return to work - acuity insurance...return to work 101 the basics the content of this presentation...

Return to Work

101

The Basics

The content of this presentation is general in nature and provided to you for informational purposes only. The

information is derived from sources believed to be reliable and is offered as a resource to be used together

with guidance from your professional insurance, legal, and safety advisors in maintaining a loss prevention

program. ACUITY assumes no liability by reason of the information contained in this document. If you have a

specific concern, you should contact your professional insurance, legal, or safety advisors.

Senior Loss Control Representative

1) How RTW controls costs & helps employees

2) Elements of a program

3) Steps to implement - See part 2 for additional details

A system can keep things from

going off track.

“Malingerer”“Overachiever”

MOST

EMPLOYEES

ARE HERE

• Impact on the company

• Impact on employees

• Company culture

• Legal implications (WC, ADA)

• Reduces:

◦ Lost Productivity

Indirect Operating Costs

◦ Claims Cost

◦ Insurance Premiums

Claims Cost:

1) Managing Care / PPO Use

2) Appropriate Treatment

3) Employee Lost Time

Impact Your Experience

Mod

Impact Your Insurance Premium

• Improves:

◦ Management-employee relations

◦ Productivity

◦ Employee morale

◦ Consistency & efficiency in handling injured workers

• Reduces loss of income (WC waiting periods)

• Reinforces

◦ A sense of security and stability

◦ Management commitment to employee welfare

◦ A positive self-image for injured worker – feels valued

• Speeds recovery

• Maintains normal working relationships with others

• Reinforces the "going to work daily" habit

• Reduces risk of litigation

• Perceptions

• Complaints

• “Give him/her a break”

Good communication can combat this

See Part 2

• Company Culture

• Legal Implications (WC, ADA)

There are several important needs:

• Administer effective first aid

• Provide effective medical treatment

• Provide information and guidance to employee

• Support employee’s psychological needs

• Investigate and analyze the incident

• Control medical costs

• Return employee to work as soon as possible

Injury Healing Recovery

The sooner an injured worker is returned to active

employment, the greater the probability of full

recovery.

TRUST

• If they don’t trust you, they may get misguided

advice elsewhere from:

◦ Family members

◦ Co-workers

◦ Friends

◦ Attorneys TRUST

• Coordination

• Documentation

• Communication

Coordinate

Document

Communicate

1. Identify responsibilities

2. Document policies/procedures

3. Identify transitional/modified work

4. Communicate & educate

5. Work with medical providers/use PPO

6. Set a time limit

HR/WC Coordinator

Supervisor

Doctor

Claim Adjuster

Employee

• WC Coordinator

• Supervisor

• Employee

• Claim Adjuster

• Doctors

• Other Management

• Report injuries to ACUITY within 24 hours

• Keep abreast of status

• Keep in contact & show compassion

• Ensure documents are completed/kept

• Help identify tasks within restrictions

• Monitor emotional state

• Monitor timing of check-ups, etc.

• Provide updates to all involved

• Outline the steps/progression following injury◦ Purpose of program

◦ Your preferred medical provider(s)

◦ How we transport to medical facility

◦ Who goes with employee to medical facility

◦ Under what circumstances employee goes home vs.

back to work

◦ Documents to use & when

◦ Timing/duration/frequency of medical follow-ups

◦ Identification of modified/transitional duty

• Document responsibilities

• Letter to doctors informing them of your policies

• Work restriction form for doctors to complete

◦ No checkbox of “off work until…”

• Modified/transitional duty offer letter/agreement

• Start with brainstorming on common restrictions

◦ One-handed

◦ Sitting

◦ 10 pounds/20 pounds for lifting

• Document essential functions or job demands

• Policies in writing (handbook & separate)

• Education/information sharing

◦ Who?

Management team

Supervisors

All employees

◦ What?

Your policies & why

How Workers’ Comp works/state regulations

• Know your state’s WC Laws

◦ Employee or Employer choice?

• Identify providers within your WC PPO

• Meet with preferred provider(s) to share

expectations & philosophy

• Have information ready to share with other

providers when/if used

• Invite providers into facility/workplace

• Any assigned transitional/modified duty has an

end date

◦ Typically the next doctor appointment

◦ New/updated duties are identified following the re-

evaluation

• No more than a month should pass between

employee medical visits/evaluations

• If no progress in set number of days, then discuss

with adjuster regarding second opinion, why they

are not progressing and what to do

• Supervisor/WC Coordinator goes to medical facility while

someone else starts investigation/analysis

• Doctor provides clear restrictions/capabilities

• Employee/supervisor brings medical restriction

information back to work

• Modified/alternate work tasks are identified

• Supervisor & WC Coordinator frequently check on

employee’s progress & alter work tasks based on

progress

Employee feels

VALUED

• Maximum ACUITY Service for Healthcare =

FREE 24/7 Nurse Triage Hotline

• Medical advice for non-emergency injuries/pain

• Assistance in determining the need for a clinic visit

• Assistance in identifying nearest in-network clinic

or specialist

• Self-care advice

Part of a cost-containment strategy

1) How RTW controls costs & helps employees

2) Elements of a program

• Coordination

• Documentation

• Communication

3) Steps to implement

See part 2 of our RTW webinar series for details on

policies, sample documents, and procedures

• For further assistance

◦ Call your agent

◦ Contact ACUITY Loss Control at 800.242.7666

◦ Send an email to ACUITYEducation@acuity.com

• “Like” us on Facebook

• Visit www.ACUITY.com