The workers' comp budget and how it is eating into your profits.

Your workers’ compensation budget if you have one, has a better chance of going up than of you winning the lottery. So now what, if in the past you supported efforts to better manage workers' comp claims by segmenting the program, developing permanent light duty/transitional duty departments or jobs, and assigning those expenses to a workers' comp budget?  While these efforts should be applauded, they may have left the organization with bigger issues. But it's never too late to change.

It is probably clear that workers' comp expenses continue to rise despite your efforts. That is because segmenting the workers' comp program rather than integrating it company-wide only leads to:

• A delay in getting injured workers back to full duty
• The need for replacement workers
• The conversion of caring managers into apathetic ones. 

If you are one of those apathetic managers, I understand why. It is not a criticism, merely a fact and the result of a program that supports this conversion. Let's face it. No one really wants to deal with workers' comp.

See, if you're like most managers, once you have an injury claim, and your worker goes off to the transitional duty department or job, and the expenses related to that injury are assigned to the workers' comp budget, you think - why should I stay involved when my primary responsibility is production? 

Let's see why washing your hands of your workers' comp claim only leads to problems further down the line for you, and why you should support keeping the expenses (and the recovering employee) in your home department.

1. Most injured employees fully recover within three weeks. Important to their recovery is maintaining social and work relationships and routines. As it is human nature to feel rejected, suspicious, saddened, and even guilty once we become isolated, it is easy for us to look to other people or groups to replace those we have 'lost'. Comrades are important to self-worth and recovery. Work injury lawyers and sometimes grumbling new co-workers are not. If you have more than one injured worker at any one time, you may not want to have them all working together. Invariably stories will be shared, and you don't want the 'but my lawyer said' stories or an entitlement culture to develop.

2. There is a valid reason to attach workers’ compensation expenses to an injured/ill worker’s home department - compliance. Managers are more likely to adhere to workers’ compensation policies and procedures (completing required paperwork on time, facilitating medical evaluations, complying with Transitional Duty, keeping in touch with injured/ill workers) if they know that any workers’ compensation expenses due to their employees will be assigned to their budget. However, managers should be diligent in emails and in reports that legitimate and even fraudulent claims' expenses should not be held against them as they are complying with and promoting management policies. 

A manager may have a severely injured worker with legitimate lost time, or an uncooperative employee. A footnote or attached document to financial and monthly reports can help to explain the reasons behind the numbers and what the manager is doing to bring them down or to control the claim. (Of note: these are the cases for which you should conduct a Transitional Duty meeting to evaluate and direct the claim. (See post dated August 12, 2012.)

3. An annual increase in an employers' overall workers’ compensation expenses (both direct and indirect) negatively affects the bottom line - that last final number that allows executives to provide annual bonuses and competitive benefits, replace worn or outdated equipment, and expand the workforce. By working together as a team, hands-on managers and their responses to injuries and illnesses, are key to keeping workers' comp expenses under control.

4. Lastly, eliminating the workers’ compensation budget also helps executive leadership to evaluate their management staff. How are the individual departments doing for safety? Is there a particular area within the organization with a higher than average number of injuries and illnesses? Perhaps there are real safety issues or employee relations problems in these areas that require intervention. 

Do You Have Light Duty/Transitional Duty Departments? If So Read On.

I've spoken a lot on Transitional Duty and why it is crucial to your loss control efforts. That's because Transitional Duty benefits everyone:

• Employers managing expenses
• Managers and supervisors responsible for production
• Injured or ill workers who are recovering

However, Light Duty or Transitional Duty 'Departments' are much less effective than a company-wide policy of having transitional duty take place in the home department. For both the worker and his or her manager, the 'out of sight out of mind' Light Duty Department leads to an apathy with the workers' compensation program, which leads to an overall increase in workers' compensation expenses. Why is this so?

1. Once injured or ill workers leave their home departments, there is little incentive for them to return to full duty. When employees are removed from their social circles within an organization, they quickly feel disconnected, and may even feel guilty for 'abandoning' their colleagues, thus avoiding them altogether. And as light duty departments are usually minimally supervised, they can easily become forgotten holding tanks, and a haven for those looking for some ‘time off’ when there is friction between a worker and his or her manager or supervisor. 

2. Managers and supervisors, intentionally or unintentionally, do lose touch with their employees and frequently look to replace them as soon as possible. They are responsible for production or service and employee absences negatively affect outcome. And, same as for the disgruntled employee, managers will have little incentive for facilitating someone’s return to full duty when that injured or ill worker is a problem employee.

3. Managers who do not have to worry about replacement costs affecting their budgets usually do not care what happens with a workers' comp claim once they wash their hands of it. They replace the injured or ill worker, and someone else worries about the cost of the workers' compensation claim. I will speak more on this in my next entry, which covers another area ripe for clean-up – the workers’ compensation budget - never a good idea even if you are the manager.

So, what to do when you have a 'Light Duty Department'? Like the light duty list, get rid of it. Check in soon for the budget discussion that goes along with keeping transitional duty in the home department.

p.s. I see I have readers (thank you for tuning in), but alas, no comments. Feel free to let me know if you agree, have questions about something I've suggested, or wish to share your own experience. I'd love to hear from you!

The Workers' Comp Doc

Summer has ended, kids are back to school, and we are all back to work in full swing. I expect this quarter brings more readers to my blog as workers' comp expenses are tallied for 2012, and the 'uh oh' factor kicks in. 

Loss control as a line of business is manageable, all you need is the right tools. As Charles Haanel (1916) reminds us, "You don't have to laboriously shove out the darkness, all you have to do is turn on the light." 

So, let's talk about the 'company doc'. This option for controlling workers' compensation expenses is an interesting one. But the question as to whether or not it is cost effective for you to employ an occupational health physician or use your local health care provider is not easy to answer. Lots of factors need consideration.

The size of your organization, the amount of funding you have, your pre-employment and mandatory testing needs, and the number of injuries and illnesses your organization experiences will all influence your decision.

Additionally, how responsive to your needs is your medical provider? For instance, how far away are they and how much time are employees taking when going there for evaluation? How efficient are they? Do they comply with return to work restrictions? Are follow-up appointments timely? Do they offer pre-employment and mandatory testing for your industry? If the answers to these questions are not satisfactory, then you may want to take the next step and contract with a physician to work with you on-site.

So, bottom line? If you have enough work for an on-site company doc, and your medical provider is less than satisfactory, you should think about hiring a physician. 

You will need to discuss with him or her as to the types of duties expected. These may include general oversight of your workers’ compensation program (policy and procedure), pre-employment physicals, health and safety exams specific to your industry (tuberculosis, hearing, pulmonary, etc.), evaluation and treatment of employee injuries and illnesses, follow-up to those injury and illnesses, return to work exams, and the substance abuse program if you have one. Also, your company doc should always evaluate any employee who is placed out of work by a medical provider off hours.

A quick note on substance abuse programs. They can be problematic and I advise that you have a third party provide this service. Having your company physician also be your Medical Review Officer (MRO), which a drug screening program requires, can create animosity and distrust of your physician in your employee base as well as put your company physician at risk, physical harm actually should a pre-employment candidate or one of your employees tests positive. 

There are national organizations that provide testing and MRO services whereby you or your medical provider become the collection site only. There are very rigid collection standards and many different methods and substances to test for. Please visit http://www.drugfreeworkplace.gov for more information. You will need to decide what you want to test for, and if you wish to conduct pre-employment testing only or random as well.

Okay, back to the company doc. There are several types of specialists you can choose from: physicians certified in occupational medicine, osteopathic physicians, orthopedic physicians, physiatrists, or chiropractors. Sometimes employers partner with generral medicine physicians such as internal medicine and family practice and/or nurse practitioners or physician assistants. Each specialty offers its own expertise, however each brings its own limitations as well.

Your first best choice is a physician certified in occupational medicine. You can find resources by going to http://www.acoem.org. The American College of Occupational and Environmental Medicine (ACOEM) represents more than 4,500 physicians and other health care professionals specializing in the field of occupational and environmental medicine. Certification requires specialized training in both injury and illness management as well as environmental conditions in the workplace.

The traditional specialties usually have some experience in occupational medicine, and can easily be advised of your policies and procedures and your needs as an organization. However, sometimes follow-up care can be longer, especially with chiropractors and orthopedic physicians. Many organizations have had success with physiatrists, who specialize in soft tissue problems. 

It may be wise to set up access to a second opinion resource. For example, you employ a physiatrist as your company physician, but have an orthopedist as backup. Both specialists must understand your organization, and can offer different skills for particular injuries and cover for one another during vacations. Regardless of the physician specialty, you have the option of hiring your on-site doc full or part time. 

You also have the option of contracting 'off-site' with hospital walk-ins (which are usually the slowest ), free standing clinics, or physician offices for your injuries and mandatory exam needs, however although this may be cheaper you lose control over availability as well as timeliness of appointments. 

If you do hire a company doc, you will have to provide a secured area where he or she can privately conduct business that has all the necessary equipment; including a sink, refrigerator, a dry storage area, and an exam table. It should also be somewhat close to a bathroom and near a reception/registration area, as you will have to provide some type of clerical support as well.

A word of caution: a company’s worker’s compensation ‘doc’ can be expensive and may be abused by employees who try to utilize him/her for other non-employment needs such as prescription filling and health checks. I have seen employers fall into the trap of running a primary care practice with their workers’ compensation dollars, while also paying for health insurance through their benefits program. Clear guidelines need to be communicated to both your employees and your company doc. 

A final thought: In some instances you will be required to facilitate an Independent Medical Exam (IME) for a workers' comp claim. An IME can be required by state mandate at any point during an employee’s recovery in order to provide a disinterested third party opinion of an employee’s ability to return to work, or whether the medical end point has been reached. 

Physicians who are also IMEs may or may not contract with an organization as a company doc. They are, most likely, not in your immediate geographic area. They are few and far between as they must be knowledgeable of specific disability guidelines. Your injured/ill worker may have to travel for an hour or more for the appointment, depending on your location.

So, good luck with all of that. If there is anything that you would like me to discuss, or if you have questions please let me know otherwise I will continue with what I believe are important to your workers' compensation loss control efforts. 

Working With Your Medical Provider

As promised, here is the installment on working with your occupational health medical provider. You want one who is sure to support your return to work program consistently.

Your company’s preferred medical provider(s) must understand return to work programs for your program to be effective. Someone with daily responsibilities in workers' compensation, needs to make prior arrangements with one or more to let them know of your Transitional Duty Program. There may be more than one medical provider in your location that is willing to work with you, so reach out to all of them to determine the best fit for you and your employees.

Most hospital systems and traditional ‘walk-ins’ have occupational health programs, however many of them merely accept workers’ compensation insurance, and/or provide health, wellness, and pre-placement screenings. Although they may provide very appropriate medical evaluation and treatment, they may not provide consistent return to work restrictions. 

They also may be inclined to give an employee ‘some time off’ (many times at the request of the injured or ill worker), not realizing that state requirements may limit the amount of money an injured/ill worker can receive. Many employees cannot survive on approximately 60% of their salary allowed by most workers’ compensation programs, and many programs have caps for high earners. Be sure to let the provider know what the rules are for your state. I can almost guarantee you that they will not know.

Your occupational health manager and nurse/coordinator should attend the meeting with each of the medical providers in your immediate location. You can do your own research or ask other employers in your area for recommendations. A drive of more than 20 minutes is probably too long, so you will want to stick to a provider as close to you as possible.

At the meeting, ask the provider’s liaison to explain their program, show you which forms you should expect to see from them, and if they issue return to work restrictions for all injured/ill workers. Minimally providers should give you a tour of their location and be open to tailoring their program as best they can to meet your needs.

When interviewing the health care provider, ask for statistics such as: 

• What percent of injured/ill workers are returned to work with no restrictions
• What percent are returned to work with restrictions
• What percent are placed out of work
• As a rule of thumb, your out of work orders should be no more than 10% of the total number of injuries/illnesses who received evaluation
• Wait times to evaluation
• Many providers will expedite injured/ill workers if you ask, and the provider can do so safely without harm to other waiting patients
• Average length of stay for non-critical care and treatment
• Important to know how long your employees are expected to be away from the work site (We found that following evaluation, some employees 'got lost' or went out to eat on their way back to the work site)
• Expectations for specific injuries
• What is typical for treatment and work restrictions for injuries easily accommodated in a transitional duty program, such as:
• Back strains
• Hand lacerations
• Repetitive motion symptoms (typing or machine induced rotations)

Be sure to advise the health care provider that you do indeed accommodate all types of injuries in your return to work program. Invite the health care provider to tour your facility to obtain a greater understanding of your industry and environment.

You should feel comfortable asking them to expedite evaluation and treatment for your injured/ill workers. The medical provider may or may not be able to accommodate on a daily basis, but may make every effort to comply when possible. Also ask for volume discounts should you expect to send workers regularly for evaluation or if you purchase other services such as drug testing or pre-employment physicals. 

What you want to establish is a working, reciprocal relationship with your medical provider so that if and when problems arise, you feel comfortable calling them to discuss.

If you find that the medical provider does not already provide work restrictions it may be difficult to get them to do so consistently as there are generally many physicians, physician assistants, and nurse practitioners working at any one facility. Gearing all of them up to your needs can be a huge undertaking. Move on to the next provider to see what they can offer.

Once you have selected a provider, be sure to educate all of your employees where they are located, times of operation, etc. Your medical provider should be able to provide you with a document for posting. Post the list for your supervisors and employees and regularly update them as needed. 

A couple of key points that will reduce employee anxiety and increase cooperation are that you have made arrangements up front for no long waits and that the provider is located no more than 20 minutes away from your facility.

Next week I will speak on the Workers' Comp Company Doc, pros and cons. 

Here is another install on Transitional Duty, being that it is the second most important element of an early return to work program and a major contributor to your loss control efforts. (The first you remember, is that injured or ill workers must report the incident prior to the end of their shift.) 

(C) nluz 7/2012

You may laugh at my cartoon (I hope you'll get at least a chuckle), but this actually occurred in one of my clinics. A pole dancer from a nearby club fell off her high heel. Our somewhat conservative doc was his usual professional self, and did come up with a reasonable 'light duty' assignment.

Research has proven that the longer workers stay out of work following an injury, the less likely they are to return to full duty. Pole dancers included. It takes approximately three weeks for a new routineto set in, and the longer injured/ill workers are immobile the longer it takes for them to recover, and the worse it is for the injury. The two best catalysts to a full recovery? Keeping up with normal routines and staying active within restrictions.

The manager/supervisor plays a major role in the development of Transitional Duty tasks, and is responsible to see that the injured/ill worker is adhering to the physical restrictions while at work, according to the physician’s documentation. It may seem difficult, but applying a common sense approach to the assignment of tasks is the best first step. There are three basic physician discharge instructions (work restrictions) following an injury. 

• Return to work with no restrictions
• Return to work with restrictions (job duties and/or number of hours)
• No work (for # days)

The first of course is easy. The employee receives return to work, no restrictions. However be sure to keep a copy of those discharge instructions in the employee’s file. It is best to show closure of an injury which can help determine if any future injuries are new or a recurrence of an old. Your workers' compensation carrier will want to know.

The second, return to work with restrictions, may be anything from reduced hours to reduced tasks; such as weight lifting limits, an elimination of one or more components of a job such as typing, driving, sitting/standing, or no wet work.

It is recommended that ‘functional’ job descriptions be developed for more complex or injury-prone jobs within an organization, and then eventually for all jobs. The following web site goes into detail on what a functional job description should include: 

http://askjan.org/media/JobDescriptions.html

For a sample Functional Job Description click here: http://www.workforcesafety.com/safety/sops/FunctionalJobDescription.pdf

From the medical provider's Work Ability/Work Restriction Instructions, the manager/supervisor then makes out the Transitional Duty assignment. Now, you may be thinking that this is a very complicated task, but it need not be. Look at the employee’s usual job duties and apply common sense to assigning restricted tasks. If you truly have questions, ask your medical provider to refer you to a physical therapist who can help you to modify job assignments. This will of course involve a charge.

It is very important to always adhere to the physical restrictions as established by the medical provider. If the home department cannot comply with the restrictions, do not send the injured/ill worker home! Make arrangements to have the injured/ill worker perform tasks in another department.

Consistency in accommodating ALL employees back to work on Transitional Duty is imperative for the success of the program.

Do not give employees the opportunity to believe that favoritism exists within your organization. The greatest challenge is in assigning tasks particularly when the program is new. Again, the common sense approach works every time. If your employee normally spends the day on a typewriter and provides you with ‘no typing’ as a work restriction, then look at other tasks that employee could perform. Filing, mail delivery, review of policy and procedure for needed revisions, answering the phone, are all tasks that may be perfectly safe for the employee to perform. 

Also look consider job sharing with another department while the employee is recovering. Every department has a wish-list of tasks that never seem to get done. Transitional Duty often provides a way to get those can’t-get-to tasks accomplished! However beware the light duty department trap. This is generally how organizations fall into the permanent light duty black hole.

For those companies that have very task specific workers such as cable companies or construction, determining Transitional Duty tasks pose more of a challenge. But you can bring the injured/ill worker into the office to assist other staff with customer mailing activities, or assign quality and safety monitoring at a work site. You may want to consider volunteer work as well, as an option for a transitional duty assignment when work restrictions are particularly challenging.

Be creative to always keep the injured/ill worker working. And always stay in touch as to how the employee is tolerating the new assignment or tasks, regardless if you consider the employee to be a problem, or if you feel guilty about the situation, or if you think asking questions is being nosy. Making excuses is easy and I've been tempted myself. But open communication shows that you care about that person, as a person. 

The third discharge instruction, no work, should be rare and only for the most severe of injuries such as head and/or eye injuries, severe bleeding requiring extensive stitches, etc. No more than 10% of your total injuries/illnesses should receive an out-of-work order. If you believe that the medical provider was too strict in its discharge instructions, contact them for an explanation and to assure them that you provide Transitional Duty. Ask for a revised work restriction form. Also, be aware that some employees will say their employer does not have a Transitional Duty program. So counter:

• To avoid ‘no work’ restrictions, a manager or supervisor should accompany the injured/ill worker to the medical provider, particularly when the Transitional Duty program is new. Be sure he/she brings the (functional) job description and any Material Safety Data Sheets (MSDS) that apply. 

This may cause staffing difficulties initially but by escorting an injured/ill worker to the medical provider you send two messages. The first is that the employer cares about the individual’s welfare. And the second is that it shows that the employer takes its Loss Control program seriously and will accommodate all injured/ill workers. This leaves little room for abuse of the system for those few employees who just want some time off or who feel ‘entitled’. 

Next week I'll provide some information on how to manage your occupation health care provider. Their cooperation is essential to your workers' compensation efforts.

The Permanent Light Duty List (A Bad Idea) Part 2

As promised, a further discussion on the Permanent Light Duty List and employees who may be on light duty or restricted work indefinitely. Both circumstances are unnecessary and a cost burden to your organization. 

Last week I spoke on limiting the length of time someone can be on light duty. An important part of this process is The Transitional Duty Meeting. I use the word transitional as it denotes a process not a condition. 'Light Duty' and 'Restricted Work' may sound permanent to an employee or to his/her manager but the terms are used interchangeably.

The Transitional Duty Meeting should be held:

• Anytime there is confusion about the employee's situation
• Prior to the end of the first three months if the injured/ill worker is requesting an extension
• At the end of the extension to sum up the case before the injured/ill worker is put out on indemnity

You will find that these meetings are not actually needed all that often, but they are an excellent communication tool after a complicated or confusing injury or illness. However, let everyone know up front that your workers' compensation policy now includes Transitional Duty Meetings. Like you and I, employees want to know what to expect.

A Transitional Duty Meeting is composed of the following people: 

• The injured or ill worker
• His/her direct report (supervisor or manager)
• A representative from Human Resources (the one who processes the claim)
• Your workers' compensation medical designee (on-site nurse, safety officer, occ health physician, etc.)
• Someone from executive leadership such as the Vice President of Human Resources or COO

The meeting should be opened by executive leadership who requests that everyone introduce themselves, then defines the purpose of the meeting; which is to be sure everyone is on the same page as to the employee's condition and expectations for recovery and return to full duty.

The injured/ill worker is then asked to present the facts about his/her situation - how the accident occurred, how he/she is feeling, how the restricted work assignment is working out, if there are any questions or issues, dates for further treatment or testing, etc. This is the time to hear directly from your employee, for you to show that you care and that you take your policy seriously.

The supervisor or manager is then asked to do the same. Have problems been noticed? Has the worker done more than what is allowed during the recovery phase? Are there questions or problems with medical appointments, etc.? 

The remaining members participate as necessary, including the sharing of relevant information from the insurer or Third Party Administrator (TPA). But executive leadership should not try to run this meeting. He/she is there to show (silent) support for the workers' compensation program and interject only when there seems to be an obstacle in the process. At this meeting dates are established, new information is provided, and follow-up is established, without the VP's influence in most cases. 

Granting an extension should only be approved when medical evaluations indicate that a full recovery is possible. If you suspect an employee to be fraudulent in his/her claim or recovery, the Transitional Duty Meeting is the best way to identify it, and can actually prevent fraudulent activity in the first place. More on fraudulent claims in a future entry. Feel free to schedule them as you or your team feels the need to do so. These meetings will prevent the need for indefinite or permanent light duty.

However, if you do have a Permanent Light Duty List, how do you get your employees safely off it? 

There is a way. The organization I mentioned last week had 13 people on its Permanent Light Duty List for up to 2 years. Within about two months, twelve returned to full duty and the thirteenth was settled with and left the organization. Here is the process:

1. Your workers' compensation medical designee (on-site nurse, safety officer, occ health physician, etc.) pulls all paperwork related to each claim and establishes a file for each individual, to include medical reports, dates of incapacity, and job description. A Functional Job Description is best if you have one.

2. Your designee makes arrangements to have each employee on the list evaluated by an occupational health physician, who will need any and all medical reports as well as the (functional) job description. 

Note: You may not have your own occupational health physician. If not contact your local hospital or workers' compensation medical provider, insurer, or TPA to find one. If there are none in your locale, many orthopedic surgeons, chiropractors, or osteopathic physicians sub-specialize in occupational health. Let them know up front why you are contacting them and the goal of the evaluation (which is a determination of an employee's capacity to return to full duty).

3. Your designee then sends a written letter to each employee on the list stating that it is time for he/she to discuss the permanent (or indefinite) light duty assignment with management and that a medical evaluation is required. Provide a date to meet.

4. Your designee discusses the situation with the employee then facilitates the medical appointment. Request that a written report is forwarded to him/her directly from the physician. In most cases, you will find that your employees will be returned to full duty.

5. Your designee then contacts Human Resources as to the outcome, as well as the insurer or TPA so they can close the case. Human Resources may need to help the employees find suitable positions within the organization if their old jobs have since been filled. You may also find that some employees choose to find employment elsewhere once they are asked to return to their old or similar position.

6. If permanent injury is identified, then it is best for the organization to seriously consider settling the claim. Discuss the findings with your TPA or insurer. Consistency is key to a successful program, and it is financially wise to cut future workers' compensation expenses now by reducing your number of current open claims. If you do not want to settle, if you feel committed to the injured worker, then ask Human Resources to place the employee in an already established job that has an existing job description for which they are fit to perform.

Next entry will be a continuation of post-injury management and the importance of an early return to work program, light duty, or as I will refer to it going forward, the Transitional Duty Program. If you have any questions meanwhile, please feel free to post and I will answer them as quickly as I can. 

The Permanent Light Duty List (A Bad Idea) Part 1

Today I thought I'd cover an easy-to-fix workers' compensation program design flaw that will get you moving towards best practice in claims control, reduce indemnity expenses, and improve employee relations. This newest easy fix? Never have permanent light duty assignments. 

Many employers think that Permanent Light Duty is the only way to manage injured workers who don't seem to be getting better. You may be legitimately concerned about your employees, feel guilty about the incident, or just plain out of ideas. And if you are like many organizations, your light duty list has been created and then forgotten. An equally offensive offshoot is the extended stay assignment. In this case the injured/ill worker is on restricted duty indefinitely. There's no end in sight which leads to a high cost of claims and a great deal of frustration. 

Being that workers' comp is a line of business within the organization like any other line of business, let's first take the emotion out of it. An employer should not be writing job descriptions for individual employees, unless of course it is to fill a hole in production or service that requires a particular expertise. Having had an injury/illness does not meet that standard. In addition, other employees, and organized labor if you are a unionized shop, do not look favorably upon specialized treatment which causes a confrontational culture within your ranks.

Also, when you have individuals on no-end-in-sight work restrictions or modified job duties for an extended period of time, those employees may be able to legally fight to make those positions permanent. Your labor law attorney will know more regarding the state laws under which you function. And I don't think I need to go into detail about workers who have issues with their supervisors, or those who don't like their jobs who end up on light duty. In these circumstances you may find both the employee and his/her manager willing to continue the light duty assignment indefinitely.

One of my clients, a large Massachusetts employer, had 13 people on its Light Duty List. The longest employee was on light duty for over two years! All but one were returned to full duty after it was medically determined that they were indeed fit to return to their old jobs. The employer decided to settle with the permanently injured worker which was accepted without contestation.

What does this mean to an employer? Improved productivity, improved employee/management good will, and reduced claims expenses. (If it's not you, then your insurer or TPA is paper managing those cases which they charge back to you.) A point to remember going forward is that most injuries heal within 3 weeks. Your light duty program must have end dates to be efficient and encourage wellness. There are some injuries that may take several months especially if surgery is involved, however the following addresses both circumstances. Let's look at the details.

Best practice programs have two important dates written into policy. The first is that light duty is a maximum of three months. Within three months the employee returns to full duty. By setting this standard your injured/ill worker knows what to expect. Remember, family and friends love to make recommendations about what to do after a work related event so you have to set the standard, and stick to it. If your employees are better in 2, 4, or 6 weeks, that is when they return to full duty.

When this is not possible and an employee is medically unable to return to full duty within three months (surgery is involved, medical evaluations are yet inconclusive), the second written policy date of importance is that light duty may be extended for an additional three months, however in order to receive the three month extension, medical evaluations must indicate that a full recovery is possible.

Next entry I will cover another unique program design element that should never be missed when an extension is required (The Transitional Duty Meeting). I will also share how we got our 13 employees safely off the Light Duty List. Meanwhile you might want to pull the files of those people on permanent (and date unknown) light duty to see what you have that needs managing. 

Hopefully you have already incorporated my first rule of workers' compensation: employees must report an injury or illness prior to the end of their shift, so that you can begin this next policy change - putting end dates to your light duty, restricted work assignments. Workers' Compensation does not have to be difficult, just managed well! Good luck, and I look forward to any comments, suggestions, or experiences you wish to share!