1. Early Return to Work Remain at Work Services Transitional Work
Vocational Rehabilitation

2. Question….. Which type of injury is most costly to an employer?
A severe traumatic injury to an employee involving multiple fractures; or,
A mild injury to an employee diagnosed as a low back sprain/strain.

3. The Importance of Early Return to Work
“…medical care costs correlate not with the severity of diagnosis, as might be predicted, but the length of time workers remain out on disability.”
Disability Management
Akabas, Galvin and Gates
The American Management Association

4. Indirect Cost Of Lost Time Is Four Times the Direct Cost
vs.
Iceberg Analogy
Could be as much as up to 10x
See next slide for more details

5. Direct vs. Indirect Costs
Medical costs
Compensation costs (insured costs)
BWC claim reserves
Hiring replacements
Training replacements
Overtime (lost work)
Legal expenses
Product/tool damage
Production delays
Loss of business (customer good will)
Explain direct and indirect costs, as well as their impact on the bottom line for the business

6. Cost Impact of Early Return to Work
Reduce payment of lost-time compensation
Direct impact on reserves
Indirect impact on premiums
Helps improve your safety and financial goals
Benefits employer and employee
Impact of Transitional Work
Stop continuation of compensation benefits
Limits negative impact to morale
Keeps IW in work environment
Promotes positive employer/labor relationships
Lower personnel costs (no hiring of temps, training new workers, etc.)
Direct Impact on Reserves

7. Benefits Of Early Return to Work Programs
Reduces costs
Reinforces management’s commitment to employee welfare
Improves morale/company loyalty
Maintains quality/production
Enhances ADA compliance
Increases safety and prevents future injuries (i.e. ergonomic improvements)

8. Benefits to the Injured Worker
Recovers more quickly
Experiences a smoother transition back to regular duty
Receives a full, regular paycheck
Jobs skills stay current
Maintains work relationships
Problems related to inactivity decrease
Transitional Work: work-site activity that is an interim step in the recovery of the IW. It should be time limited, employment based and look at the IW’s ability to perform their original or targeted job. TWP’s involve participation from both management and labor which promotes overall awareness of company’s disability goals and objectives. The role directs the developer to involve local unions, physicians, MCO’s and other rehab/medical professionals. This allows for more parties to the claim or stakeholders to become aware of employer’s intentions and the benefits of TW.
Two services are Remain at Work (RAW) and Return to Work (RTW). RAW is for Medical Only claims and RTW for Lost Time claims. Implementation of RAW programs will help prevent IW’s from becoming LT.
TW can limit exposure of the employer to the high costs associated with long-term lost time claims.

9. Remain at Work

10. Goal of Remain at Work
Services to injured workers with Medical Only Claims to prevent Lost Time

11. Eligibility Injured Worker has a Medical Only Claim.
Injured Worker is experiencing difficulty at work due to the allowed condition.
The employer, injured worker or physician has identified the difficulty.

12. Transitional Work

13. What is Transitional Work?
Work-site program for workers with physical restrictions
Focus on progressing the worker to a specific job
Program is time limited and individualized

14. Transitional Work Program
May include progressive conditioning, on-site work activities, and education for safe work practices.
May include job modification or alternative work assignments.

15. Transitional Work Light Duty Light duty is opened ended
No therapeutic goals defined
Transitional work has a starting and ending date
Offers work hardening or other therapeutic benefits

16. Transitional Work Light Duty
Responsibilities of employer or employee are not outlined
No alternative plan if light duty fails
Responsibilities are clearly defined in writing
Alternative plan will be developed

17. Philosophy needed Buy-in by top management Labor/employee involvement
Commitment for openness
Confidentiality
Policy that is logical and fair

18. Transitional Work Program Basic Elements
Corporate analysis
Labor/employee involvement
Policy / Procedure
Functional job analyses
Program evaluation mechanism
Agreement is between employer and developer.
Transitional work program developer , employer, & labor work together to create a customized, employer-specific transitional work program.

19. BWC’s Transitional Work Employer Grant Programs
Transitional WorkGRANT$ for employers with 50 or more employees
Transitional WorkGRANT$ EZ for employers with 1-49 employees

20. Information on BWC’s Transitional Work Grant Programs
>Ohio employers >Transitional WorkGRANT$

21. Vocational Rehabilitation

22. Vocational Rehab Eligibility
Lost time claim
Continued physical restrictions
IW is not working and on compensation on date of referral such as TT, NWWL, PTD, Salary continuation in lieu of TT

23. Vocational Rehab Eligibility-cont’d
IW at MMI or received a PPI award and not on comp (lost time claim, continued physical restrictions)
Job Retention-IW is working but has a previous lost time claim, continued problems related to allowed condition(s) of claim documented by POR and employer

24. The Return to Work Hierarchy (OAC 4123-18-05)
Injured workers return to work as follows:
Same job, same employer
Different job, same employer
Same job, different employer
Different job, different employer
Skill enhancement, short-term training may help at any step in return to work.
Through out today’s program we have made frequent reference to the RTW hierarchy. The case manager is required by BWC rule to follow this hierarchy when returning the IW to work and to sequentially eliminate each step prior to moving on to the next step. By following the hierarchy disruption to the IWs life is minimized. You can see that a worker returning to work at the 4th step of the hierarchy, different job different employer, would probably need much more extensive services to return to work than a worker would need if going back to the same job.
T- The next step of the rehab process focuses on the IW’s responsibilities while participating in a rehab plan. The case manager must verbally go over the Rehab Agreement to ensure that the IW understands what their responsibilities.

25. What strategies do we use at each step of the hierarchy?
If returning to same job, same employer?
If returning to a different job, same employer?
If returning to same job, different employer?
If returning to a different job, different employer?

26. Questions about early return to work and remain at work programs?