Return to Work (RTW) After an injury

Return to Work Goals Early, safe, sustainable Focus on ability Improve worker retention and satisfaction Increased time at work, productivity Stable employment Implemented fairly Reduced cost-direct medical and indemnity

Return to work program Formal- Written policies and procedures Guides supervisors and employees Consistency Informal- No written policies Case by case Relationship based Department practices

Why is early return to work good for the worker? Earning wages Maintain benefits Social aspect of work/be with co-workers Self esteem Focus on ability On the job work conditioning Communicate with the employer Keep their job/sense of job security Likelihood of RTW diminishes over time

Early return to work is good for the employer Promote faster recovery Reduce loss of productivity Keep skilled worker Reduce training costs of new workers Decrease WCF premiums Decrease indemnity costs Complements health and wellness

Work Releases Physician discusses goals for early and safe return to work with the worker Physician provides objective restrictions Use medical guidelines if available Communicate restrictions to employer Ask for regular job description Ask for modified duty job description Support the employee and employer for early and safe return to work

Why keep moving? Newton’s law of motion: A body in motion tends to stay in motion and body at rest tends to stay at rest, unless acted upon by an outside force.   Return to work Patients who are active, tend to have better outcomes Patients who are taken of work, tend to remain off work

Provide restrictions Identify impairment Identify restrictions or functional limits Make restrictions clear and objective Ask the employer for job descriptions Ask the employer for modified duty job descriptions Employer determines accommodation

Tips: Do’s and Don’ts Don’t Write: Instead, write: Patient should work in a stress-free environment Patient to work in quiet environment to minimize frequent distractions and interruptions. Patient should not multi-task Multi-factorial assignments must be broken down into discreet tasks or Memory prompts may be supplemented no more than 3x’s daily with personal check-ins or reminders by supervision personnel. Patient should be off on Mondays Patient should only work 32 hours per week. It should be the employer’s decision as to how they assign their employee to the work schedule. No night or evening shifts (this assumes that impaired night vision is not a relevant medical diagnosis) Patient should only work 8 hours per day. Again, it should be the employer’s decision as to how they assign their employee to the work schedule. Patient should be allowed to go home, early, or as needed Patient may work 6 hours per day form (Date) to (Date), followed by 7 hours per day from (Date) to (Date) and 8 hours per day beginning (Date). No overtime Patient may perform their usual and customary duties, within regular working hours. Patient should only drive the new buses Patient is to avoid strong vibrations or jerking movements affecting the pelvis, lower back regions while seated to include driving activities Patient should not work with their present supervisor and should be assigned to a different department Patient should be assigned tasks he/she is fully competent to perform and is encouraged to review daily accomplishments and any difficulties, 2x a day with a supervisor/manager.

Job Descriptions Employer may have Clinic can provide service

Employer Successful Return to Work Commitment to health and safety Fewer lost work days Support the injured worker (highly predictive of successful RTW) Make modified duty available Meet with the injured worker quickly Responsible Return to Work Coordinator Communicate with the health care provider about work and demands Reduced costs and work comp experience

How is the clinic doing? Measure: Length of time away from work given Claim duration to Med Stat Medication prescribing Complementary treatment-PT, Acupuncture, Chiropractic Share results with the physicians; how the department is doing and how they compare with their colleagues Use evidence based guidelines, if available: Reed, ODG, ACOEM

How is the employer doing? Multiple measures: Written policies and procedures Modified duty tasks identified Direct medical costs decreased Indirect costs-indemnity/lost work days, experience rating lower Relationship with the physician Employee satisfaction Supervisor satisfaction

Case Study Burton Blatt Institute, Syracuse University Heavy construction concrete company Informal RTW program in 2005 49 time loss WCF claims and 1,176 lost work days in 2005 2005 annual cost $464,000 Applied RTW strategies… In 2010, 7 time loss claims 2010 annual claims cost $1,088 2010, Work Comp Modification Rate decreased by 25%

RTW Strategies Applied Meetings with physicians to explain RTW program Meetings with injured employees to show support Review work restrictions and determine work ability/tasks Same day contact with physician, provide job description, work with the physician to find appropriate work Conduct accident investigations on all injuries, by safety best Monitor recovery and adjust work tasks Ongoing contact with the injured worker

What questions do you have? Thank you! What questions do you have?