Return to Work Programs Bureau of Workers Comp
Return to Work Programs Bureau of Workers’ Comp PA Training for Health & Safety (PATHS) Pennsylvania Workers’ Compensation Act 57 PPT-064 -01 1
Return to Work Program • Defined: A program designed to restore injured workers to their former lifestyle in the safest and most effective manner possible; a planned and coordinated program among workers, union reps, employers and health care providers Return To Work PPT-064 -01 2
Return to Work Program GOALS: - Return an employee to full time work - Reduce costs due to lost time - Adopt “best practices” One program found that “RTW programs save about 30 to 40 percent of workers’ compensation indemnity payments. ” PPT-064 -01 3
RTW Programs An RTW program must consider applicable laws such as: § Pennsylvania Workers’ Compensation Act, as amended § Americans with Disabilities Act (ADA) 1990 § Americans with Disabilities Act Amendments Act of 2008 § Family and Medical Leave Act of 1993, with 2009 updates PPT-064 -01 4
PA Workers’ Compensation Act (WC Act), Section 306(b)(2), provides in part: “If the employer has a specific job vacancy the employee is capable of performing, the employer shall offer such job to the employee…” PPT-064 -01 5
ADA of 1990 Americans with Disabilities Act (ADA) 1990 • Requires employers provide “reasonable accommodation” to qualified persons ADA 1990 Defines “Employer” as: • All private and public employers • With 15 or more employees • In each working day • In each of 20 or more calendar weeks • In the current or preceding year PPT-064 -01 6
Disability: ADA Defined ADA Defines a “Disability” as: - A physical or mental impairment that affects the performance of a major life activity, to include work - A history of such impairment - Perceived as having such an impairment Does NOT include temporary condition or impairment PPT-064 -01 7
ADA Amendments Act of 2008 (ADAAA) - Retains the intent of ADA but changes interpretations: - Directed EEOC to revise regulations defining “substantially limits” - Expand “major life activities” - Mitigating measures other than “ordinary eyeglasses or contact lenses” shall not be considered in assessing if a person has a disability PPT-064 -01 8
ADAAA - Episodic impairments or those in remission are disability if they substantially limit a major life activity when active - Providing a person subjected to an action prohibited by ADA (e. g. , failure to hire) due to an actual or perceived impairment will meet the “regarded as” definition of disability unless impairment is transitory PPT-064 -01 9
ADAAA • Those under “regarded as” are not entitled to reasonable accommodation • Definition of “disability” should be interpreted broadly. • Employers are required to follow the intent of ADA SHRM, Society for Human Resource Management (www. shrm. org) PPT-064 -01 10
ADAAA Compliance Steps - ADA training: supervisors & managers - Flexible accommodation process, consistent, reasonable - Review/modify policies and job descriptions • Ensure essential job functions • Procedures re: accommodation and treatment PPT-064 -01 11
Family & Medical Leave Act 1993 Act addresses: - Needs of work force - Development of “high performance organizations” GOALS: - Recognize workplace demands and family needs - Preserve family integrity - Economic security and family stability PPT-064 -01 12
Why Return To Work Programs? • To restore injured worker to former lifestyle • Partnership between: - Workers - Union - Employers - Health care providers PPT-064 -01 13
Full Potential Realized By: § Reducing financial burdens to - Employers - Workers’ families § Reducing negative effects due to time off work § Unions protect rights of their members § Specialized plans by health care provider § Support primary care provider in RTW decision PPT-064 -01 14
Effective RTW Plan Supported by top management Management recognizes plan’s value: • Tangible (cost containment) • Intangible (employee dedication) PPT-064 -01 15
Costs of Absence To Workforce: - Replacement workers - Increased benefit costs - Loss of potential income To Employer: - Production recovery - Quality/hiring of replacement workers - Lower morale PPT-064 -01 16
Costs of Absence To Employer • Increased training costs • Overtime • Non-productive work time (accidents) • Increased premiums • Other non-recoverable costs PPT-064 -01 17
Benefits of RTW • Employer • Injured worker • Co-workers • Union • Health care professional • Family • Support networks: - Consultants - Community - Friends PPT-064 -01 18
Safe Environment Creating a Safe Environment - Safety inspection - Housekeeping rules - Hazard inspection PPT-064 -01 19
General Safety Rules Address: • Behaviors • Environment • Hazards • Equipment • PPE • Reporting of accidents, incidents, conditions PPT-064 -01 20
Accident Investigation • Determine direct cause • Prevent similar future occurrences • Document facts • Provide cost data • Reinforce joint labormanagement safety commitment • Determine corrective actions PPT-064 -01 21
Accident Investigation General Steps: • • • Be prepared Survey the scene Respond to emergency Secure the area Gather evidence: photos, interviews • Analyze information-write report • Recommend changes/implement corrective action • Follow-up PPT-064 -01 22
RTW Program: (9 Steps) Developing a RTW Program Step 1: RTW Committee (or Disability Management Team) Step Step 2: 3: 4: 5: 6: 7: 8: 9: Policy Statement Develop Provider Panel Job Task Analysis Alternate Work Assignments Provider Form Communicate Policy to Workforce Educate Workforce Stakeholder Responsibilities PPT-064 -01 23
Step 1: RTW Committee Or Disability Management Team (DMT) Establish workplace policy Guide/monitor program administration Case management Direct injured worker’s recovery to full time employment • Evaluate job positions to improve loss prevention and safety • Union shop = Rep on committee • Confidentiality of employee information (HR rep only) • • PPT-064 -01 24
Step 1: RTW Committee “Transition-to-Work” (TTW) is a joint effort with DMT Those for whom plan is designed should have input 1. Supervisor meets with injured party after injury and maintains contact with party or family until ready to return PPT-064 -01 25
Step 1: RTW Committee Transition to Work 2. Ready to return: injured works with management to create a plan toward full time work 3. Time returned increases until party is full time again PPT-064 -01 26
Step 1: Management and workforce reps • Develop strategy to communicate support and commitment • Union requirements viewed if applicable PPT-064 -01 27
Step 1: Employee Rep • Provides information about union requirements of modified duties • Monitors and assists in creating temporary accommodation positions • Acts on behalf of the worker in matters of seniority and job assignments • Acts as liaison to workforce by keeping co-workers informed on committee progress PPT-064 -01 28
Step 1: HR or Safety Staff • Direct case activities • Allocate resources to modify tasks or work sites • Coordinates final arrangements for alternative work • Monitors injured worker’s progress PPT-064 -01 29
Step 1: Health Care Rep • Provider or occupational health nurse • Volunteer from company WC panel • Direct medical rep would be good asset - Form format - Questions - Follow-up advice PPT-064 -01 30
Step 2: RTW Policy Statement Philosophy based on: § Workforce involvement of management, supervisors, workers § Establish joint employee/management committee § Treat injured/ill with dignity, consideration and respect § Commit to support injured worker’s medical treatment § Focus on person’s capabilities-not disabilities § Commit to return worker to original job § Mandatory participation by labor and management PPT-064 -01 31
Step 3: Develop Provider Panel § Provide written notice to injured workers of their rights (WC Act Section 306(f. 1)(1)(i) & 34 Pa. Code Section 127. 755) § Employee free to choose any provider on list § Emergency treatment not required from list § After emergency, employee shall seek treatment from list § No list? Employee can chose treatment from any provider PPT-064 -01 32
Step 3: Designated Health Care Provider List § Must contain at least six providers § Three of the six must be physicians § No more than four may be coordinated care organizations § Each provider, on list, must include: - Name Address Telephone number Area of medical specialty PPT-064 -01 33
Step 3: Health Care Provider List Step 3: Designated Health Care Provider Listed providers must be: § Geographically accessible § Specialties appropriate for anticipated work-related medical problems of employees PPT-064 -01 34
Step 4: Job Task Analysis Assess workstation and job design functions: § Loss prevention § Identification of alternate work assignments § Eliminate hazards § Identify risky jobs and redesign § Avoid accidents before they occur PPT-064 -01 35
Step 4: Identifying Alternate Work Assignments Managers and workers review existing job descriptions Perform Job Task Analysis (JTA)using task analysis checklist Checklist: § Identify root cause of unsafe conditions § Prioritize and address worst problems § Make hazard prevention a priority § Provide information to health care provider treating injured § Determine job modifications PPT-064 -01 36
Step 4: Questions During JTA § Activities involved § Physical functions required/ how frequently § Duration § Typical daily schedule § Equipment and tools required/how used/ postures involved § Skills required § Weights lifted/how often PPT-064 -01 37
Step 4: Questions • Allow workers closest to activities to participate • Conduct force/exertion tests for job • JTA drafted, have employee sign off before injury occurs • Keep JTA up to date, review often PPT-064 -01 38
Step 5: Alternate Work Assignments • Designed to accommodate limitations; restrictions temporary or permanent • Modify injured worker’s original job • Reduce hours or combine other tasks Ask: q What tasks could worker perform? q What tasks now need to be done more frequently? q What tasks could be assigned to others? q Ensure prevention of re-injury q During recovery, emphasize capabilities PPT-064 -01 39
Step 6: Provider Form • So injured can inform treating provider of RTW program • Identify information required for needs • Consult medical reps on RTW committee PPT-064 -01 40
Step 7: Communicate Policy § To workforce in writing § Statement: signed/dated by employee and filed in personnel file § If union, first confer with union before posting new policy § Post in visible area of workplace PPT-064 -01 41
Step 8: Educate Workforce § § Ensure all are aware of RTW principles & practices Educate supervisors and workers of returning injured worker’s needs Inform all employees of RTW benefits: § § § § Employee orientation to explain RTW program Provide continuing education Display mission statement/policy Include information in employee newsletter Sensitivity training to aid co-workers understand Support/education to injured worker’s family RTW team: educate injured workers on new tasks or modified jobs PPT-064 -01 42
Step 9: Inform Stakeholder of Responsibilities • After injury, develop and manage individual RTW plan • Responsibilities for: - Employer - Health care providers - Injured worker - Union or worker rep PPT-064 -01 43
Step 9: Employer Responsibilities § Provide worker and family support § Maintain fact-finding not fault finding during investigation § Review report and address job related issues § Develop RTW plan § Communicate return-to-work opportunities PPT-064 -01 44
Step 9: Employer Responsibilities § Provide health care provider with accurate task list to assess worker’s suitability for a position § Maintain communication with HCP and worker about progress of individual § Detailed job descriptions and make temporary and permanent accommodations § Monitor injured worker’s progress during treatment and upon return PPT-064 -01 45
Step 9: Health Care Provider • Team approach • Treat all effects of injury; and possible psychological impact • Initially, identify appropriate treatment; make realistic prognosis when worker will be able to RTW PPT-064 -01 46
Step 9: Health Care Provider • Focus on worker’s recovery; advise worker and employer when a RTW is medically appropriate PPT-064 -01 47
Step 9: Health Care Provider • Contribute medical knowledge to RTW plan • Identify other inhibiting factors to worker’s return • Communicate any potential workplace risks effecting return to work; follow-up with prompt intervention • Tailor each treatment plan to be medically appropriate PPT-064 -01 48
Step 9: Injured Worker • Obtain medical treatment • Influence design of the individual plan • Follow treatment plan • Keep regular contact with employer to inform of progress and needs PPT-064 -01 49
Step 9: Union or Worker Rep • Work with employer and worker to develop appropriate work plan • Represent injured worker: - Job security - Appropriate treatment - Re-employment assignments PPT-064 -01 50
RTW Essential Elements § Set up list of clear steps followed after an injury § Set up communication lines with health care provider, management and union § Set up contact schedule to monitor progress with worker PPT-064 -01 51
RTW Essential Elements § Evaluate/enhance RTW program regularly § Have RTW as part of benefit package § Identify some RTW opportunities before they’re needed PPT-064 -01 52
RTW Essential Elements Ø Positive/flexible; focus on capabilities not disabilities Ø Use accommodation methods: - Videos in job modification - Workplace redesign - Rehab efforts Ø Promote cooperative environment Ø Maintain contact with all partners Ø Ensure RTW tasks appropriate to worker’s capabilities Ø Injured worker assists in identifying suitable work PPT-064 -01 53
Ability to Return to Work Notice of Ability to Return to Work The notice of ability to return to work must be given promptly upon receipt of medical evidence that the employee is able to return to work! FORM LIBC-757 PPT-064 -01 54
Notice of Ability to Return to Work WC Act Section 306(b)(3) provides: If insurer receives medical evidence the employee is able to return to work in any capacity, then the insurer must provide prompt written notice, on a form prescribed by the department, to the employee, that states all of the following: (1) Nature of employee’s physical condition or change of condition, PPT-064 -01 55
Notice of Ability to Return to Work (2) That the employee has an obligation to look for available employment, (3) That proof of available employment opportunities may jeopardize the employee’s right to receipt of ongoing benefits, and (4) That the employee has the right to consult with an attorney in order to obtain evidence to challenge the insurer’s contentions PPT-064 -01 56
Summary A Return to Work Program is: • A program designed to restore injured workers to their former lifestyle in the safest and most effective manner possible • A planned and coordinated program among workers, union reps, employers and health care providers PPT-064 -01 57
Program Success: (9 Steps) RTW Program Success Depends on: Step 1: RTW committee (or team) Step 2: Policy statement Step 3: Develop provider panel Step 4: Job task analysis Step 5: Alternate work assignments Step 6: Provider form Step 7: Communicate policy to workforce Step 8: Educate workforce Step 9: Stakeholder responsibilities PPT-064 -01 58
Questions? PPT-064 -01 59
Contact Information To contact a Health & Safety training specialist: Bureau of Workers’ Compensation 1171 South Cameron Street Room 324 Harrisburg, PA 17104 -2501 717 -772 -1635 RA-LI-BWC-Safety@pa. gov PPT-064 -01 60
Website To download the Return-to-Work Manual, go to: http: //www. portal. state. pa. us/portal/server. pt/comm unity/return-to-work/14478 RTW al u n a M PPT-064 -01 61
- Slides: 61