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Claims Management

Prevent Your Injured Employees from Becoming a Statistic

Once an employee becomes injured, the clock starts ticking and the likelihood of returning them to work drops significantly with time. A proactive return-to-work program can help.

May 24, 2021

The statics related to post-injury return to work are harrowing. According to the Washington State Department of Labor and Injuries, the chance of an injured employee returning to full employment after a six-month absence is 55 percent. After one year away from work, that chance of returning drops sharply to 32 percent. After two years away from work, the chance of returning to employment falls to a meager 5 percent.

Employers have one tool to help their employees avoid this potential path to permanent disability – a strong return to work program.

“There are significant benefits for all parties involved,” said Lisa Haug, Managing Director – Medical Management. “Effective return-to-work programs promote faster recovery by keeping the injured employee active, engaged and motivated. Conversely, these programs help the employer mitigate claims exposure and associated costs.”

Employers can use the following steps as a guide to establish or enhance their return-to-work programs:

1. Create a Written Policy All return-to-work programs should have the same objective – returning injured employees to full health and productive work, while mitigating the risks and costs associated with the workers’ compensation claim. State this objective clearly in your policy and then outline the step-by-step process that will help you achieve it. Include each stakeholder’s role and responsibilities. Once complete, create a policy acknowledgement form that employees can sign to acknowledge policy understanding and receipt.

2. Assign a Program Coordinator Designate an individual best suited to manage the program. This person will be responsible for promptly reporting claims to the insurance carrier, identifying and updating key contacts, and maintaining the appropriate program communication materials like letters and authorization forms. This person will serve as the first point of contact for all program stakeholders.

3. Involve Nurse Case Management Nurse case management can be an integral part of the team and impactful at communicating the program to medical providers and injured workers. Nurse case managers often serve as liaisons between the injured worker, provider and employer. Their involvement can assist in moving treatment forward and advocating for return-to-work when appropriate in an objective, positive, measurable way.

4. Communicate the Program Provide clear communication about your program to anyone involved. This could include employees, managers, your insurance carrier, healthcare providers and, if applicable, labor representatives. Provide these stakeholders with your policy, a description of processes to be followed and key contact information. Once established, review your program with all employees and management on a regular basis to ensure the process is understood and followed consistently. Injuries may be a rare occurrence in your organization, so this will help ensure your return-to-work program runs smoothly when an injury does occur.

5. Perform Job Analyses It is critical to evaluate and define the physical demands of each job within your organization. To create a clear picture of core requirements, this analysis should include information about responsibilities, skills, tasks, outcomes and work environment for each position.

6. Identify Alternate Duty Jobs When the injured employee’s physician releases him or her to work with restrictions, you can use your job analysis to identify suitable alternate-duty jobs. Compare physical requirements of the positions within your organization to the restrictions assigned by the physician. To help facilitate the return-to-work process, it is often beneficial to send the list of qualified jobs and their descriptions to the employee’s physician.

7. Report Your Success Metrics Metrics like claim duration, cost, lost workdays and return to work claims percentage can help you evaluate your program’s success. There are several measurement and benchmarking tools available to help measure program utilization and effectiveness. Communicate key performance indicators to management to illustrate your program’s impact and value to the organization.