12Return to Work and Stay at Work Bona FideOffers of Employement
13Texas Workers' Compensation Act (Labor Code, Title 5, Subtitle A, Section 412.051) A program designed to assist employees who sustain compensable injuries to return to work
14Immediate savings when TIBS cease Potential benefitsin return-to- work programImmediate savings when TIBS cease
15Other Benefits to the Employer - Direct Savings: Productivity increases and human resources are utilized to the maximum extentWage costs for substitute employees are saved.Litigation costs are normally prevented or reducedPossible reduction or ending of medical costs
16Benefits to the Employer - Indirect Savings: Work delays and business interruptions are eliminated when the experienced employee returns to work.Co-workers are not required to perform extra duties to compensate for the absent employee.Communications and relations between employees and management are enhanced.Recruitment and staff training costs of new or substitute employees are saved.Goodwill and a positive image with the public and employees are created, as the employer is perceived as a caring employer
17Benefits to the Injured Workers: Employee concerns about continued employment are resolved.Full or partial wages are earned which brings the employee's income closer to pre-injury wages than workers' compensation temporary income benefits alone.They remain active and mobile when returned to the productive workforce.Self-esteem, morale and personal security are maintained or restored through gainful employment and a productive life style.Stress, boredom, and depression associated with the injury/illness and being out of work are reduced or eliminated, not only for the injured worker, but for the family or significant others.Physical conditioning through a work-life discipline is maintained.
19Successful return-to-work programs Knowledgeable, proactive return to work coordinatorContinuous education and trainingJob descriptionsJob hazard analysisOn-going identification of positions suitable for alternate duty assignmentsWritten communicationsEarly intervention and prompt, sympathetic regardConsistent application of a detailed return to work policy and proceduresFormsAccurate and systematic evaluation
20You and Your front-line supervisors must be on board!
21http://www. sorm. state. tx Workers-Compensation/ Return to Work Programs"Position Description”DWC 73 "Return-to-Work Status"SORM 85 Return To Work PolicyBona-fide Job Offer of Employment Notification
23First:a) An employer or insurance carrier may request the treating doctor provide a Work Status Report by providing the treating doctor a set of functional job descriptions which list modified duty positions which the employer has available for the injured employee to work. The functional job descriptions must include descriptions of the physical and time requirements of the positions.
24Second:(b) An employer may offer an employee a modified duty position which has restricted duties which are within the employee's work abilities as determined by the employee's treating doctor.
25Third:In the absence of a Work Status Report by the treating doctor, an offer of employment may be made based on another doctor's assessment of the employee's work status provided that the doctor made the assessment based on an actual physical examination of the employee performed by that doctor and provided that the treating doctor has not indicated disagreement with the restrictions identified by the other doctor.
27Fourth:c) An employer's offer of modified duty shall be made to the employee in writing and in the form and manner prescribed by the Commission. A copy of the Work Status Report on which the offer is being based shall be included with the offer as well as the following information:1) the location at which the employee will be working;2) the schedule the employee will be working;3) the wages that the employee will be paid;4) a description of the physical and time requirements that the position will entail; and5) a statement that the employer will only assign tasks consistent with the employee's physical abilities, knowledge, and skills and will provide training if necessary.None of these elements may be overlooked and the offer MUST be made in writing.
28Fifth:d) A carrier may deem an offer of modified duty to be a bona fide offer of employment if:1) it has written copies of the Work Status Report and the offer; and2) the offer: a) is for a job at a location which is geographically accessible as provided in subsection (e) of this section; b) is consistent with the doctor's certification of the employee's work abilities, as provided in subsection (f) of this section; andwas communicated to the employee in writing, in the form and manner prescribed by the Commission and included all the information required by subsection (c) of this section.
29Sixth:(e) In evaluating whether a work location is geographically accessible the carrier shall at minimum consider:(1) the affect that the employee's physical limitations have on the employee's ability to travel; (2) the distance that the employee will have to travel; (3) the availability of transportation; and (4) whether the offered work schedule is similar to the employee's work schedule prior to the injury.
30Seventh:(f) The following is the order of preference that shall be used by carriers evaluating an offer of employment: (1) the opinion of a doctor selected by the Commission to evaluate the employee's work status; (2) the opinion of the treating doctor; (3) opinion of a doctor who is providing regular treatment as a referral doctor based on the treating doctor's referral; (4) opinion of a doctor who evaluated the employee as a consulting doctor based on the treating doctor's request; and (5) the opinion of any other doctor based on an actual physical examination of the employee performed by that doctor.
31Eighth:(g) A carrier may deem the wages offered by an employer through a bona fide offer of employment to be Post-Injury Earnings (PIE), as outlined in §129.2 of this title (relating to Entitlement to Temporary Income Benefits), on the earlier of the date the employee rejects the offer or the seventh day after the employee receives the offer of modified duty unless the employee's treating doctor notifies the carrier that the offer made by the employer is not consistent with the employee's work restrictions. For the purposes of this section, if the offer of modified duty was made by mail, an employee is deemed to have received the offer from the employer five days after it was mailed. The wages the carrier may deem to be PIE are those that would have been paid on or after the date the carrier is permitted to deem the offered wages as PIE. (Post Injury Earnings)
33The employee may decline the employer's offer of an alternate duty job and remain on leave. However, the Texas Workers' Compensation Act allows income benefits to be reduced when an employee refuses a bona-fide offer of employment. This reduction in benefits is permitted regardless of FMLA.
34Changes in the Designated Doctor and Required Medical Examination rules As of January 1, Rule (c), the Designated Doctor’s role has expanded to include the resolution of questions regarding(1) impairment caused by employees compensable injury(2) the attainment of MMI(3) the extent of the employees compensable injury(4) whether the employee’s disability is a direct result of the work-related injury;We are already being warned not to use this rule for # 3 or # 4, but that’s a different class.(5) the ability of the employee to return to work (RTW); or(6) issues similar to those described in 1-5.
35Sample RTW forms are provided on SORM’s website at
36Bona Fide Offer of Employment Letter (SAMPLE) Delivery Confirmation RequestedDear (claimant):Our office is in receipt of medical information from Dr. _____________ outlining the restrictions under which you are able to return to work. Pursuant to Workers' Compensation Commission Rule 129.6, this letter is a Bona Fide Job Offer for you to return to work consistent with information provided herein. Our office will abide by the physical limitations as outlined by the physician. The office will only assign tasks consistent with your physical abilities, knowledge and skills and will provide training if necessary.Position title 2. Hours of duty: ____a.m. / p.m. until ____ a.m. / p.m. 3. Wages: $____Hourly $____Weekly $____Monthly 4 Job description, including duty hours, and maximum physical requirements of the position (lifting and approximate lbs.; approximate time stooping, pushing, standing, sitting, etc.): 5.Address, location, and approximate distance in miles from employee’s residence Beginning date of the position _________ Ending date of the position________Should you have any questions, please contact the undersigned below.Sincerely,
37For more information about return to work, please go to SORM’s website at:
38Officer Garry Parker Texas Department of Public Safety Travel SafetyOfficer Garry ParkerTexas Department of Public Safety
41SORM 200The State Office of Risk Management 200 (SORM 200) is the sole source for collecting statewide information from state agencies regarding their expenditures for risk management activities, insurance purchases and non-workers’ compensation claims made or settled against the agency.The intent of the SORM 200 is to capture costs associated with agency Risk Management Programs, and to compile information necessary for SORM to include the administrative costs of risk in the Office's biennial report to the legislature.
42SORM 200 The SORM 200 is divided into two parts: Part I - Risk Management Expenditures: the intent of this section is to capture those costs associated with agency’s direct risk management costs.Part II - Insurance and Risk Related Expenditures: used to submit non workers’ compensation insurance information for the current fiscal year.
43SORM 200Data for SORM 200 is requested from each agency for online input by October 30 of each fiscal year.Database is closed on October 30 and any additions or corrections can only be entered by SORM personnel.Data is being analyzed for data integrity.
44Cost of Risk FY 03, 04, 05 CASH BASIS Risk Management Programs Workers’ Comp ClaimsCost ContainmentSettlements & JudgmentsBonds, Insurance & DeductiblesActuarial ServicesCourt Costs & Attorney FeesRisk Management & Claims AdminLost, Damaged & Destroyed PropertyFY 03$ 27,262,58867,571,1771,279,9563,512,08011,732,27912,0001,901,0626,086,276539,687FY 04$ 33,029,73754,650,8721,146,7115,653,48415,417,8954,5001,866,3696,458,034504,585FY 05$ 26,171,31152,534,0241,380,9504,190,85814,934,03313,000971,0066,525,0553,103,681ACCRUED COSTSReserves for Future ClaimsIncurred But Not ReportedTOTAL COST OF RISK63,259,24167,860,000$251,016,34550,99,36784,966,000$254,690,55354,103,73277,929,244$241,856,894
45Expenditures vs COR % Cost of Risk $ 251,016,345 $ 254,690,553 FY 03FY 04FY 05Cost of Risk$ 251,016,345$ 254,690,553$ 241,856,894Risk ManagementExpenses$ 27,262,588$ 33,029,737$ 26,171,311PercentageRM Expenses/COR11%13%
47Property & Casualty Claims Virtually, any event, where damages to persons or property, that may cause a financial loss to the agency must be reported. This includes:1. Injuries or damages (insured or uninsured); automobile accidents involving agency owned vehicles whether owned, non-owned or hired;2. Agency owned vehicle damage (automobile physical damage) or third party vehicle damage (automobile liability - property damage);3. Property damage which may includes theft/vandalism of personal property. ;
48Property & Casualty Claims 4. Right to sue notices from EEOC or Department of Human Rights (employment practices type), injuries to volunteers (accident type);5. Injuries to the public within/on state owned/managed facilities or premises (slips and falls).
58Agency Outreach & Training Bradley PraisTraining Specialist
59Regional Open Enrollment Results 3 Completed: 700+ Students, 32 AgenciesMost Popular:Bloodborne PathogensStress ManagementAnger & Conflict in the WorkplaceProblems:Limited attendance by smaller field officesLimited announcements to field offices
60Sample Schedule: AM Day 1 Day 2 Day 3 Room 1 Room 2 Room 3 9:00 9:15 Day 1Day 2Day 3Room 1Room 2Room 39:009:15StressNotaryOffice9:30PublicSafety9:45CPRSupervisor's10:00ADSOAccidentClaimsRole10:15InvestigationCoordinatorin10:30VickiErgo10:45Anger&11:00HAZCOMDianeWorkplace11:15Conflict11:3011:4512:00
61Sample Schedule: PM Day 1 Day 2 Day 3 Room 1 Room 2 Room 3 12:45 1:00 Day 1Day 2Day 3Room 1Room 2Room 312:451:001:151:30SolvingSlips, TripsBack Inj1:45ADSOConflict& FallsLiftingWorkplace2:00(Cont)Violence2:15for2:30DefensiveFirstClaimsManagers2:45DrivingAidCoordinator3:00 (Cont)ConfinedBloodborne(Cont) 3:15SpacesPathegons3:3015 PaxShort3:45Van4:004:154:304:455:00
62Regional Open Enrollments Schedule Harlingen: February Hosted by TSTCNacogdoches: June Hosted by SFAOpen Dates: April, August, October
63New Classes Driving Safety: 4hrs CPR & First Aid: 8hrs, Limited availabilityOffice Safety: 1hrClaims Coordinator: 2 daysSupervisors Role in Safety: 3hrs
64Pinpointing your Exposures: Loss Trending and Benchmarking through the State Office of Risk ManagementPresented by:Benny Vanden AvondSORM Risk Management Specialist
71Risk Identification through REPS: Questions, Questions, Questions
72Identified Risks Two Employees complained about indoor air quality 22 Automobile Accidents occurred in Fiscal Year 2005, but only six occurred in Fiscal Year 2006Our agency spends 17.04% of our Risk Management Program Expenditures on Employee SalariesBlah, Blah, Blah…
73Risk Identification through REPS Blah, Blah, Blah…
74Identified Risks Two Employees complained about indoor air quality Have you had previous complaints?22 Automobile Accidents occurred in Fiscal Year 2005, while six occurred in Fiscal Year 2006Has your fleet size significantly changed?Our agency spends 17.04% of our Risk Management Program Expenditures on Employee SalariesHow does this compare to other state agencies?
91Benchmarking with CORR Agencies can use the CORR information to benchmark their risk management expenditure performance compared to statewide totalsIndividual agency expenditure data for the past four years is available within the RMIS section of the SORM website.Agencies should find the percentage columns particularly useful for benchmarking efforts.
98Benchmarking with CORR F - Salaries$13,55017.04%G – Benefits$5,5006.92%H – Travel$1,2001.51%Total Expenditures$79,500100.00%
99Summary Risk Analysis is a vital piece of the Risk Management Process Loss Trending and Benchmarking are just two of many risk analysis techniques availableREPS, OPCC, and CORR are valuable risk analysis tools provided through SORM
100Risk Management User Group Thank you for attendingHappy Holidays!!