Accidents Happen

It’s a fact of life that at some point employees will be injured or contract an illness while on the job. How you respond to getting them back to work significantly impacts their view of their job and the company. Studies have shown that companies with effective advocacy-based return to work programs have happier and healthier employees, less absenteeism with shorter time off work and higher productivity, lower healthcare costs, better claims outcomes, and more effective cost controls on workers’ compensation insurance, including potential carrier premium discounts. In fact, according to testimony before the Senate Committee on Health, Education, Labor and Pensions, studies show that employees who are satisfied with their employer’s positive injury/illness return programs result in employees returning to work 50 percent faster with 54 percent lower cost than companies without such programs. The report also cited the likelihood that an employee will litigate the claim was reduced.

Legal Considerations

In addition to state workers’ compensation laws protecting employees with on-the-job injuries/illnesses from retaliation that may include denying or slowing a return to work, applicable employers must comply with the federal Family and Medical Leave Act (FMLA) that provides job and benefits protection for up to 12 weeks and state family and medical leave laws that provide similar protections. The federal Americans with Disabilities Act (ADA), along with state disability nondiscrimination laws, requires employers to provide employees with reasonable accommodations so they can work unless those accommodations create an undue hardship for the company. These situations require an interactive dialog to examine the possible work modifications that can be made, and every situation is unique.

There are a number of key issues for employers to consider related to disabilities and returning employees to work after disabling accidents or injuries, including:

The employer may not refuse to return to work an employee who is able to perform the essential functions of the job, with or without a reasonable accommodation, unless the employer can show that returning the person to the position poses a “direct threat.”
The fact that an employee has had a disability-related occupational injury does not, by itself, indicate that the employee is unable to perform the essential functions of the job or that returning the employee to work poses a direct threat.

Ultimately, an employer bears the responsibility for deciding whether an employee with a disability-related occupational injury is ready to return to work safely in the employer’s work environment. Employers should review the recommendations from the rehabilitation counselor, physician, or other specialist and determine whether the employee can perform the essential functions of the job, with or without reasonable accommodation, or can work without posing a direct threat to self or others.

Consult with your legal and insurance advisors for assistance and options to help guide your decision not to return an employee to work following an injury or illness.

Return-to-Work Program Features

Developing a formalized plan with assigned responsibilities and training for managers, supervisors, and employees provides the framework for all involved to respond appropriately. The goal is to bring employees back to work after an injury or illness safely and in jobs where they can be productive. The program should be customized to reflect your company’s policies and be compliant with applicable federal, state, and local laws and regulations.

Include a Policy Statement

Provide a statement of the purpose for your program, such as: “(Company name) recognizes the value and importance of our employees. We are committed to working with employees who become injured or ill due to work-related or non-work-related causes to return them to work as quickly and safely as possible.”

Other policy points that may be included are:

Definition of employees covered by the return to work program.
Reporting process — to whom, frequency of reporting, and if advance notification for return to work is needed.
Medical evaluation documentation and use of a medical provider process.
How physical limitations will be assessed in the interactive process for reasonable accommodation.
Process for limited duty or transitional assignments to bring employees with slight impairment back to work safely.
Definition of the consequences if an employee refuses to participate in the return-to-work program.

Appoint an Implementation Team

An implementation team should be established to develop the procedures, guidelines, and accountabilities for managing your return-to-work program. Typically, this team would be comprised of a senior executive, human resources leader, safety officer, risk manager, and benefits manager. The size and composition of the team would depend upon the complexity of the program and size of the company.

Once the program is established, all members of the management and supervisory team should be trained so that they are clear about the process and their responsibilities, followed by an orientation for employees.

Best practice tip: Assemble a “Return-to-Work Kit” with all related forms and processes that will help team members complete all the necessary paperwork and implement the process for returning employees to work following injury or illness. Be sure that the team knows where the kit is located.

Choose a Medical Provider

A key component of successful return-to-work programs includes retaining an outcome-based medical provider who will work with you to provide the best care for your employees and get them back to work as quickly and safely as possible. The provider should understand your return-to-work policy and goals, and the provider will give you a timetable for the employee’s return to work or expectations regarding improvement and recovery.

Your health insurance broker or carrier representatives may provide insight and resources to assist you in finding a preferred medical provider. Be sure to ask them for assistance.

Document Job Duties and Requirements

Before you actually need this information in a return-to-work situation, complete descriptions for each of the jobs in your company, including essential duties and the mental and physical requirements of those jobs. Keep them on file so you will be ready to supply to your medical provider and the employee’s physician if needed. That way, the medical provider can make a determination and recommendation for a full return to work status or light, modified, or transitional duty opportunities.

A best practice is to identify potential modified or transitional duty positions within your organization in advance so that you will be ready to accommodate an employee returning to work when needed. This accelerates the ability to get employees back to work more quickly, which reduces the amount of carrier wage replacement benefits and positively impacts your workers’ compensation claims experience.

Keep the Communications Flowing

Good communication is essential to better return-to work-outcomes. If communication breaks down, it could lead to an employee feeling neglected and believing that the employer is not interested in the employee returning to work as quickly as possible. This increases the exposure for the company to lengthier claims, potential lawsuits, and higher costs. Everyone needs to know the role they play and what responsibilities they have in keeping the communication channels open in order to make the program run smoothly.

All communications and interactions should be documented, including:

Date of injury/initial clinic visit.
Physician status reports and follow-up visits.
Contact between employee and manager or human resources logs (phone calls, emails, etc.).
Interactive process to determine potential reasonable accommodations.
Written modified transitional duty offer letter.
Refusal of modified transitional duty.

Note: If an employee refuses the modified transitional duty offer, the carrier may discontinue benefits.

How much communication with the injured employee is too much? Or too little? Outlining the expectations for employee contact during an injury or illness is important. While there are no specific sets of rules on this topic, the general practice is to:

Contact the employee within the first 24 hours after the injury or illness to show concern and answer any questions.
After the initial contact, the frequency of the contact will depend upon on the medical provider’s recommendations based on the health situation.
While frequency varies for each situation, a good general rule is to follow up every other week to make sure the employee has everything he or she needs, understands the benefits being provided, and has an opportunity to get answers to any questions.
In cases of work-related injuries or illnesses, risk managers may suggest that you call the employee before any follow up medical visits to remind the employee of the appointment and/or after the visit to ensure all is going as expected.

The goal is to show the employee that the company cares about his or her well-being and is sincerely interested in the medical progress and ability to return to work.

All employee contact should be documented to prevent misunderstandings later, especially in cases where an injured or ill employee stops communicating with the employer or voluntarily resigns the position after getting hurt on the job. This documentation can prove critical in the event of benefits disputes or discrimination and retaliation claims.

Returning Employees to Work Is Good Business

A great return-to-work program begins with the creation of a clear set of expectations regarding the company’s goal to return employees to work following disabling injuries or illnesses. Having a corporate culture that supports productive work behaviors and fosters respect among employees is critical. Identifying the specific accountabilities, policy, and processes so that everyone in the organization knows what to do in the event of an absence from work due to disability is important. This includes communications, benefits continuation, medical follow-up, outlining specific accountabilities and job accommodations, and identifying modified or transitional work. The return on investment with successful return to work programs is measurable and is the product of well thought-out planning between the company, the medical provider, and the employee.

Return-to-Work Guide

From: Staffing