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June 25, 2014

Return-to-Work: a Success Story

Summary:

One minute into my first day as chairman of an RTW subcommittee, I was told: "We can't do this here; we have a union shop."

I was once hired to be the chairman of a return-to-work (RTW) subcommittee for a corporation that owned several major national newspapers. One minute into my first day, I was told: “We can’t do this here; we have a union shop.”

Several months later, the program we designed had full union support, and the CEO praised it as having the most effective return on investment in the company’s history. We reduced lost-wage replacement costs by 33% and saved the company millions of dollars.

How?

The company historically had a passive role and no formal policy about having injured workers return to work until they could perform the “full duties” of their jobs. Consensus formed that, through the development of a “modified duty” program, we could return disabled employees to some form of meaningful work sooner, helping the employee recover while increasing the productivity of the company.

We decided not to use the term “light-duty,” which carried a negative connotation among employees. We also had to overcome the traditional mindset of line supervisors that they didn’t want employees to return to work unless they were “100%.”

We found many other reasons why previous attempts at implementing an RTW policy had failed. The length of restricted-duty “transition periods” wasn’t specified, and labor relations problems arose because the company only provided meaningless busywork to injured workers. There was also a lack of commitment at all levels of management — RTW was considered to be only a human resources issue – so there was little coordination of efforts within the company.

Perhaps most importantly, there was a pervasive lack of knowledge about workers’ compensation. Although front-line supervisors play a critical role, they were generally not held accountable for making decisions that accomplished the goals of an RTW program. In addition, workers’ compensation costs were not allocated back to specific departments.

I conducted site visits at five business units and reviewed policies, procedures and site-specific circumstances, cultures, resources and needs. I also reviewed best practices during weekly discussions. The unions were included in my site visits to get their input and to gain their respect and cooperation.

We determined that there was potential for significant savings regarding lost-wage replacement costs by developing a consistent RTW policy for both occupational and non-occupational disabilities. We truly believed we could reduce workers’ comp and disability abuse and costs, improve productivity and allow disabled employees to return to full-pay quicker. Everybody would win.

The key to success was getting the support of senior management and developing a well-planned, thorough communications campaign. We knew we had to get buy-in from the labor unions.

We designed brochures for employees and developed comprehensive training for supervisors. We improved communication about medical determinations of injured workers’ capabilities and restrictions. We arranged for accommodations by supervisors that were not open-ended. Employees’ progress was closely monitored, and all communications between injured workers, medical providers, claims administrators and supervisors documented.

The real key to success was to shift accountability for RTW from HR to department supervisors. Originally, 100% of workers’ comp costs were allocated to the corporate risk management department; in a paradigm shift, the company tied 25% of supervisors’ annual bonus to workers’ comp costs in their departments. This change got their attention and encouraged cooperation.

We also changed the policy to allow injured workers on temporary modified duty to earn full pay. This gained the support of the unions by showing that modified duty was truly a benefit to the injured worker. But those on temporary modified duty were not entitled to overtime, to encourage the worker to return to full duty as soon as possible and restore that eligibility.

We also got labor and management to agree that, while state law allowed as much as one year to report an injury, prompt reporting was crucial. This allowed claims administrators to begin paying medical claims and benefits sooner.  It also expedited the necessary state and OSHA reporting, any necessary investigations of the accident and medical documentation of work restrictions.

Supervisors began to cooperate more. One might ask another, “Can you use some help this week?  I have an employee who can answer phones for you.” That way, one supervisor got added help while the other avoided having workers’ comp costs allocated back to his department. The injured workers benefited by returning to full pay, and management believes that they returned to their normal jobs sooner because there were not allowed to stay home unless it was medically necessary.

“We can’t do this here” turned into a corporate-wide written policy that worked. A follow-up analysis found that 50% of the RTW accommodations had zero cost to implement; 20% cost less than $500; and 10% cost less than $1,000.

The company saved millions and greatly improved labor management relations.

A real success story.

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About the Author

Dan Miller is president of Daniel R. Miller, MPH Consulting. He specializes in healthcare-cost containment, absence-management best practices (STD, LTD, FMLA and workers’ comp), integrated disability management and workers’ compensation managed care.

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