Sample Injury Management/Return to Work Process

Sample Injury Management/Return to Work Process

INTRODUCTION

MANAGEMENT'S ROLE

PURPOSE

POLICY STATEMENT

IMPLEMENTION

INJURY MANAGEMENT/RETURN TO WORK PROCESS

THE INFORMATION PRESENTED IN THIS “SAMPLE INJURY MANAGEMENT/RETURN TO WORK PROCESS” AND ATTACHMENTS HAVE BEEN COMPILED FROM VARIOUS SOURCES BELIEVED TO BE RELIABLE. HOWEVER, THE PLAN YOU ADOPT SHOULD BE DESIGNED BY YOUR ATTORNEY OR HUMAN RESOURCES PROFESSIONAL TO COMPLY WITH STATE AND FEDERAL LAWS.

INTRODUCTION

An injury management/return to work process is a post injury procedure designed to ensure quality medical care, contain medical costs, reduce opportunities for litigation and return injured employees to full gainful employment at the earliest possible time.

MANAGEMENT'S ROLE

The soaring cost of Workers’ Compensation insurance to our organization will be contained. Rather than accepting injury related expenses as a fixed cost of doing business, we will be proactive in this process and focus our resources on:

Educating our employees
Loss reporting
Utilization of Preferred Workers’ Compensation medical providers
Return To Work (RTW)
Documentation

The success of this process is dependent on a strong partnership between

our management staff, employees, medical care providers and our Workers'

Compensation insurance provider.

PURPOSE

To safely return employees to appropriate full, transitional or modified job duties as soon a medically practical after an injury or illness.

POLICY STATEMENT

(Organization) is committed to providing a safe and healthy work environment for all full, part time employees and temporary/contract employees.

Preventing occupational injury and illness is a primary objective of this organization.

If an employee is injured, we will use our return to work process to provide assistance.

We will get immediate, appropriate medical attention for employees who are injured on the job and will attempt to create opportunities for them to return to safe, productive work as soon as medically possible.

Our ultimate goal is to return injured employees to their original jobs. If an injured employee is unable to perform all the tasks of the original job, we will make reasonable effort to provide transitional/alternative productive work that meets the injured employee's capabilities.

We will ensure the employee's return to work is in compliance with all requirements of the Americans with Disability Act (ADA), Family Medical Leave Act, and the Hawaii Workers' Compensation Law and Rules.

The support and participation of management and all employees is essential for the success of our return to work process.

IMPLEMENTATION

Educating Our Employees

Fear and uncertainty are primary reasons for injured employees to delay reporting injuries and to seek assistance from attorneys. This may be due to concern over medical bills, lost income or even the loss of employment. We will take whatever action is necessary to alleviate these fears, specifically:

- All employees will be provided with a copy of the Employee Return to Work communication letter.

- All employees will be provided with a general explanation of the Workers' Compensation system and the benefits it will provide.

- All employees will be instructed in accident reporting procedures.

- All employees will be informed of the organization's

“Preferred/Approved Workers' Compensation Medical Providers”.

However, all employees still reserve the right to choose their own

medical provider.

- Employees will be informed of the medical provider’s names,

telephone numbers, addresses, and the medical providers expertise.

This information will be posted in key locations through out the

organization.

- Of particular importance, all employees will be informed of our

substance abuse policy, fraudulent claim prevention and

transitional/alternative jobs and other aspects of returning to work.

Injury Reporting

- Procedures have been established which ensure all employees have

the responsibility and incentive to report all accidents immediately.

-The Hawaii WC-1 Employer’s Report of Industrial Injury report will be prepared and reported to the workers' compensation carrier within 24 hours by fax, e-mail or mail.

Follow state requirements for distribution of hard copies.

-Near-miss incidents are to be reported and investigated

and corrected action taken as soon as possible using the organization’s Injury/Illness Accident Investigation form.

Utilization of Medical Providers

The use of preferred/approved physicians, clinics or hospitals is an important injury management decision. We will monitor the medical care provided to our injured employees to the maximum extent permitted by the Hawaii Workers' Compensation Disability Compensation Division laws and rules, and will:

- Recommend medical facilities that provide appropriate treatment,

quality care and effective service.

- We will provide a copy of the Return to Work Physicians letter to the treating physician.

- Whenever possible, we will encourage physicians treating our

employees to visit our organization to observe our operations to

better understand the way we conduct our business.

Return To Work (RTW)

To effectively manage the cost incurred as a result of work related injuries, the following nine-point plan will be closely followed and monitored:

Ensure that initial treatment is provided. Immediately following

injury, provide necessary first aid and see that the employee is taken (by the employee’s supervisor or designee) to a medical provider as required. Document all details regarding the date and time of the injury, the type of first aid provided and the name of the physician, clinic or hospital where the employee received treatment.

Notify the organization's workers' compensation coordinator

immediately following an injury.

Provide to the treating Physician the following information.

This information should include:

A description of the employee's current job, with details on postures (standing, sitting, walking) and physical demands (lifting-weight and frequency, hours worked, tool usage, etc.).

A copy of the Physician’s Return to Work communication letter.

A copy of the injury report describing how the injury occurred if available.

A statement of our organization's position on returning injured employees to work on a full time or part time basis.

Employee Work Status Report . It is critical to

obtain the treating physician's response to any work restrictions our injured worker may have.

Contact the Employee. Employee contact should be made in

person or by phone within 24 hours.

Send the employee a “Get Well” card.

Reassure the employee of our organization's commitment to their well being.

Assess the employee's understanding of the treatment he or she received.

Ask if the employee has any specific questions about future plans, treatment, etc.

Follow up with your Insurance Adjuster. Within 24 hours of initial treatment to obtain details regarding recommended additional treatment, return-to-work expectations and specific job restrictions. Discuss specific timetable for the employee’s timely return to work.

Maintain contact with the employee, physician and the claims

adjuster. During employee's absence from work we will continue to monitor progress:

Contact the employee at least once every week to inquire about their recovery and express our concern for their return to good health.

Contact the physician and the claims adjuster to discuss recovery progress and any changes in the timetable for the employee's return to work.

The organization's workers' compensation coordinator should schedule periodic contact with the claims adjuster.

Persons may include during the contact the supervisor and or manager, the organization's nurse if appropriate, and the personnel director at a minimum.

An update and status of all employees injured and off work will be discussed, in addition, to the employee's expected return to work.

Establish an injury management record. For each case involving lost time and/or follow up medical treatment, establish an injury management record. This record may include:

A copy of the organization’s injury report

Documentation of initial treatment, a copy provided by the employee

Copies of medical bills provided to the organization by the employee or treating physician

A log of all phone conversations with the employee, physician and claims adjuster

Progress reports from the physician and employee

All activities regarding treatment and recovery should be logged and

documented whenever possible. Explain any progress toward return

to work and discuss with all appropriate parties involved.

Indicate the date the employee returned to work and in what capacity

(full duty, part-time, limited physical activity, etc.)

Documentation contained in the employee’s file should also be forwarded to the claims adjuster.

Bona Fide Offer of Employment

Written documentation of transitional or alternate job assignments will be presented to the employee in a bona fide offer of employment letter.

Job assignments will adhere to restrictions and limitations.

Job assignments continuing beyond ninety (90) days will be carefully supervised to ensure that actual or anticipated improvement of the employee's condition is occurring.

Employees may reject a bona fide offer of employment, however rejection of such an offer may present cause for termination of benefits.

Date:

To: All Employees

From: President/CEO

RE: Return to Work Policy

(Company/Organization Name) is committed to encouraging timely return to work (injured employees returning back to work as soon as medically possible). This effort is to fulfill the company’s intent, to encourage full recovery of both the body and spirit of injured employees.

Depending on individual employee capability and medical feasibility, to the extent that work is available company will provide either part-time or full-time limited duty in their position or in an alternate or transitional part time or full time position.

As a result of suffering a work-related injury, the company will assist employees to minimize the time their wages are reduced.

Research has shown that an employee, who re-enters the work environment as quickly as medically possible, even if the return is for a limited amount of time or in another capacity, recovers more quickly than an employee who is unable to return to limited duty work assignments.

In addition, studies have shown that when injured employees return to the work environment they receive encouragement and support from their co-workers, which helps the healing process.

Should you have any questions, please contact (name of Workers’ Comp. coordinator, supervisor etc.)

Date:

To: All Physicians

From: President/CEO

RE: Return to Work Policy

(Company/Organization) has entered into a timely return to work effort to foster the ability of injured employees, returning back to work as soon as medically` possible. This effort is to fulfill the spirit and intent of our company, which is designed to encourage recovery of both the body and spirit, of injured employees by providing either part-time limited duty in their original position or full time duty in an alternate position depending on individual employee capability and medical feasibility.

The company is committed to helping employees minimize the time their wages are reduced as a result of suffering a work-related injury.

Research shows that a employee who re-enters the work environment as soon as medically possible, even if the return is for a reduced amount of time or in another capacity, recovers more quickly than an employee who is unable to return to work.

In addition, studies have shown that when injured employees return to the work environment, as soon as medically feasible, they receive encouragement and support from their co-workers, which helps the healing process.

All medical restrictions, if any, prescribed for the employee will be met by the (Company/Organization) when the employee returns to work.

For additional information on the employee’s job duties, please refer to the attached job description.

Return-To-Work Program

Successful return-to-work programs start by changing the focus from the negative, “What the employee CAN’T do” to the positive, “What the employee CAN do”. Once an employee’s abilities are identified, it is much easier to identify tasks that fit the abilities.

Work is the Best Medicine – A positive self-image and hope for the future are critical to a speedy recovery. Each day of dependency on others undermines an employee'’ self image and hope. Each day of positive contribution back on the job rebuilds self-confidence and a positive outlook. The longer an employee is off work the lower the chance they will ever return. Once employees return to work, their frequency of medical treatment is drastically reduced.

Management Commitment to Total and Immediate Accommodation – Management must make a positive commitment to their employees to provide them the opportunity to return to the work force just as soon as their abilities can make a positive contribution to the organization. A goal should be set in each case to return the employee to work within 72 hours of the injury or release from the hospital. Obviously, this goal will not be reached in every case. However, without a goal, many employees that could be returned to work will end up staying out longer than necessary simply because their case was not addressed. Most importantly, it requires a view of people as important resources, not expendable commodities.

Relationship with TreatmentCenter or Physician - Make a concerted effort to identify reputable, fair medical providers in your locality. You can even invite the providers to your facilities and take them on a tour. Explain your return-to-work program and types of jobs, and demonstrate your sincerity in providing security for your employees. Encourage your employees to use these providers’ services.

Communication: Employee, Family, Physician, and Insurance Carrier – Keep in touch with your injured employee and their family. The supervisor of the employee should make the contact. This person is the authority figure the employee reports to and therefore elicits the greatest effect on the employee’s motivation. Contact should be made the same day of the injury, and at regular intervals thereafter – the more often, the better.

The treating physician should also be contacted regularly. Someone can accomplish this other than the employee’s supervisor. Let the physician know you have a personal interest in your employee and you are concerned about their recovery.

Keep in regular communication with your adjuster from our claims department. HEMIC will “press” for results and support your return-to-work policy with the treating physician or treatment center.

Analyze Existing Jobs – Each job in your organization should be analyzed according to the necessary physical requirements, abilities to carry out the job, what body parts are needed, and what limitations would not affect one’s performance on this job. Once completed, this allows recovering employees to be matched with positions based on their abilities and limitations.

Ways to Return Your Employee to Work

Modified Work – Modified work is when an injured employee is brought back to work and placed temporarily within an existing job that is not as physically taxing or demanding as their normal job. This temporary job placement must meet the physical restrictions that a physician has assigned to the injured employee.

Restricted Work – Restricted work is where an injured employee is brought back to their normal job with restrictions assigned by a physician. For example, this may involve placing a 30-pound lifting restriction on the injured worker. It is important to impress these restrictions as mandatory to everyone including the injured worker, their supervisor and others that may be assigned to work with the injured worker.

Temporary Assignment – Temporary assignment is where positions are specifically created which will accommodate the restrictions of any injured employee within a company. These positions may be previously established or created as injuries dictate.

Gradual Re-acclamation – Gradual re-acclamation is when an injured employee is gradually, over a period of time, brought back to their full working capacity. This process begins with 2 or 3 hours of work a day or 2 or 3 days of work a week, and gradually increased as time passes.

When an Injury Occurs

Compassionate Response - Many employees who have never been injured on the job don’t understand how workers compensation insurance works. These employees, and even veterans of workers compensation, will decide in the

first 60 minutes after the accident whether a confrontation may be necessary to be compensated, or whether their needs are being sincerely accommodated. Once their mind-set is created, it is very difficult to change. Work to create a positive mind-set. Many organizations become callous because of bad experiences with employees who took unfair advantage of them, and begin to treat all employees as suspect. Your return-to-work program should be based on quick, effective medical treatment for damage sustained to your most important resource, and a strong desire to restore that resource to full capacity at the earliest acceptable time.

Explanation of Benefits – Explain fully to the employee how much of their salary they will receive and when they should expect it. Also, assure them that all medical expenses pertaining to their job-related injuries will be paid and how the process works. Be sincere and consoling. Answer their family’s questions, if any. If you do not know the answers to questions, or your not sure of the appropriate answer to provide, consult with your claims representative at HEMIC for consultation. Do not commit to services provided by your insurance carrier. A HEMIC Claims Specialist will be contacting the injured employee as soon as we have received the injury report.

Maintain Employee Communication – As part of the responsibilities of the claimant’s supervisor, regular and frequent communication should be maintained with the claimant. This process starts at the moment of injury. The supervisor should attend the first visit to the physician with the employee in every case, if at all possible. If there is hospital confinement, the supervisor should visit the employee on the first day.

Regular phone calls at a minimum of weekly should be made to the employee and their family to express concern and provide assurance about returning to work as soon as possible. Encourage fellow employees to also maintain contact with the injured employee.