adhere to any physical restrictions.

The return to work program is an employee The return to work program is an employee benefit, a privilege. Employees are expected to benefit, a privilege. Employees are expected to be productive. be productive.



Evaluate and Improve the program.Evaluate and Improve the program.

Open discussion with employee, supervisor, Open discussion with employee, supervisor, physician when an employee returns to full duty.physician when an employee returns to full duty.

Find out how well the program worked.Find out how well the program worked.

Feedback on ways to improve the program.Feedback on ways to improve the program.

Ensure executive management has a “buy in” to Ensure executive management has a “buy in” to return to work. return to work.


Transitional Duty WorksTransitional Duty Works

Effective in both public and private sector. Effective in both public and private sector. Nationally, there is an 18% decrease in Nationally, there is an 18% decrease in

disability costs.disability costs. 23% effective for ORM. 23% effective for ORM. Keep productivity and employee moral up.Keep productivity and employee moral up.


Transitional Duty WorksTransitional Duty Works

Transitional Duty Employment is Transitional Duty Employment is economical.economical.

Injured workers are returned to a Injured workers are returned to a productive lifestyle.productive lifestyle.

Return-to-work makes good business Return-to-work makes good business sense.sense.

IT’S A WIN – WIN SITUATION. IT’S A WIN – WIN SITUATION.


What Does the Claims Person Do?What Does the Claims Person Do?



Before the treating physician is ready to release Before the treating physician is ready to release the the

injured worker to return to work, obtain a copy of injured worker to return to work, obtain a copy of the the

job description to present to the treating job description to present to the treating physician.physician.



If the job of injury falls within the restrictions If the job of injury falls within the restrictions thethe

treating physician is ready to release the treating physician is ready to release the injuredinjured

worker, benefits can be stopped.worker, benefits can be stopped.



If the treating physician still places restrictions If the treating physician still places restrictions

on the injured worker once he has reviewed on the injured worker once he has reviewed thethe

job description, job description, The adjuster will contact the employer. The adjuster will contact the employer. Determine if accommodations can be made Determine if accommodations can be made

to the injured worker’s current position? to the injured worker’s current position?



If accommodations can be made to the If accommodations can be made to the injured injured

worker’s current positionworker’s current position

Benefits stop. Benefits stop.



If the treating physician If the treating physician will notwill not release the release the

injured worker to return to work, restricted duty injured worker to return to work, restricted duty

to their job of injury but theto their job of injury but the

Injured worker can return to work, other Injured worker can return to work, other

employment, employment,

Vocational rehabilitation services will be Vocational rehabilitation services will be initiated. initiated.



Calculate what 90% of the injured worker’s Calculate what 90% of the injured worker’s pre-injury wage will be.pre-injury wage will be.

Advise counselor to only identify those jobs Advise counselor to only identify those jobs that will place injured worker within 90% of that will place injured worker within 90% of pre-injury wage. pre-injury wage.


The Object of Vocational RehabilitationThe Object of Vocational Rehabilitation

Assist the injured worker in returning to the same Assist the injured worker in returning to the same position;position;

Assist the injured worker in returning to modified Assist the injured worker in returning to modified position with his current employer;position with his current employer;

Assist the injured worker in returning to a related Assist the injured worker in returning to a related occupation with another employer in the same field occupation with another employer in the same field

or if necessary, on–the-job training.or if necessary, on–the-job training.


The Object of Vocational RehabilitationThe Object of Vocational Rehabilitation

Vocational Rehabilitation should Vocational Rehabilitation should

return the injured worker to work with a return the injured worker to work with a minimum of retraining, minimum of retraining,

as soon as possible after the injury occurs. as soon as possible after the injury occurs.

Transitional Duty Employment is how this is Transitional Duty Employment is how this is done.done.


QuestionsQuestions

Are there any questions?Are there any questions?


ReferencesReferences

www.sorm.state.tx.uswww.sorm.state.tx.us

www.returnetoworkmt.com

Treating the Whole Elephant: A Treating the Whole Elephant: A Holistic Approach to Reducing Workers’ Holistic Approach to Reducing Workers’ Compensation Costs by Rebecca Compensation Costs by Rebecca ShaferShafer

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