TRANSITIONAL DUTY EMPLOYMENT Karen C. Jackson Office of Risk Management Facilitator.

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Presentation transcript:

TRANSITIONAL DUTY EMPLOYMENT Karen C. Jackson Office of Risk Management Facilitator

Expected Workshop Goals Reduce some of the high costs of workers’ compensation

Expected Workshop Goals A better understanding of Transitional Duty Employment

Transitional Duty Employment Reduce workers’ compensation costs Workers’ Compensation more effective

Workers’ Compensation Coverage Injured workers entitled to – medical – indemnity benefits

ORM Workers’ Comp Statistics 5000 active claims 1000 compensation checks regularly $48 mil on workers’ compensation Money comes directly from agency budgets

Transitional Duty Employment Enables IW to go from here

Transitional Duty Employment To here

Agency Concerns Can’t take IW’S back to work unless full duty Civil Service won’t let us take IW’S back unless they are at 100%

Dispel the Myths

Senate Concurrent Resolution No Cooperation between – Department of Civil Service – Division of Administration – Office of Risk Management Formal return-to-work program for state employees

Civil Service Circular No July 9, 1997 Return-To-Work Policy for classified State employees

Civil Service Circular No Allow state employees injured on job to come back to work – Light duty – Limited duty – Restricted duty

Pilot Program Pinecrest Developmental Center Highest volume of workers compensation lost time claims Highest workers’ compensation premiums

Pilot Program Pinecrest developed transitional duty policy 1 year pilot

Before Pilot Program They ain’t gonna take me back!

After Pilot Program Pinecrest employees returned to work, limited duty

Pilot Program First six (6) months of transitional duty pilot – 15% reduction of monthly indemnity pay-out

Pilot Program 36% reduction of indemnity pay-out at end of one (1) year

Pilot Program Beneficial ORM sought legislative remedy to require state agencies to have transitional duty program IW’S would be RTW once released by treating physician

Senate bill 689 Gave ORM authority – develop and – administer transitional duty program for state employees

R.S. 39:1547 Good for Louisiana Took an act of legislation to get this done

Related Legislation R.S. 39:1543 Loss prevention audit process – Do state agencies have TD program? – Are agencies actively trying to RTW IW’S back to work?

5% Premium Penalty Failure to have policy Failure to have transitional duty employment program Failure to return IW’S back to work once released May affect outcome of safety audit

Transitional Duty Employment ORM developed Transitional Duty Program. Administered by contract vendor.

ORM’s Transitional Duty Policy

Transitional Duty Employment Mirror ORM’S TD policy or develop own

Case Study LaWanda

Case Study - LaWanda Friends Co-workers Relatives

Case Study - LaWanda LaWanda got hurt on the job and now she’s not working WHY?

Case Study - LaWanda Reason is simple— LaWanda ’s employer won’t let her work

Case Study - LaWanda LaWanda ’s doctor says she can work

Case Study - LaWanda LaWanda feels like she can work

Case Study - LaWanda But -- LaWanda ’s not working

Case Study - LaWanda Some background on LaWanda

Case Study - LaWanda Help mentally deficient residents with activities of daily living

Case Study - LaWanda Pulled muscle in back 3 months ago – and now LaWanda can’t work

Case Study - LaWanda ORM starts workers’ compensation benefits

Case Study - LaWanda Conservative treatment Dr. Mild for 3 months Dr. Mild says LaWanda can do something Releases LaWanda to RTW except… can’t lift over 25 pounds

Case Study - LaWanda LaWanda is so happy she can go back to work

Case Study - LaWanda LaWanda takes supervisor copy of RTW slip – RTW slip has lifting restriction of no more than 25 pounds

Case Study - LaWanda Supervisor says, – “I can’t use you LaWanda until you can come back to work full duty.”

Case Study - LaWanda Took all the wind out of poor LaWanda

Case Study - LaWanda LaWanda goes home - gives bad news to adjuster Develops renewed interest: – The Young & The Restless – Jerry Springer – Gardening

Case Study - LaWanda Because LaWanda ’s not allowed to work, restricted duty -- Compensation benefits continue to be paid

Case Study - LaWanda LaWanda ’s doctor doesn’t see what the big deal is, – As her doctor, he knows LaWanda can work

Case Study - LaWanda LaWanda doesn’t see what the big deal is either, – She knows she can work – She can do everything her job requires her to do except the lifting

Case Study - LaWanda LaWanda ’s supervisor doesn’t see what the big deal is, either – After all, LaWanda ’s being paid workers’ comp anyway, right? – What’s the big deal?!

Transitional Duty Employment The big deal is: once workers’ compensation benefits are started – they continue until IW RTW or – is released to RTW regular duties by treating physician

Rehabilitation of Injured Workers If an IW unable to return to previous work earning 90% or greater of pre-injury wage …

Rehabilitation of Injured Workers R. S. 23:1226 Employer must provide rehabilitative services -job placement -retraining

Rehabilitation of Injured Workers Rehabilitation of IW’S automatically adds an additional $5,000 – $13,000 to value of a claim.

Rehabilitation of Injured Workers Employers must make every effort to return IW’S back to work Even if cannot return to work full duty.

Rehabilitation of Injured Workers As long as IW off work – comp and medical benefits continue – these affect premiums

Transitional Duty Employment R.S. 23:1221(3) IW entitled to supplemental earnings benefits (SEB) if unable to earn 90% or greater of pre-injury wage.

Transitional Duty Employment SEB based on 66 2/3 difference between pre-injury wage and what employee now capable of earning.

Transitional Duty Employment While this reduces benefits, benefits are still being paid.

Rehabilitation of Injured Workers If the claim is settled $30,000 - $40,000 added to value of claim.

Transitional Duty Employment Only way to stop payments altogether

Transitional Duty Employment Return IW to work with employer on transitional duty

Transitional Duty Employment Transitional duty can be: – Job modification – Light duty – Restricted duty

Cut Workers’ Compensation Costs Absolute must to keeping workers’ compensation costs down

Transitional Duty Employment When IW sitting home watching Dr. Phil

Transitional Duty Employment Commercial comes on asking, – “Have you been hurt on the job? – Call me, I’m a lawyer, I can help. – I can get you top $$ for your claim.”

Transitional Duty Employment This is how he does it and employers help IW’S attorney by not returning IW’S back to work light duty

It Doesn’t Matter What It’s Called Transitional Duty Light Duty Restricted Duty Modified Duty Temporary Assignment of Duties

Just Do It! Whatever you call it, just get ‘em back to work! Absolute must for keeping workers’ compensation costs down.

Think About It Would you like for your employee to sit here?

Think About It Or here?

Think About It When an employee is home collecting a comp check -

Think About It The work piles up!!! Somebody’s gotta do it or it doesn’t get done

Successful Transitional Duty

Focus of Transitional Duty Employment Focus on what the IW CAN do

Focus of Transitional Duty Employment Do not focus on what IW CANNOT do

Focus of Transitional Duty Employment Transitional Duty Employment doesn’t have to be nicest, coolest, best job you have to offer.

Successful Transitional Duty Exercise discretion and caution in determining the transitional duties to be assigned.

Successful Transitional Duty Transitional duty employment must not lower the performance standards and expectations of the job as a whole

Successful Transitional Duty Transitional duty employment should not establish a precedent for a lower level of duties and performance that other employees might then expect to be applied to them

Successful Transitional Duty Transitional duty employment should not have the effect of permanently lowering the employee’s Civil Service job title.

Successful Transitional Duty Department of Civil Service, Program Assistance Division can give guidance in evaluating transitional duty employment.

Successful Transitional Duty Transitional Duty feasible – IW released to some form of employment

Successful Transitional Duty Open mind of employer

Successful Transitional Duty Agency involvement Employer must make accommodations when IW has been released to some form of restricted duty

Successful Transitional Duty Commitment required at all levels of agency – Management – Employees

Successful Transitional Duty Develop a Transitional Duty Employment statement Communicate with the injured worker

Successful Transitional Duty Do not work someone outside of the restrictions –Leads to re-injury –Make doctor take employee off work permanently

Successful Transitional Duty Modified job offers –identify tasks ahead of time – notify IW in writing Job modification should come in all sizes and shapes

Successful Transitional Duty A DEAL’S A DEAL. Make sure job is open and available when IW returns to work

Transitional Duty Works Effective in both public and private sector 18% decrease in disability costs Keep productivity and employee moral up Get employee back into work environment as soon as medically possible

RETURN TO WORK PAYS Employer credibility – Employees – Medical professionals – Attorneys

RETURN TO WORK PAYS Attorneys can’t bluff adjusters

RETURN TO WORK PAYS Decreased medical cost Decreased indemnity costs

RETURN TO WORK PAYS OFF Adjusters free to concentrate on substantive claims handling

RETURN TO WORK PAYS OFF Litigation diminished

RETURN TO WORK PAYS OFF Employees are not separated from the worksite unnecessarily

RETURN TO WORK PAYS OFF Transitional Duty Employment helps comply with ADA

Transitional Duty Works It’s economical IW benefits: returned to a productive lifestyle Employer benefits: no double encumbering Return-to-work makes good business sense IT’S A WIN – WIN SITUATION

HANDOUT

Website information ORM website for workers’ comp forms: LDOL / OWCA’s website: ?LookupValue=OWCA ISIS WEBSITE

Adjuster Assignments – p. 1

Adjuster Assignments – p. 2

Adjuster Assignments – p. 3

Contact Information Contact me: Karen C. Jackson State Risk Claims Manager P. O. Box Baton Rouge, LA (p) (f)

Are there any questions?