Easing the ‘Return-to-Work’ Process for Injured Workers

By Jackie Payne, Vice President Medical Management Services, Mitchell Casualty Solutions | July 24, 2017

In 2015, the U.S. Bureau of Labor Statistics reported that 2.9 million non-fatal workplace accidents occurred that year. Of this, over 50 percent of the injured workers experienced time lost from work. A number this large obviously eats into a company’s productivity, which is why employers and carriers are continuously looking for ways to ensure their return-to-work programs are effective and focused on what’s best for injured workers.

Let’s start with defining what the goal of any return-to-work program is: it’s to get the injured worker back to their pre-injury condition in a safe and timely manner. Typically, these programs are comprised of all of the accommodations and resources that are needed to facilitate the processes that make up the return-to-work program for injured workers. Employers and insurers generally collaborate to create these return-to-work programs and are responsible for identifying and providing work arrangements that accommodate any restrictions or limitations that may interfere with an injured worker’s return to work.

In pursuit of building out an effective return-to-work program, employers and carriers should keep in mind the following best practices and elements, while also recognizing the potential factors that could affect the success of an injured worker’s return to work.

  1. Addictive behavior: If an injured worker has a history of addiction or shows signs of addictive behavior, there is a chance the medication they are prescribed to relieve their injury can trigger their behavior or addiction – thus disrupting and demotivating their will to return to work. In these instances, it’s important for insurers and employers to be aware of whether an injured worker might be affected negatively by opioids and other pain relievers.
  2. Relationship with employers: If an injured worker has a negative relationship with their employer, or the employer does not recognize that the employee is an essential part of the workplace, injured workers can lose their sense of worth, making them less likely to want to return to the workplace.
  3. Fear of re-injury: Employees who are injured on the job, especially when performing an activity they do frequently, creates a new sense of fear, leaving workers wondering, ‘what if this happens the next time I perform this task?’ That feeling of ‘what if’ might be enough to stop an injured worker from hurrying back to work.
  4. Unnecessary litigation: It’s common to see injured workers confused or feeling frustrated by what they believe is a complex workers’ compensation program. If they feel like the insurer or their employer has failed to educate them on the workers’ compensation process or doesn’t share a concern for their well-being, the injured worker may seek legal counsel, which can add to the cost of the claim, delay the return and generate hostility toward injured workers.
  5. Multiple workers’ compensation claims: In general, when an injured worker has multiple claims open, it can be somewhat confusing to keep track of which injury is being accounted for, ultimately delaying settlements and prolonging the return-to-work process.
Creating an effective return to work program: The employer’s role

Until now, most employers have focused their return-to-work programs on containing costs and reducing days lost, representing a more transaction-centric approach to workers’ compensation. However, experts now say that changing the primary focus to supporting the injured worker in return-to-work programs can improve outcomes for all parties involved – this is just one of many best practices to strengthen employee engagement and ultimately support an injured worker’s return to work.

What we describe below are three of the most effective best practices and elements employers should consider when building out an effective return-to-work program.

Establishing and effectively socializing the company’s return-to-work policy

In order to set the right expectations, it’s essential for employers to clearly define, establish and communicate their return-to-work policy and protocols to internal employees across the organization, as well as communicate out to their external program vendor partners.

Often, it’s not until after the fact that nurse case managers know the employer’s return-to-work policies, which can cause discrepancies in expectations. If the nurses are aware earlier of the employer’s policy and its goals of the program, it could lead to easier and more effective facilitation of processes.

Stay in touch with the injured worker

Employers who keep the lines of communication open with injured workers post-injury are playing an important role in keeping the worker engaged. Injured workers tend to withdraw from their employer and coworkers when they are recovering. Losing that sense of connection has the potential to demotivate injured workers from wanting to return to work. To that end, by highlighting that the employer’s return-to-work program focuses heavily on the injured worker and their health and wellness, staying in touch with the worker becomes an essential part to uplifting an injured worker’s wellness to keep them motivated to return to work quicker.

Modify and accommodate light-duty job assignments

The goal is to keep the worker engaged even if the work that they come back to post-injury is not the work they are used to performing. Employers should consider making accommodations or modifications to job positions so that the injured worker feels safe and supported to return to their job. Even small modifications can yield significant results – such as, not lifting more than “x” amount of pounds. Larger accommodations, for instance, offering the flexibility for employees to telecommute or work part-time, can also yield great results – as they are providing employees with the tools and resources they need to carry out their responsibilities. Studies have shown that the longer an injured worker is out of commission, the more likely it is that they don’t return to work at all. Because of this, there is an imperative to helping injured workers avoid long delays in returning to work, and accommodating light-duty job assignments is one way of doing so.

How insurers can work with employers to ensure an effective return-to-work

It’s common for employers to programmatically coordinate their return-to-work efforts with an insurance company. It makes sense to engage vendor partners in return-to-work initiatives, such as medical management organizations’ case management programs. As a result, employers can then leverage these company’s subject matter experts who are well versed in this particular area of expertise – and have the ability to help refine the programs for optimal outcomes.

Last piece of advice: partner with a medical management organization to refer the case to case management

In an ideal world, the first notice of treatment of an injured worker should be forwarded to the medical management organization partner for case management triage. Realizing that not every case warrants a nurse at the beginning, employers and carriers benefit from having a “trigger” list of injuries on which it would be advantageous to enlist early case management. The key to cost containment is not to prohibit workers from care or provide less desirable care, but rather to ensure the right care is provided at the right time. Early case management facilitates treatment:

  • Provided within networks, if applicable.
  • Provided within evidence-based guidelines.
  • And engages the injured worker to educate them on the workers’ compensation process, which can often be a confusing and frustrating process for most.
Everybody wins with an effective return-to-work program

It’s essential for employers and insurers to work together to create an effective return-to-work program. Addressing the challenges head-on that arise when creating a return to work program ensures an injured worker is never lost in the process. A successful return-to-work program aligns the employer, insurer and injured worker, and can make the recovery process less worrisome for the person impacted. Ultimately, that peace of mind can help speed up their recovery process and make sure the injured worker feels supported – which means the employee gets back to work sooner.

Jackie Payne is vice president of Medical Management Services for Mitchell Casualty Solutions.