Employee Return to Work

Table of Contents

Return To Work Program Logic

The NYS WCB Return to Work Program Handbook

New Program Implementation Team

Seven Best Practices

Roles and Responsibilities

Return to Work Policy 

Steps of a Return to Work Program

Develop Individualized RTW Plans

Important Communication Guidelines

Properly Managing the Interplay Between RTW, ADA and FMLA

Evaluating the District’s Return to Work Program

 

Return To Work Program Logic

The logic of a Return-to-Work (RTW) is based on the belief that employees are the   most valuable resource of a school district.  By working together, District administrators, employees, bargaining unit representatives, healthcare professionals, can control the effects of disability and absenteeism in the workplace and insurance/claims service providers.   The workers compensation community is united about the necessity of an effective RTW program in order to deliver high quality treatment to injured employees and to maintain high morale and overall workplace satisfaction.  And, the economic value for all stakeholders is undisputed.

The NY State Workers’ Compensation Board clearly supports RTW programs, as evidenced by the resources available on its website, including a Handbook for all employers, regardless of size.   The Handbook states, “

While accident prevention is the best way to reduce overall injury costs, an effective workplace Return to Work (RTW) Program is the best way to manage cost and improve recovery after an injury has occurred.”

 

The NYS WCB Return to Work Program Handbook

The NYS WCB Handbook is a 31-page document that introduces best practices and explains the components of an effective program.  The handbook highlights these vital points:

1. Creative thinking in developing Individual Return to Work Plans that anticipate and avoid pitfalls will have better RTW outcomes.
2. While employers [districts] are encouraged to include as many aspects as practicable, there are two essential elements to all successful RTW programs:

• First, the employer [district] must commit to returning employees to work in a timely and safe manner.
• Second, employers [districts] must have on-going communication with their injured employee starting right after the injury occurs and continuing throughout the recovery period.

In addition to the describing the components of an effective program, the Handbook also includes these helpful documents:

• Sample RTW Policy Statement
• Sample Letter to Treating Doctor
• Sample Release of Medical Information
• Transitional Assignment (draft Form RTW-
• Plan Development Worksheet (draft Form RTW-1)
• Sample Individual Return to Work Plan
• Guide for Writing Job Descriptions
• How to Use the Physical Demands Task Assessment H
• Physical Demands Task Assessment (draft Form RTW-2 )
• Letter Making a Bona Fide Offer of Employment (draft Form RTW-5)
• Answers to Your Questions about Returning to Work Appendix

New York State Workers’ Compensation Board Return to Work Program handbook (PDF)

Online version

New Program Implementation Team

Prior to the initiation of a return-to-work program, an Implementation Team should be formed. This team is responsible for establishing and implementing policy and procedures. The size and make-up of the team will vary based on the needs and organizational configuration of the district. Members of the Implementation Team may include: Assistant Superintendent, Chief Business Official, Human Resource/Personnel Director, Benefits Coordinator, Employee Safety Officer, Risk Manager.  

Once the Implementation Team is identified, the members should meet to develop policies, procedures, training and positive support strategies. In order to ensure that all parties understand the return-to-work process and to provide for the equal treatment of each employee, the RTW policy should be incorporated in the district’s written personnel policies and procedures.  

The Implementation Team should ensure that there are up-to-date processes and procedures for the following:

• Reporting of the injury/illness
• The Job Activity Analysis
• Definition of a Transitional Employment Team
• Definition of a Transitional Employment Team Meeting
• Development of a Transitional Employment Plan
• Monitoring the Transitional Employment Plans
• Maintaining Contact with the Injured/Ill Employee
• Assessing for Reasonable Accommodation
• Program Acceptance and positive supports for participation

After finalizing the written policy and procedures, the Implementation Team will likely want to develop a schedule for training/orientation of all employees. It is suggested that training be conducted first for all of management, then all supervisors and, finally, all other employees. Training needs will be determined by the size of the district. A small district may have just one meeting to inform all employees of the return-to-work policy and process. RTW program information can then be included in new employee orientation and in annual benefit program updates.

Seven Best Practices

A roadmap for an effective RTW program is created by seven best practices that the WCB Handbook outlines as follows:

1. Proactive “behaviors” in the workplace lead to successful RTW outcomes.
   • Management must invest resources and time in promoting the RTW Program.
   • Labor must support RTW programming and demonstrate support by including the RTW Program in collective bargaining agreements.
   • Commitment to safety issues is the accepted norm across the organization.
2. The employer trains supervisors in work disability prevention and includes them in RTW planning.
   • Supervisors are vital to the success of RTW due to their proximity to the injured employee and their ability to manage the immediate RTW environment.
   • Supervisors that are trained in the RTW process, taught to be positive and empathetic in early contacts with injured employees, and active in the RTW process have positive RTW program outcomes.
3. The employer contacts the injured or ill employee early.
   • Early contact is a core component of most disability management programs and helps the injured employee feel connected to his or her workplace. Contact within the first week or two is a guideline, but the actual time frame may vary depending on the employee’s specific situation.
   • If the injured employee feels the contact is a reflection of the employer’s concern about finances and not about his or her health this can adversely affect the RTW process.
4. The employer designates an individual to have the responsibility to coordinate RTW.
   • Designate a RTW Program Contact who has sufficient knowledge to coordinate the RTW process effectively. The responsibility of the RTW Program Contact is to communicate all RTW program processes with all the stakeholders and is the gatekeeper of work restrictions.
   • The RTW Program Contact assists the injured or ill employee to navigate through the healthcare system.
   • The RTW Program Contact can provide RTW supervisor training and help develop a pool of temporary assignments. Developing these transitional assignments is an ongoing process related to organizational change and the injured employee’s needs.
   • The RTW Program Contact should facilitate the development of written roles and responsibilities for all RTW partners to avoid role confusion and duplication of effort and to clarify expectations. The Program Contact should also facilitate the development of written roles and responsibilities for each RTW Committee for the same reasons.
5. The employer communicates with health care providers about the workplace demands, as needed, and with the injured employees’ consent.
   • Exchange paper-based information (e.g., information on job demands and/or work accommodation options sent to the treating physician by the employer); provide the physician with succinct and essential information about the employee’s job and workplace to assist with RTW planning.
   • Converse by telephone about work and job demands (initiated by either party).
   • Timely communication between the treating physician and the workplace, mediated by the employee or not, will provide for better RTW outcomes.
6. The employer makes an offer of transitional work to the injured or ill employee so he or she can return early and safely to work activities suitable to their functional capability.
   • Offer of transitional work is the core element of disability management and requires many considerations – the employee’s functional capacity, functional impairment and limitations, and medically-based restrictions. A Work Accommodations Form (WAF) is completed by the treating physician and used to match the temporary transitional assignment.
   • Return the employee to practices with which they are familiar and utilize ergonomic worksite assessments as a component of the RTW program.
   • Identify a procedure for what to do when a transitional assignment offer is declined.
   • Ensure that assignments comply with all legal requirements including the American with Disabilities Act (ADA) and state workers’ compensation statutes.
7. The RTW Committee ensures that the Individual Return to Work Plan supports returning the employee without disadvantaging co-worker and supervisors. RTW planning is more than matching the injured employee’s physical restrictions to a job accommodation.
   • Planning must acknowledge RTW as a socially fragile process, where co-workers and supervisors may be thrust into new relationships and routines.
   • If others are disadvantaged by the RTW plan, this can lead to resentment towards the returning employee, rather than cooperation with the RTW process.

Roles and Responsibilities

The responsibilities for the district suggested by the WCB are: 

• Provide a safe work environment
• Train employees on proper reporting of accidents and injuries
• Review the accident investigation report and address any job-related issues
• Provide information to employees about the workers’ compensation system and benefits
• Develop written RTW policies and procedures
• Make a commitment to return injured employees to their pre-injury employment, whenever possible
• Designate a RTW Program Contact to coordinate the RTW program and communicate with employees
• Regularly communicate with the injured employee during the time away from work and monitor progress upon the injured employee’s return
• Communicate early with the treating doctor and insurance carrier to encourage recovery and return to work
• Develop functional job descriptions and identify job requirements that clearly identify physical activities required to do the work
• Wherever possible, make every effort to develop and provide meaningful return to work opportunities so that the post-injury job is consistent with an assessment by the injured employee’s treating physician, with the goal of offering the injured employee alternative suitable and available work that is comparable in nature and earnings to the pre-injury job
• Focus on a person's capabilities, not their disabilities
• Conduct open house of the work site for area doctors
• Be proactive
• Provide a copy of the Workers’ Compensation Board’s Answers to Your Questions about Returning to Work to employees.

The WCB Handbook also outlines specific roles and responsibilities for all of the following partners in the RTW process.

• Injured employee
• Injured employee’s legal representative
• Healthcare provider(s)
• Collective bargaining unit representatives
• Supervisor or manager
• Co-worker(s)
• Carrier
• Workers’ Compensation Board

Return to Work Policy  

The Return to Work policy explains your company’s RTW program to the workforce. The district’s policy statement will be a point of reference throughout the entire development and maintenance of its RTW program and sets the general scope and guidelines for your program. Developing written policies and procedures provides for standardization of the district’s response to RTW issues, and ensures that injured employees are treated fairly and consistently.   The WCB Handbook describes what should be included in the District’s policy and offers a sample policy. 

Steps of a Return to Work Plan

The WCB Handbook suggests the following steps that the district  should take to care  for  the injured employee.

1. After notification of a workplace injury or illness, establish a RTW Committee, including the designated RTW Program contact, a designated employee representative or union representative, the injured employee, and the injured employee’s supervisor.
2. Assign roles and responsibilities for each committee member.
3. Provide a written job description that assesses the physical demands of the injured worker’s job to the treating physician.
4. Review the treating physician’s report on the injured employee’s ability to do his or her current job or transitional work.
5. Develop accommodations to the injured employee’s job duties or recommendations for transitional work assignment, if necessary.
6. Develop an Individualized RTW Plan.
7. Return injured employee to pre-injury job when employee is medically released for regular work, with accommodations if necessary.
8. Provide a written bona fide transitional work offer to the injured employee, with a target 90-day time limit.
9. Monitor the employee’s progress, recovery, and return to work with adjustments and accommodations when necessary to ensure a successful outcome. Communicate this progress to the employee’s treating physician.

Individualized Return to Work Plans  

An Individual Return to Work Plan describes the actions that need to be taken to return an employee to his or her pre-injury job. The provision for transitional work is key to a successful RTW program and should be considered in any Individual RTW Plan. Transitional work activity can be a modified version of the injured employee's original job, the same job with reduced hours, or a combination of tasks from other positions. It can be full or part time, but should be a time-limited assignment that is directed toward the injured employee's full return to his or her pre-accident job. The work must be productive and suitable to maintain the employee's sense of worth.

To identify alternate assignments, determine:

• What necessary tasks could the injured employee perform?
• What tasks, now performed occasionally, need to be done more frequently?
• What tasks could be assigned to someone else?

Be certain to know the. It is essential that physical and other demands of the alternate jobs or assignments are within the limitations as prescribed by the injured employee’s health care provider to ensure prevention of re-injury and the full rehabilitation of the employee.

Plans should developed jointly by the RTW Program Contact, the injured employee, the employee’s supervisor, the employee’s health care provider, and the union representative, along with the injured employee’s legal representative, if any.  Each plan should also include the responsibilities of the employee, the supervisor or manager, and any co-worker who will be assisting the injured employee, and the actions each must take to achieve the RTW Plan goal.

It is important that the plan have a beginning and an end. There should be a clear definition of what is considered progress (e.g., the employee can work five hours a day by week three, or the employee can assume a certain task by week five). Plans should include a graduated work outline with appropriate timetables consistent with the treating physician’s assessment of the injured employee’s capabilities. Graduated work assigns an injured employee to appropriate transitional work activities as soon as he or she is medically released to perform any work. The employee is then expected to take on work of increasing complexity, duration, and/or physical difficulty. It is important to stress that this should be achieved in increments consistent with the treating physician’s recommendations and with the goal of eventually returning the injured employee to his or her pre-injury job at full capacity or with modifications to accommodate any permanent disabilities.

During recovery, injured employees need their capabilities emphasized rather than their limitations.  Goals and timetables should be established to help the injured employee achieve the final goal of returning to pre-injury employment, with accommodation if there is permanent disability.

Important Post-Injury Communication Guidelines

Communicating appropriately with employees after an injury has occurred is critical.  The WCB developed guidelines to encourage proper communications by, and with, the employee, employee’s counsel, the district, the  workers' compensation insurer, insurer’s counsel  claims service provider,  counsel, the WCB and health care providers. A more detailed treatment of these communications can be provided by the district legal counsel.

Communication Guidelines (NYS WCB) – PDF  

Answers to Employees’ Questions About Returning to Work (NYS WCB) – PDF  

Properly Managing the Interplay Between RTW, ADA and FMLA

There are important relationships between best practices of an RTW program and requirements under the Family Medical Leave Act (FMLA) and American’s With Disabilities Act (ADA). The interplay is s complicated and can lead to problems. There are potential legal and ethical responsibilities and failure to comply with the applicable laws can result in substantial penalties including legal fees, lost wages, back pay, compensatory and punitive damages. This interplay is often referred to as the Bermuda Triangle of employment law.   It is imperative for SBOs and HR directors to understand the overlapping leave laws and how to apply them consistently. 

With the ADA and Workers’ Compensation there is usually no set limit to the amount of leave time an employee may need, either as a reasonable accommodation or due a work-related injury.   Any absences under the ADA or Workers’ Comp all run concurrently with family medical leave. (FML)

When designating FML time for a Workers’ Compensation absence, note the following important differences:

ADA

• Designation of FML is considered an accommodation.
• Engaging in the interactive process is important in determining if FML is necessary.
• Employee may need additional time after 12 weeks.

Workers’ Compensation

• If an employee is on FML, you cannot force light duty.
• Employee may need additional time after 12 weeks.

Evaluating the District’s RTW Program 

RTW programs allow districts to take a proactive approach in assisting injured workers to return to safe and productive work activities as soon as possible following an injury. An effective RTW program can provide many benefits to all partners in the return to work process. Evaluation is critical to identifying the strengths and weaknesses in your RTW program and increasing its efficacy. Information obtained through an evaluation facilitates continuous improvement.