Transitional Return-To-Work in Workers’ Compensation Claims: New Strategies

Return-to-work (RTW) policies and practices have been around since the beginning of workers' compensation (WC), dating back to the early 1900s, and have evolved—especially in recent times. RTW programs are designed to help restore injured or ill workers to their former positions safely and effectively.

The historical aim of such efforts has been heavily focused on helping the employer as a cost-saving measure—although there are other benefits we'll discuss as well. RTW is a proven strategy for reducing experience modifications and workers' compensation premiums by lowering the cost of disability payments. In addition to the disability savings, there is long-standing recognition among Human Resources and benefits administrators that returning injured employees to work as soon as practicable saves costs related to absenteeism, lost productivity, training replacement workers, and litigation.

The Journal of Occupational & Environmental Medicine published a study showing the cost savings of RTW programs. After a 10-year time frame, lost time claims decreased by 73% and overall WC claim costs were 54% lower. Another study published by Rand found that employees in an RTW program return approximately 1.4 times sooner, a decrease of three to four weeks in duration, than injured employees who did not participate in a program.

Even when an employee declines a return-to-work offer, the employer still reaps the savings since the employee may not be entitled to temporary disability when they reject a reasonable offer. As you can see, there is a financial incentive and benefit for both the employee and employer to have an RTW plan. Before we discuss the new strategies, let’s first recap what traditional RTW strategies entail.

Traditional RTW Strategies: Modified and Alternate Work

When an injured employee is released to return to work, employers usually begin with an exploration of “modified” duties based on the work restrictions. Modified work is when the physical requirements of an employee’s usual and customary occupation are adjusted in some way to allow the employee to continue to perform the same job. This might involve ergonomic accommodations or redesigning a workspace, such as providing an administrative worker who has a restriction of no prolonged sitting with a sit/stand work desk. Or it might consist of restructuring job tasks, perhaps using team members for assistance.

While the assessment of modified duty is an important first step in triaging RTW, employers should also explore "alternate" work opportunities if they are unable to accommodate modified duties. It's not a new concept, but alternate work is often overlooked. This option takes into consideration the employee’s transferable skills, knowledge, and experience to find other suitable work alternatives, even though they may differ greatly from the employee’s pre-injury position. For example, a physical laborer might also have project management skills that could be used while not requiring heavy lifting. Some employers have success offering alternate work by making short-term training available for injured employees to fill in knowledge gaps.

"Modified" work involves adjustments to allow an employee to continue to perform the same job, such as redesigning a workspace or restructuring job tasks. "Alternate" work taps into the employee's other skills, providing them with duties that may be unrelated to their usual job.

Employers that have a store of job descriptions for potential modified or alternate work arrangements on hand can prevent delays in the RTW process. These job descriptions can be swiftly provided to treating physicians to communicate the availability of light duties to expedite obtaining the doctor’s sign-off.

For a job description to be most effective, it should include both a description of the work and the physical demands. Photos of the workstation can also help doctors visualize the work more accurately. Most carriers have template forms on hand. They can be amended as necessary according to the doctors’ comments. If modified duties are not available, completing a transferable skills analysis with the injured employee can help vet alternative work options. This does not have to be formal and can be a simple conversation with the employee.

Missed opportunities also arise when an employer believes they must give the employee full-time light duties. Many successful return-to-work cases include reduced hours. There is still a cost savings benefit to the employer since the WC claim will only pay a partial versus full disability. This also benefits the employee by providing routine and structure and increasing motivation during their recovery.

New and Evolving RTW Trends: Nonprofit Work

Not-for-profit work is a great option when the pre-injury employer is unable to provide either modified or alternate light duties. ReEmployAbility is a company that partners with insurance carriers and nonprofit employers, such as Goodwill, to find transitional work for injured employees. They operate nationally and have a high success rate. Since the company does much of the coordination and management—working directly with the employee, physician, and claims adjuster—this helps relieve the employer’s administrative burden. Some insurance carriers offer similar in-house programs.

These types of programs have the added benefit of making the employee feel a part of the community and providing a greater sense of purpose that comes with volunteering. The employer is required to pay the employee’s full or partial salary during the not-for-profit assignment. A potential side benefit is the possibility of the employee’s salary being a tax-deductible charitable donation. Employers should consult their corporate tax advisor to determine eligibility.

RTW programs not only provide a clear return on investment (ROI) for employers, but they also provide value on investment (VOI) by providing health and wellness benefits to employees and improving morale in the workplace. 

Employee benefits of return-to-work programs include:

• Less anxiety, depression, and boredom

• Enhanced sense of well being, social support, and connection

• Minimized financial concerns

• Greater sense of control

• Reduced chance of decreased muscle tone

Amid the Great Resignation, refreshing your RTW policy and marketing it as an employee benefit may be a way to attract and retain workers as employees see their employer is taking care of them.

RTW in the Age of the Pandemic, Endemic, and Technology

In the wake of the pandemic, new doors have opened to RTW solutions. Consider the same remote work possibilities that proved successful during lockdown for injured employees transitioning back to work.

Flexibility and creativity are keys to success. Here are various ways to accommodate employees with physical limitations:

• An office employee whose only restriction is driving might be allowed to temporarily work from home.
• An employee who must rest their hands every hour to prevent a carpal tunnel flare-up might be given more schedule flexibility with remote work.
• Advances in technology such as voice-activated software that converts speech dictation to text offer many applications and are another consideration for employees with limited use of their hands.
• Employers could use existing automation to accommodate employees with heavy lifting or repetitive motion restrictions, particularly in production lines, manufacturing, and food processing.
• Taking it a step further, integrating robotics into workflow may help prevent injuries caused by heavy work in the first place.
• Injured workers receiving medical treatment could be encouraged to take advantage of telehealth when feasible to reduce travel and lost time.
• Employees who commute to an office or travel for client meetings and are prohibited from weight bearing could temporarily participate virtually over Zoom.

When remote temporary light duties are feasible, it’s important to understand the worker’s home environment and any obstacles to productivity and offer help when possible. If there are ergonomic issues, the insurance carrier’s loss control department might be able to assist. In addition to recovering from an injury, employees may face family challenges, such as caregiving duties if they have young children and/or aging parents. If your employee benefits package includes a caregiving benefit, make sure to remind injured employees about these and other resources, such as your employee assistance program (EAP) if you have one. In this way, RTW can be integrated as part of an employer’s health and wellness initiatives.

Similarly, with so many overlapping disability and leave laws, including the recent COVID-19 sick pay regulations such as CA SB 114, employees will no doubt appreciate employers incorporating information about other absence management and leave policies as well as public health guidance and local and federal mandates into the RTW policy.

The pandemic has also changed the way employers and employees communicate. With less in-person interaction, employees feel more disconnected even without an injury. A disabling injury just adds insult to, well, injury. It’s important to check in with injured employees more frequently throughout their recovery and transitional work period so they feel supported, and adjustments can be made to jobs as necessary. Consider designating an RTW coordinator from your HR or people team to minimize employee frustration and improve communication.

Commit to Employee Benefits by Updating Your RTW Policy

Employers now have a new lens from which to view RTW plans, plus expanded options, such as technology tools and remote work, when assessing modified and alternative work.

Woodruff Sawyer has created an editable transitional RTW policy template for sharing with your new employees at the time of hire, and for sharing with injured employees to let them know there are options for returning to work. This shows your team you’re serious and dedicated to their health and well-being.

If you have questions about RTW programs or policies, contact your Woodruff Sawyer Account Executive.