Early Returns To Work Add Value--In More Ways Than One

Some companies fear that bringing an injured employee back to work early means theyll pay salary for limited work and that it makes more sense to let the workers compensation carrier pay the claim until the employee is fully recovered.

In fact, even companies on a fixed-premium workers compensation plan may benefit from an early return-to-work program by being viewed as a more favorable risk and eligible for better pricing.

Longer term, the company may benefit from a lower experience mod. (Experience modification factors adjust workers comp premiums for individual insureds to reflect the specific companys actual loss experience.)

More significantly, injured employees out on disability incur a host of uninsured costs, including reduced productivity, lower workplace morale and extra expense. The U.S. Occupational Safety and Health Administration, The Hartford and other carriers have developed software that allows companies to input variables and calculate indirect costs starting with the initial injury.

At one time, a work-related injury often meant that an employee couldnt work at all. Employers, fearful of employee re-injury, were reluctant to allow an injured employee back to work unless the worker had achieved full recovery.

This practice shifted to one of placing workers in modified work or "light duty" jobs, but those positions often were narrowly defined so the injured workers physical abilities had to fit the requirements of the assigned job. Those jobs frequently were not meaningful. So neither the employer nor employee derived much benefit from the work. Also, the term "light duty" sometimes carried a stigma.

Today, some enterprising carriers are helping client companies introduce a more effective version of return to work that addresses these issues and others. Carriers are helping employers identify transitional employment that not only allows employees to return to meaningful work, but also increases an employers productivity. Assignments are created by pulling together tasks the injured worker can safely perform and combining them into meaningful work.

This approach is particularly beneficial for small and mid-sized employers whose claim volume is low and who lack sophisticated in-house risk management departments. In some circumstances, carriers can even assist employers who do not have transitional employment available by partnering with charities, temporary agencies or return-to-work vendors to find temporary opportunities outside of the employer.

This proactive approach is especially important since some studies show that employees out of work for more than 12 weeks because of a work-related injury have less than a 50 percent chance of ever returning. Studies also show that performing meaningful work appropriate for their abilities helps injured workers recover faster.

Instituting a formal program demonstrates the companys commitment to helping employees return to work as safely and quickly as medically appropriate after being injured on the job. Ideally, a clearly documented plan, communicated to employees at their time of hire and at intervals during their employment, helps workers understand that they are expected to come back to work in some capacity as they recover and demonstrates that the company will support them during this process.

If no formal plan is in place at the time of injury, a business can turn to its carrier for help.

Carrier-assisted return to work programs can be of particular benefit to small and mid-sized companies that typically lack the experience or resources to focus on creative ways for returning injured employees to work. These businesses can work with their insurance carriers and agents to develop programs suited to their needs and to generate ideas for transitional employment.

Insurers are particularly well-placed to help clients identify transitional work opportunities, since they write similar types of business for many companies in different parts of the country. They understand that transitional jobs for employees at California firms also can work for companies in the Northeast or the Midwest.

Changing the mindset of everyone in the company is critical to a successful return to work program, starting with the language of asking "when" and "in which function" rather than "if" the injured employee will come back.

"When" and "which" must be part of all discussions with the injured worker, the insurance carrier and medical provider to ensure that everyone is focused on the same goal–returning the employee to productive work as soon as medically feasible.

Even before theres an injury, the employer should identify and document all job functions, related duties and any associated physical requirements, while determining which jobs can be modified to accommodate workers with injuries. The company should explore all possibilities, even those outside the company. Be sure that a variety of employees are involved in this process, since some of the best alternatives often come from staff.

Companies should consider temporary employment opportunities at a local non-profit organization, since non-profits usually have more work than workers. Some non-profits seek out and regularly employ workers with permanent disabilities, and it can give the temporarily injured worker a lift to see just how productive these workers can be.

In particular, charities allow injured employees to remain productive by completing purposeful work and contributing to a charity in need of assistance. A side benefit: they may learn new skills.

Speed usually improves outcomes, and even severely injured employees can be placed in appropriate jobs as soon as they are medically able to work. For example, an electrician who suffered a serious head injury worked temporarily for the Red Cross until he was able to resume his full-time duties for his employer.

Finding an appropriate position is just one of the barriers to return to work. Insurers can also help businesses identify and manage non-injury related factors, such as conflicts with other workers or supervisors, or childcare arrangements. These and other personal issues can significantly slow–even halt–the employees recuperation and potentially increase workers compensation expenses.

For some companies there may be up-front resources required to establish a return-to-work plan, but the benefits of such programs far outweigh the expense. Getting back to work helps injured employees resume their pre-injury lifestyles and income. For employers, a thorough, ground-up return-to-work orientation can decrease disability durations, improve their worker compensation ratings and raise staff morale.

If not now, when?

Gregory Crabb is vice president for workers compensation claims at The Hartford.

Reproduced from National Underwriter Property & Casualty/Risk & Benefits Management Edition, August 25, 2003. Copyright 2003 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.