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.