The workers’ compensation program that compensates employees injured at the workplace as well as those that have acquired work-related illnesses on the basis of a medical chart review is built on mutual responsibility. The employer and the insurer are responsible for paying the due benefits as quickly as possible so that the worker can get the required medical treatment. The employee has the responsibility of returning to work at the earliest. An injured or sick worker means lost productivity, and it can be challenging for the employer if he/she stays out longer than necessary. This is why employers must constantly appraise their programs and remove any barriers that discourage productive employment and return to work.
The employer has a dual responsibility. They have to be compassionate and show that they care for the worker at a difficult point in his/her life. At the same time, they have to keep the business running efficiently and make sure that the injured employee gets back to work as soon as possible. It is important to note that each worker is unique and what works for one employee may not work for another.
Here are some effective steps to follow to ensure a successful return-to-work program for employees.
- Identify disincentives if any, and remove them: Make sure that out-of-work employees do not receive more income and benefits than they receive while working via a particular program design. Disincentives could be:
- Open-ended job return: It is not advisable to hold a job open indefinitely because the employee will have the wrong expectations. A worker could enjoy savings by staying home such as saving on commuting to and from the workplace, childcare, and other work-associated costs. Make sure that a specific time limit is set in compliance with the ADA, and the federal Family and Medical Leave Act as well as any state leave laws applicable.
- Disability benefits/unemployment compensation: Some employees can receive short-term disability (STD) instead of wages after 6 weeks or qualify for unemployment compensation. It is likely that the employee may be able to obtain both workers’ compensation and STD/unemployment benefits. Take this into consideration.
- Supplemental income and wage continuation programs: Supplemental programs pay extra wages to a worker on workers’ compensation, therefore the worker doesn’t lose any money. Wage continuation programs require the employer to pay 100% of salary instead of workers’ compensation for injuries of short duration. Since workers’ compensation is tax free, it translates to the worker often receiving more than 100% of pre-injury earnings.
- Pension and retirement plans: Plans that don’t allow for offset of workers’ compensation benefits could allow a worker to receive workers’ comp benefits as well as a full pension. In such an instance, an injured worker may decide it is more beneficial to receive permanent, partial or full disability.
- Vacation and sick time: It is important to make sure that employees’ vacation or sick time doesn’t accrue when they are on workers’ compensation because it will enable the injured worker to stay away from work for a longer period of time.
- Implement a proactive return-to-work program: An employee who remains out of work for more than 12 weeks following a job-related injury has less than 50% chance of ever returning to work, studies show. Additionally, getting workers back to work will reduce the overall claim cost associated with the incident because the major chunk of workers’ comp costs is payment for lost wages or indemnity. This necessitates the creation of a formal return-to-work program that adopts a systematic approach to the process of reintegrating employees into the workforce. When implementing a good return-to-work program, employers and the claims management team can consider the following things:
- The benefits the injured worker is receiving by not working, and whether those are excessive.
- The goals of the program including successful return-to-work after an injury.
- The opportunities to make improvement involving the worker in return-to-work and the transitional duty process.
- Ensure good communication and set expectations: Make sure that you set the expectations of employees prior to a work-related injury. They should have a clear idea about safety and injury prevention, policies and procedures related to reporting an injury, and also information about post-injury care, and return-to-work best practices. It is best that there are written policies and procedures elaborating the program limits. Employee brochure and wallet card containing contact and how-to information are great user-friendly options. Communication is paramount at all phases of the return-to-work program. Reinforce the message that the injured employees are valuable assets to the organization and they are wanted back in the workforce. Maintain constant dialogue with the injured worker from the time the medical absence starts until after he/she has returned to normal job duties. Regular meetings can be scheduled with HR or counsellors to ensure that the worker feels that his or her requirements are being adequately addressed.
- Enable a smooth transition, with suitable adjustments: This should be done in such a manner that the worker feels cared for physically, mentally, and emotionally. A smart injury/illness management policy will promote faster healing and recovery for the injured employee. Any modifications made should take into account the safety of the employee, how effectively they can function, and the financial investment involved. Take the following steps:
- Evaluate the physical requirements of each job available at the company and develop a transitional-duty work description for each position.
- Restate your policy when an injury occurs, and request the employee to review the full policy documents as a reminder and also for compliance.
- Make sure to discuss with the injured employee transitional-duty jobs that can accommodate their medical restrictions.
- Inform the worker that the transitional duty job requirements will change as he/she recovers, and the treating physician reduces work limitations.
Employers can consider making the following workplace adjustments:
- Provide training or retraining if necessary
- Implement a phased return to work
- Modify working hours/work patterns if practical
- Modifications to work equipment
- Excuse absences for doctor’s visits/treatment/rehabilitation
- Consider privacy and HIPAA requirements: HIPAA becomes applicable any time an employee falls sick or gets injured at the workplace. HIPAA could become a challenge when an employee is returning to work when he/she is still handling the remaining effects of a medical event. Take the case of a worker who is recovering from a painful injury and has returned to work where he may be required to operate heavy machinery. The worker may be on opiates or other such pain medication, which makes it risky for him to do the work. The employer cannot discuss what medication the employee is on, unless he willingly discloses the information. The best way to handle such situations is by hiring a mediator who can coordinate between insurer, healthcare providers, employee, and your organization. This ensures adequate protection for all parties involved.
A good return-to-work program can boost employees’ self-esteem, and encourage them to do their duties with minimal disruption. Other benefits include:
- Minimize fraudulent claims
- Save costs in terms of training and recruiting extra employees
- Speed up the healing process for the injured employee
- Promote good morale throughout the company
- Enable the worker to mentally and physically become accustomed to the work schedule
- Reduce negative financial impact brought about by an injury or illness at the workplace.
Even with the best measures in place, claims may arise. In situations in which the employee seems to be extending the disability or develops conditions that were not presented at the time of injury, employers must be prepared to fight claims. In such cases, investigations, medical examinations, documentation, and medical chart review may become necessary. Employers can minimize workers’ comp claims by ensuring that their return-to-work program is used for all injured workers justly, irrespective of the injury or the medical services provided. Focus on getting the employee back to work at the earliest possible; this can be achieved with robust policies and by identifying suitable transitional duty opportunities.