Return-to-work mistakes often prove costly

Traditionally, employers focused on helping employees who were injured at work get back to work early with RTW. Recognizing the value of a healthy workforce, the commonalities of recovering from on and off the job injuries, the efficiencies of coordinating RTW efforts, and the greater risk exposure to discrimination claims when workers are treated differently depending on the reason for their absence, some employers are moving toward integrating occupational and non-occupational cases to reduce absences and lower claims costs.
Whether the program is an integrated occupational/nonoccupation RTW or a traditional RTW, the economic and legislative landscape poses challenging issues for employers. Here are 10 common mistakes:
• Failure to effectively manage the increase in number of employees covered by the Americans with Disabilities Act (ADA). The ADA requires covered employers (those who have 15 or more employees) to assess accommodations for any worker who might need them regardless of whether the disability arose from a work or personal injury or illness. The Equal Employment Opportunity Commission has taken the position that employers with inflexible leave policies violate the ADA by failing to accommodate employees covered by the act.
• Insist employees be released to “full duty” before returning to work. Considerable evidence exists about the value of RTW programs that provide a means for employees to transition back into their full-duty jobs with responsibilities and tasks modified for short periods of time. Insisting on a return to “full duty” increases workers’ compensation costs and heightens the possibility that the injured employee will fall prey to a “disability syndrome” – the failure to return to work when it is medically possible. • Do not account for comorbidities. Comorbidities are health issues that can complicate or delay an employee’s recovery, such as diabetes, obesity, hypertension, depression, and so on. While it’s important to ensure that the duration of modified job assignments is not indefinite, inflexible adherence to the guidelines can lead to problems and potential discrimination suits, particularly when there are comorbidities involved.
• Fail to commit the budget or resources. While the RTW has not escaped the pressure to cut costs during the sputtering economic recovery, the direct and indirect costs of absences as well as the exposure of noncompliance with federal and state regulatory and statutory requirements is likely to be far more costly than implementing a RTW process.
• Be deterred from setting up transitional assignments because the employee “may get hurt again.” Employer and employee fear of re-injury often hampers RTW efforts. This of course is a risk, but an even greater risk is having the employee stay at home and develop a “disability attitude” that extends the absence and drives up costs.
• Don’t distinguish “light duty” from “transitional work” from “reasonable accommodation.” The definition of these terms is complicated and confusing. Occupational RTW assignments are best described as transitional tasks. Limited in duration such tasks help the injured worker return to full productivity by being progressively adjusted in line with medically documented changes in the employee’s ability. • Rely on the physician to guide the RTW process. While many employers have recognized that they need to take the lead role with both the treating physician and injured worker, others still rely on the physician. While physicians are medical experts, they do not have essential information about workplace policies, job demands and the availability of transitional work.
• Don’t understand how laws overlap and conflict. The overlapping and often-conflicting requirements of ADA, FMLA, workers’ compensation and a plethora of state laws are an administrative nightmare. More than one law can affect the same situation and each must be considered.
• Don’t stay focused on the goal and establish consequences. An Integrated Benefits Institute survey revealed a RTW focus on the employee’s own job, modified as necessary, ranked as the most important factor in successful RTW. Requiring mandatory participation was the second-most-important program feature affecting RTW success.
• Believe workers’ compensation settlements resolve other liabilities.
One size does not fit all. Obligations under the various laws are reconciled separately. •


Kevin Ring is the director of community growth for the Institute of WorkComp Professionals. He can be reached at kevin@workcompprofessionals.com.

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