SUPERVISOR’S ROLE IN RETURN TO WORK(LIMITED DUTY AND PERMANENT JOB OFFERS)

BEST PRACTICES IN FEDERAL WORKERS’ COMPENSATION:

SUPERVISORY COURSE

OBJECTIVESIdentify supervisor’s role and responsibility in returning

injured worker to suitable workDiscuss components of an acceptable work statement

and use in affording suitable assignment to injured worker

Recognize the difference between a limited duty assignment and permanent job offer

Identify necessary components of a limited duty offer and permanent job offer

Explore methods and options to afford an injured worker suitable work

SUPERVISOR’S ROLE

Advise employee of responsibility to : Keep supervisor advised of work status-written Provide SPECIFIC written limitations, if any, and duration Return to work when work capacity exists Advise of next follow-up appointment Request permission to be absent due to injury/condition

Supervisor is responsible for: Instructing employee of above responsibilities Affording suitable work to the injured worker – in writing Ensuring work status is obtained following EACH medical visit Acting on related leave/LWOP requests

LIMITATIONS

Must be from the attending physicianMust be in writingMust be specificShould not be open-ended

Should have a “to” or “end” date“indefinite” as end date is not acceptable

WHAT IS A LIMITED DUTY ASSIGNMENT?

Normally not a permanent, long-term assignmentDoes not always result as permanent job (but may)Not an assignment to a graded and classified position

description or functional statementMust be in writingVerbal offers allowed but must be offered in writing

within 2 business days of verbal offerAssigns duties commensurate with physician’s

recommended limitationsMay or may not be in same unit, same tour, same

schedule, same position…

What if…Limited duty is not on same tour or schedule and

employee loses pay? If eligible for COP, COP will cover loss of pay to the

extent otherwise prohibited by law. If no COP, employee may claim loss of wages with

OWCP by filing a CA-7 through the WC Office. Supervisor will need to provide tours and work

schedule for employee to reflect what these would have been “but for the injury”

WHY OFFER LIMITED DUTY ?

Employee is injured, not totally incapacitated for all workRegulation requires when work capacity exists, employee

must seek workIf employer fails to offer suitable work, employee may

receive COP and eventually compensation until suitable work is offered.

Decreases chargeback and COP costs to the employing agency

Studies show improved recovery periodImproves moral of employee(s)

WHEN TO OFFER LIMITED DUTY?

Work status indicates existence of work capacityEmployee indicates desire to return to work*Nature and severity of injury is not consistent

with recommendation of total disability*Immediately (if any of the above exist)*

* In absence of work status or release to work with limitations, coordinate list of tasks with WC Specialist to submit to attending MD for review and approval.

HOW DO I OFFER LIMITED DUTY?

Determine specific limitations (work status)Offer in writing (or if verbal, follow in writing)Include beginning date, tour and work scheduleInclude tasks to be performedRe-state specific limitations recommended by MDInclude contact for instruction and leave requestAcceptance/Declination by employee and signaturesDuration of assignment

Indefinite vs. Specific ending date (“temporary”)

SAMPLE-LIMITED DUTY MEMODate: May 29, 2013 To: Employee Name (118)  From: Supervisor’s Name, Nurse Manager (118)Subject: Limited Duty Assignment In reference to your traumatic injury (or occupational condition if applicable) on April 3, 2013, the following limited duty assignment is offered to you in Nursing Service based on your physician’s recommendations dated May 28, 2013. Your tour of duty will initially be 7:30am-4:00pm, Monday through Friday. This assignment will be effective today, Wednesday, May 29, 2013. Your duties will consist of:  -answering and referring phone calls

-monitoring residents north and south end-documentation in CPRS-assisting in feeding all residents-vital signs using electronic devices-passing medications/treatments such as passing ointments, creams, etc. from med cart. (Note: Push/pull force for med cart is 12 pounds on tile)

These duties are within the restrictions as specified by your Attending physician of lifting/carrying, pushing/pulling up to 20 pounds. It is also noted by the physician to keep trying to reach above the shoulder but not in excess of 1 repetition per minute throughout the workday.

 If you encounter any problems or difficulties in relation to your injury/condition, please advise your supervisor immediately and contact your physician as soon as possible if needed. Your assignment will be continuously re-evaluated following any medical visits and/or receipt of additional medical information. This is to assure compliance with your physician’s recommendations and to meet the needs of the medical center.  This assignment does not affect your employment status.

you remain employed as a Nurse, VN-0610, Level 3, Grade 1, currently step 21 with salary of $55,363 per annum. Your assignment will continue until such time as additional restrictions are imposed or modified. If you have any questions, please contact your supervisor or the FWCP office (ext. 9991 or 9996.) ________________________ ___________Supv Name, title Date -------------------------------------------------------------------------Initial one:____ I accept the above assignment and will adhere to my restrictions and observe safe work practices. ____ I decline the above assignment because (specify reasons): _________________________________________________________________________________________________________ ___________Employee Name Date 

WHAT IF…

the employee accepts the offer?the employee declines the offer?the employee refuses to sign with acceptance or

declination?the employee doesn’t agree with all the tasks

assigned?the employee doesn’t want to change tour or work

schedule?the offer is not appropriate; not suitable?

BEST PRACTICE PROCESSES-Limited Duty

WC Office receives copy of work statusSends email to supervisor and next level of need to offer

limited duty Includes copy of work status and/or states limitationsIncludes template or sample to followIndicates date required (immediate)Follow-up after deadlineNext follow-up to next level supervisor and so on…

No Limited Duty Available?

Supervisor replies as such with reason(s) to all on emailService Chief or Service Line Manager certifies no limited

duty exists in service. Notification is forwarded to HR staffing (et al) to

coordinate limited duty across organizational lines with copy to facility leadership.

Identified limited duty is provided to supervisor and limited duty offer is made in writing.

“Home” service incurs cost of employee while assigned to another service

REASONABLE ACCOMMODATION AND WORK COMP

Two (2) separate programs for permanent conditionsReasonable Accommodation

Separate from workers’ compensation Does not retain the pay of injured worker

Permanent Job Offer Separate from Reasonable Accommodation May protect the pay and benefits of the injured

workerCannot share information between 2 programs without

specific written release from employee

Permanent Job Offers

Employee has work capacity but cannot perform the full scope of DOI (Date of Injury) position

Attending MD (or in some cases OWCP) has identified permanent limitations

Compare permanent limitations with physical demands of DOI position

Determine if adjustments can be made to tailor the duties and demands of the position to comply with recommended limitations….

CONTINUE IN DOI JOB?Revise position description or functional statement to comply

with limitations Ensure physical demands re-state recommended limitations or are clearly

compliant with recommended limitations. Ensure description of duties or functions are void of any possible

interpretation of being noncompliant with limitations.Request review of revised description/statement by WC

SpecialistRequest review and classification by Classification Specialist

(include OF-8 if applicable) Do NOT identify position as limited duty or OWCP position. Identify position as “incumbent only”

Following classification, WC Spec will prepare permanent job offer letter for presentation or mailing to employee

Needs a Different Job?

Follow same process as with non-availability of limited duty.

WC and HR staffing will coordinate identification of appropriate position Offer existing vacant position compliant with limitations Offer existing vacant position with adjustment of duties/demands to

comply with limitations Create new position

Following identification and classification of position, WC will prepare job offer letter for presentation or mailing to employee.

Permanent Job Offer-Loss of Pay or GradePermanent job offer can be developed to afford pay

retention Indefinite Protects employee’s salary-based benefits Pay is set at less of DOI pay or 150% of top step salary of

grade of position offered Any remaining pay loss can be claimed by employee with

OWCP – known as an LWEC (Loss of Wage Earning Capacity) Paid to employee tax free May result from loss premium pays such as night

differential, Saturday, Sunday, Holiday and/or on-call pay that cannot be included in pay retention calculation.

REQUIREMENTS

Must offer classified and graded positionMust be same employment tenure as when injured

Temporary job offer is not suitable for an injured permanent employee

Temporary job offer may be suitable for an injured temporary employee (time limit must be appropriate)

Location of job offered must be within 50 miles of employee’s geographic location

Must consider other conditions/limitations that may have occurred or changed since DOI

REQUIRED INFORMATION IN A JOB OFFER LETTER

Description of duties of position (i.e., Position Description)

Physical requirements of the dutiesWork schedule (include tour)Organizational and geographic location of the jobDate on which job offer will first be availableDate by which employee is to notify employer of

decision to accept or refuse offerProvide pay/position information (Title, Pay Plan, Series,

Grade, Step and Salary )

USEFUL INFORMATION TO INCLUDE

Assigned Service of PositionPerson to report to, where and what time and

day. Effective date of job change or re-employment

ACCEPTS ACCEPTS REFUSESREFUSESNotify WC and HR

staffing of decision immediately.

Prepare SF-52 to effect job change

Advise WC on effective date of employee’s actual return or report for new position.

No response is considered a declination

Notify WC and HR staffing of decision immediately.

If employee is working, make every effort to continue current work assignment pending suitability decision by OWCP.

EMPLOYEE RESPONSE

Potentially ValidPotentially Valid Potentially Not ValidPotentially Not Valid

Working elsewhereCondition has worsenedMedical information was

not currentPhysician submits position

is not within physical capacity

Agency withdraws offer Position no longer available

Tour of duty/work schedule

Does not wish to relocateNo promotion potentialReceiving constructed

LWECIs retired or elects to retire

or separatePersonal dislikes of offer

Reasons for Declination

Continue Limited Duty Pending Suitability

Upon notification to OWCP of employee’s declination: OWCP must determine suitability of position offered

If suitable, OWCP will afford the employee 30 days to reconsider their decision or face possible termination of benefits for failure to accept suitable work.

If NOT suitable, OWCP will advise employee and employer requiring the job offer to be revisited.

During 30 day period, make every effort to continue to afford the employee suitable limited duty

Following 30 day notice from OWCP, if employee provides no medical evidence or valid reason(s) to support declination of offer , final 15-day notice to employee will be issued by OWCP to allow employee to ACCEPT position offered.

FAILURE TO ACCEPT SUITABLE WORK

Loss of employment-Removal/Termination Management has the right to assign work Employer is not required to offer another position the

employee would prefer

Loss of compensation benefits Compensation for wage loss is terminated at the end of 15 day

notice if employee fails to accept suitable permanent job offer Medical benefits may continue

Employee may wish to pursue retirement or voluntary separation

LET’S LOOK CLOSER…

LIMITED DUTY AND PERMANENT JOB OFFERS

EXERCISE 1

Jane Smith, Food Service Worker in Nutrition & Food Service slipped in hot syrup that had been spilled on the floor, fell and injured her right ankle. She has been off work, per doctor’s orders since the injury. Her claim was accepted for Right Ankle Fracture. She has had surgery and the physician has released her to return to work with the following limitations:

Sedentary work onlyLimited walkingNo prolonged standing

Follow-up appointment indicated on work status as “4 weeks”

EXERCISE 2

On 1/10/13, an LPN filed a traumatic injury claim for right rotator cuff tear and is placed off work at time of injury. Claim is accepted for same and surgically repaired in November 2010. Claimant is released to return to work 7/15/13 with limitations of:

No pushing, pulling or lifting greater than 25 poundsNo reaching above the shoulder

Follow-up appointment on work status states: “PRN”

EXERCISE 3

Joe D. (RN) provides a return to work statement from MD indicating the following restrictions due to an accepted back injury:

No lifting greater than 2 pounds No pushing or pulling No overhead reaching

The supervisor offers the following written limited duty: Answering telephones Clerical duties Charge Nurse with no direct patient care

EXERCISE 4

Clarification was requested from attending MD and received regarding MD’s recommended limitations for Jane Smith (Food Service Worker with right ankle fracture).

No lifting greater than 20 poundsNo pushing or pulling greater than 10 poundsNo standing or walking more than 30 minutes at a time

EXERCISE 5

Jane Smith (Food Service Worker with right ankle injury) was offered limited duty by her supervisor in a telephone conversation on Monday 6/18/12, to return to work Tuesday 6/19/12. She agreed and accepted but did not return to work until Monday, 6/25/12. She has filed a CA-7 requesting compensation for loss of pay for 6/19 through 6/24. A Report of Contact from the supervisor dated 6/18/12 was provided to the workers’ compensation office to document the limited duty offered via telephone.

EXERCISE 6

Peter Piper provides a work status from his MD indicating release to return to work with limitations:

Sitting up to 4 hours continuously Walking up to 2 hours/ standing up to 1 hourReaching above shoulder 1 hourClimbing ½ hourPushing, pulling, lifting up to 25 poundsNo twisting, bending, stooping, squatting or kneeling

The following duties were stipulated in the written limited duty offer:

Sedentary duty to include clerical work in support of serviceReceiving patients/visitors and referring to appropriate officePicking up mail twice dailyAnswering phone, messaging and referring callers

EXERCISE 7

Tommy Tonka provides work status indicating restrictions of no climbing more than 4 feet; no kneeling, squatting or crawling. May occasionally walk up to 50 feet at a time, may lift up to 30 pounds as tolerated. The supervisor lists the following tasks in the written limited duty offer: Normal duties minus what your physician stated Light duty tasks Complete all installation work orders All other duties as tolerated

EXERCISE 8

Xander, Nursing Assistant, was offered & accepted a written limited duty assignment 2/7/13 compliant with his physician’s recommended limitations of:

No lifting, pushing or pulling over 30 poundsStanding and walking limited to1 hour alternating minimum 15 minutes sittingBending limited no more than 15 minutes per hour

He provides the supervisor with a work status dated 8/12/13 indicating same limitations as permanent.

QUESTIONS

CONTACT INFORMATION

Jacqueline “Jackie” WiserVISN 9 FWCP Product Line Manager

MidSouth Healthcare Network

210 Glenis Drive

Murfreesboro, TN 37129

615-225-6981 (o)

615-898-6594 (f)

jacqueline.wiser@va.gov