1. Lowering Workers Compensation Costs & Improving Return to Work Rates Marilyn Neuhausel MS, OTR/L, TWD Occupational Therapy Solutions, LLC May 15, 2012

2. The Presentation Objective For you to leave with 2-3 concrete ideas that will improve your return to work rates after an injury has occurred.

3. The Financial Impact of Work Related Injuries

4. The Average Medical Cost Per Lost-Time Claim

5. 2012 Lost Time injuries BWC sets $45,000 in reserves for each case

6. Carpel Tunnel Syndrome Lost Time Average Costs $7,675.03$17,544.48 $19,060.09 Indemnity Average Costs $4,091.22$15,797.47$17,509.73 Total Cost $11,766.25$33,341.95$36,569.82 1 st Year 3 rd Year 5 th Year Based on Private & Public Employer Claims in Open MIRA II Status

7. Rotator Cuff Tear Lost Time Average Costs $ 15,097.70$26,005.02 $34,381.31 Indemnity Average Costs $4,711.81$19,394.63$26,548.88 Total Cost$19,809.57$45,399.65$60,930.19 1 st Year 3 rd Year 5 th Year Based on Private & Public Employer Claims in Open MIRA II Status

8. Degenerative Thoracic or Lumbar Intervertebral Disc Disorder Lost Time Average Costs $ 12,467.20$ 30,395.69 $44,332.25 Indemnity Average Costs $ 8,658.43$24,035.89 $37,062.93 Total Cost $21,125.63$54,431.58$ 81,395.18 1 st Year 3 rd Year 5 th Year Based on Private & Public Employer Claims in Open MIRA II Status

9. The injured worker must be 100% recovered before returning to work

10. The Old School Approach: Role of the Physician The POR controls the length of time off work and the duration & the types of treatment

11. The Old School Approach : Impact on the Injured Worker Their isolation from work affects the injured worker’s attitude, their physical condition, and their motivation for return to work

12. Physicians of Record Surgeons Rehab Specialists Your MCO The BWC The Ohio Legislature Company Culture The Supervisors The Union Corporate Philosophy General Manager Return to Work Coordinator Influences on Return to Work Rates

13. Destination Excellence: What Employers Will See From BWC o Less red tape o More consultative assistance o The injured worker is back to work sooner o Increased accountability

14. BWC’s Destination Excellence Focus on Injured Workers o Decrease in lost workdays o Decrease in average claim costs o Shorten the claim tails o Reduce Permanent Total Disability frequency

15. Transitional Work Bonus Program Rewards companies that use their TWP (developed between 2001 and 2006) or plan to implement one in 2012. Previous grant recipients must show proof of the transitional work program use/updates Back end bonus up to 10% off premiums Must be current on premiums and no lapse >45 days Private employers must have submitted the bonus application by May 25, 2012 Public employers must submit the bonus application by October 31, 2012

16. Transitional Work Program Definition Transitional Work Program Definition A workplace program that provides an individualized interim step in the recovery of an injured worker with job restrictions.

17. The employer: Direct involvement in work return The injured worker: At work while performing real job tasks

18. What if your Current Transitional Work Program is not Effective? Submit the application and have the BWC representative determine what needs to change to improve the program Confer with your MCO to ensure that all cases are managed well

19. Transitional Work Program: The Components

20. The Written Policy  Entry, Exit and Extension Guidelines  The Timeframe: 45, 60, 90 days  Roles and Responsibilities  The Essential Forms  Methods of evaluation

21. The Job Analyses Material handling Non-material handling Positional requirements Frequencies Environmental Exposures

22. List of Modified Duty Tasks ◦ Involve the Supervisors ◦ Refer to the job analyses ◦ Sort the tasks according to physical demands ◦ Get the union’s buy-in

23. Training

24. Build your RTW Team Initial Treating Provider Field Case Manager Managed Care Case Specialist Physician of Record The Union Rep Onsite TW Therapist Clinic Based Therapist Surgeons & Physiatrists The Supervisors

25. Return to Work Services: Enhancing your T W Program

26. Modified Duty Off-Site Program Have your MCO arrange to use a non-profit organization for an injured worker who is medically stable, but has restrictions that cannot be accommodated Usually lasts 90 days or less. The injured worker is productive, maintains their “worker mentality”, and they heal more quickly.

27. Combining Modified Duty Off-Site & Transitional Work Progress from MDOS to TW as restrictions are lifted Divide the shift between TW & MDOS when you don’t have enough work for a full day or when POR has set a GRTW program Move the IW from TW to MDOS if there is a set back or there is not enough work

28. Onsite Transitional Work Therapy Address the Barriers Use the job tasks to improve function Must Show Progress 6-8 weeks in Duration Teach body mechanics and safe work methods

29. Ergonomic Assessments Reasonable Accommodations Increase Productivity Reduce Hazards

30. Fitness for Duty Functional Capacity Evaluations Onsite at the Company or Offsite Assesses the injured worker’s ability to perform the job tasks

31. Internet Resources Internet Resources Job Accommodation Network www.jan.wvu.edu BWC Safety and Hygiene Department www.ohiobwc.com

32. What if Return to the Same Job at the Same Company is Not Feasible? Vocational Rehabilitation Options Same Company/Different Job Different Company/Same Type of Work Different Company/Different Type of Work

33. In Conclusion By using your transitional work program and RTW rehab services, you will decrease costs and significantly improve return to work rates

34. Your Questions Difficult Cases?? Concerns??

35. Thank You Marilyn Neuhausel, MS, OTR/L, TWD Occupational Therapy Solutions, LLC Cell Phone : 419-366-6391 E-mail: mneuhausel@aol.com