Jeffrey Cavignac, CPCU, RPLU, president and principal of San Diego-based Cavignac & Associates (www.cavignac.com), a leading commercial insurance brokerage firm providing a broad range of insurance and expertise to design and construction firms, as well as real estate-related entities, law firms, manufacturing companies and the general business community, offered the following insightful guidelines.
As workers compensations costs continue to escalate, employers are constantly looking for ways to manage and control their claims. Ultimately, claims determine workers compensation premiums, and the only way to control premiums is to reduce claims.
One claim reduction technique is to implement an effective Return to Work Program. In essence, Return to Work Programs involve taking injured workers and temporarily placing them in job assignments (different from their normal work) that accommodate their work-related injuries. Specifically, Return to Work Programs fulfill three basic objectives:
1. To facilitate recovery and promote rehabilitation.
2. To prevent abuse of the workers compensation system.
3. To reduce the cost of temporary disability.
Before writing and implementing a Return to Work Program, employers likely will need to make some major policy decisions. The first decision deals with the maximum length of the transitional work (alternate duty) assignment. Most transitional work periods range from 60 and 120 days.
Setting a time frame accomplishes several things: It forces the employer to monitor and manage the claim within the agreed-upon time frame. Moreover, it clarifies to the employee that the alternate duties are not permanent, and that he or she is expected to make the transition back into a regular full-time job within a set number of days.
The second issue an employer has to deal with is those injured employees that are not candidates for transitional work, or who are unable to return to a permanent job. Usually, the best alternative (and sometimes the only alternative) is vocational rehabilitation.
Furthermore, the employer must communicate the purpose of the company’s Return to Work Program to both management and employees. Managers and supervisors need to understand the objectives of the Return to Work Program. Likewise, staff members need to be educated on the rehabilitative benefits of transitional work and its temporary nature, as well as the alternatives for employees who cannot work their way back into a regular job.
Finally, the employer must be in a position to communicate alternative duty assignments to a treating physician other than the company’s designated provider. It may be helpful to prepare in advance a pamphlet or letter outlining the available assignments. Doing so will help the injured employee’s doctor to better determine if he or she is a candidate for these temporary positions.
The purpose of a Return to Work Program is to minimize the impact and cost of disabling injuries as they pertain to a company and its employees. Keeping this in mind, employers may want to consider implementing alternative or transitional job requirements that can be offered when appropriate to injured employees on a temporary basis. Following are a few suggested guidelines:
Subsequent to a work-related injury and based on the physician’s evaluation of the injured employee’s capabilities, the employer will determine whether or not an alternative job would be an option.
A transitional job offer will only be made available when the work benefits the company.
The transitional job will end with the date the employee receives a regular release, and it may be ended at any time if there is no longer a need for the transitional work.
Each case will be assessed individually, based on need. Transitional work may not be implemented in every lost time claim.
Wages will not necessarily be the same as that of the regular job. In some cases, employees may be eligible for a wage supplement from the company’s workers compensation insurance company.
On-the-job injuries and occupational diseases will be evaluated by a team consisting of the injured employee, his or her supervisor, the company owners, the insurance company, and the injured employee’s physician.
Keep in mind that alternative or transitional work responsibilities should be beneficial to both the employee and the company. Employers setting up a Return to Work Program for the first time may want to obtain assistance from their insurance broker or workers compensation company. The goal is to develop an effective program that ultimately will reduce workers compensation claims for employers.