May/June 2013
Return-to-work programs get injured employees back into a productive role as quickly as possible, which is beneficial for both the employee and the employer, experts say.
By Kim Fernandez
The scrap industry had 3.8 nonfatal injuries per 100 workers—a total of 4,500—in 2008, according to the U.S. Bureau of Labor Statistics (Washington, D.C.). No recycling company wants an employee to get injured on the job, but if an injury occurs, you can make the best of that bad situation by having a return-to-work program. Such programs help injured or ill employees safely return to work as soon as it’s medically practical. Return-to-work programs assign such workers to light, modified, transitional, or temporary duty inside or outside the company. The worker might take on a temporary assignment, fill a vacant position, swap jobs with another employee on site, or even work for a while at a local nonprofit.
Getting an injured employee back to productive work is critical because the longer an employee is away from the workplace, the greater the chance he or she will never return. Only 50 percent of workers who are on disability leave for five or more months return to work, according to a 1996 report by the U.S. General Accounting Office. Injured employees return to the work force three to four weeks faster, however, in workplaces with formal return-to-work programs compared with those that do not have such programs, according to a study of California employers.
The return to work has multiple benefits, according to testimony Kenneth Mitchell, a managing partner of WorkRx Group (Worthington, Ohio), gave before a March 2012 hearing of the U.S. Senate Committee on Health, Education, Labor, and Pensions. The workers “report greater financial and emotional well-being, reduced need for health-care services, and greater life satisfaction than those who do not return to work.” Further, companies with return-to-work programs report less absenteeism, shorter times off work, and “measurably” lower health-care costs per employee, he said. At that same hearing, Karen Amato of SRA International (Fairfax, Va.), testifying on behalf of the Society for Human Resource Management (Alexandria, Va.), pointed out that, “for the employer, the ability to return trained, skilled employees back to the workplace can avoid recruitment and replacement costs and reduce direct and indirect costs of absence and disability.”
Return-to-work programs have their challenges, however. Simply assigning an injured employee temporarily to a different job isn’t going to solve every problem and could set the company up for trouble down the road, experts say. It’s prudent to have solid return-to-work procedures in place, inform employees what your company expects of them if they become ill or injured, consider the impact of the return-to-work plan on the injured employee and his or her colleagues, and know what local, state, and federal laws come into play.
Immediate Response
A successful return-to-work program begins with handling an injury case promptly and correctly on the day of the injury, experts say. A company’s action at this stage can determine the overall duration and cost of the injury claim. When an employee is injured on the job, after his or her immediate medical needs are met, “it’s very important to manage those cases and call a third-party administrator immediately,” says Steve Forystek, director of health, safety, environment, and transportation for PSC Metals (Mayfield Heights, Ohio). Claims managers “expect you to call within a day. If you haven’t [informed them] for a week or 10 days, how are they supposed to help you?”
A quick response could lead to a quick return to work. In his testimony, Mitchell stated that “individuals appear to make return-to-work decisions near the onset of the disabling event, onset of symptoms, and diagnosis.” Those who know their employer’s return-to-work expectations, policies, and procedures might be more likely to plan for their return accordingly.
That quick return can reduce costs. In many states, if the worker is off work for more than three days, the insurance companies consider the claim an indemnity/lost-time claim, writes Dennis Chandler of Day-1 Systems and Chandler Consulting (Scottsdale, Ariz.), in a report titled “Constructing Return to Work Programs: Building for Better Returns.” Conversely, if the employee returns to work in modified duty within three days, many insurance companies will classify the claim as medical only, which is less costly.
Injured workers’ prompt return to work also could keep inspectors from the Occupational Safety and Health Administration (Washington, D.C.) at bay. The inspectors take the amount and severity of injuries under consideration when selecting facilities to inspect, Forystek says. That’s why, “if you have a case, you want to manage it as effectively as possible. If you can manage a case so it doesn’t end up becoming a lost-time incident, you’re that much further ahead. If you have an awful year with lots of lost-time cases, you might be inviting an OSHA visit.”
Alternative Assignment Strategies
Injured workers might not be able to do their regular jobs in the days, weeks, or months after their injuries, but that doesn’t mean they can’t do any job. “When opportunities for transitional work or light-duty assignments are available, disabled individuals are twice as likely to successfully resume work following an injury,” according to research Mitchell cited in his testimony.
At OmniSource Corp. (Fort Wayne, Ind.), the objective of the return-to-work program is to keep injured employees “engaged in activities that are productive for them and for the company as much as possible and avoid them just sitting at home,” says Greg Kadziolka, corporate safety director. “Our goal is to bring the person back to work as soon as medically possible.” As long as medical professionals say the injured employee can perform the assigned task, “it’s our stance to say they need to come to work,” he says. “Our policy is written in a way where [not returning to work] isn’t really an option for an employee who’s cleared for at least modified work duty.”
In most cases, OmniSource places employees in vacant positions that are appropriate to their injuries. For certain employees, that could mean swapping a truck driver’s seat for a desk chair or a forklift for a broom. If, for example, the injured employee can’t walk and his or her usual job requires walking, “they can be productive in the office setting,” Kadziolka says. “There are a lot of different ways to find meaningful employment for them.” The point is, there’s likely a job somewhere in the company for an injured employee to do with the same pay and benefits, he notes.
In his experience, returning to work “does a lot for that employee,” Kadziolka says, noting that time off can make a bad situation worse. When sitting at home, injured workers “get demotivated, disinterested, and depressed,” he says. “That lack of interaction with other people and [lack of] camaraderie take a big toll on people. We want to avoid that as much as possible and maintain their hopes and positive attitudes by bringing them back to modified duties at the work site.”
Similarly, Alter Trading Corp. (St. Louis) uses its “return-to-duty” program to “get people to flow in immediately if they have a potential lost-time accident,” says Jeff Wilke, director of health and safety. “We want to return them to work as soon as possible, making sure we can accommodate their restrictions. We want to get them active and find a position for them.”
Alter informs employees when it hires them that it might offer them “transitional duties” if they’re injured to give them time to heal and get back to their regular jobs. “We don’t say where it will be or what it is,” Wilke says. “It’s a job, and we write it down as a bona-fide offer that still pays their regular wage.” Sometimes that means looking around the yard to find work that needs to be done, even if it’s not a regular job the company would have filled with a full-time employee. “We can customize a job to the employee,” Wilke says. “If the weather’s nice, for instance, [the injured worker] could paint railings or walls, or they could sort nonferrous metals or move into the parts room and help with inventory there.”
Alter has doctors and other professionals, such as physical therapists, visit its yards to determine which duties are appropriate for injured workers and where the company can modify the job or the work environment to accommodate them. This expertise has been valuable, Wilke says. “If someone can’t climb ladders, you’d think they might be able to operate a front-end loader, but the process of physically getting them into that loader can be an issue,” he explains. “We have people come help us evaluate the ability of that person to get back into that equipment or find a way to get them back to work.”
To ensure you’re on solid legal ground in offering these temporary or modified jobs, it helps if your company’s job descriptions are general enough to encompass a variety of tasks. “You have to leave descriptions open enough so that if you have to reassign an employee to a less physically demanding aspect of their job, it’s not a restricted-duty case,” Forystek says. He cautions managers that alternative work assignments must be meaningful and productive. Otherwise, injured workers could view work they consider demeaning or “make-work” as punishment, which could damage their morale. Alternatively, workers might claim the tasks the company gives to one injured worker are not equivalent to those it gives another who suffers a similar injury. “If you create a morale issue or it looks like you’re giving someone favorable treatment, we’d rather not have that situation,” he says. That’s one reason OmniSource prefers to put recovering workers in established positions. The workers might get to choose among several available jobs, which gives them some flexibility, but “we give them jobs that are done by others … no one is put in a favorable position,” Kadziolka says. “We have yet to run into a roadblock where someone refuses to do a modified job here or off site.”
Some companies that cannot find a temporary or vacant position suitable for an injured worker at their facilities lend those workers to a local nonprofit organization. Sending them to the local Salvation Army, Goodwill, or other charitable organization—while the company pays them their normal salary—can help them feel productive while allowing them and the company to support the community. Consider a variety of factors—including the employee’s injury, personality, attitude, and work ethic—before assigning him or her to work with an outside group, OmniSource’s Kadziolka says. “You don’t want to put anybody in a situation where it could be the wrong fit. You’re putting your company’s reputation out there, and the last thing you want is for a disgruntled employee to be in a situation he or she doesn’t want to be in.” But he and others can cite numerous success stories where these temporary jobs have changed workers’ lives. “After retiring from here, several of our workers pursued continued volunteer work or employment from organizations we sent them to,” Kadziolka says. “They got more out of it than they thought they would.”
Navigating the Obstacles
Returning injured employees to work sounds like—and usually is—a great idea, but the arrangement must meet legal scrutiny, too, says Nancy Barnes, a partner at Thompson Hine (Cleveland) who specializes in employment and business litigation and employment-related issues. “We tell clients to make sure they’re considering all the implications of the laws we call the Bermuda Triangle—state workers’ compensation, the Americans With Disabilities Act, and the Family and Medical Leave Act,” she says. “Those statutes can sometimes create conflicting responsibilities for employers,” and it’s easy to run afoul of them.
For example, if your company implements a return-to-work program only for employees who are injured on the job, a worker who becomes injured off the job could accuse your firm of failure to provide a reasonable accommodation to him or her under the ADA. The same potential exists under the FMLA. If that law applies to your company and the injured worker, the worker might be able to take leave without pay instead of returning to work. “If someone qualifies under FMLA, you cannot force them to return to work even if they could perform some sort of light duty,” Barnes says. In short, she says, employers must keep all three laws—as well as local regulations—in mind before deciding what a return-to-work program will offer to or require of an injured employee.
Barnes also cautions employers about simply finding work for injured employees to do instead of assigning them to another defined job at the site. Giving an injured employee the option of a completely different job that’s not equivalent to his or her original job—because it has a different pay rate or lacks benefits, for instance—raises the question of whether the alternative job qualifies as a “true reasonable accommodation” under the ADA, she says. If the company continues to give the worker his or her existing pay and benefits and just changes the work assignment, however, it probably would not create ADA issues, Barnes says. Keep in mind, too, that the ADA doesn’t require employers to create a new position as an accommodation, she says. Companies that choose to do so are creating a precedent; other employees who seek a reasonable accommodation because they have become disabled or injured and can no longer perform their jobs could use that against them.
The process of managing an injured worker’s return to work is challenging for employers, Barnes concedes, especially when there’s no clear end date to an employee’s disability status. Many times, employers “see certifications from medical-care providers that say someone can come back to their regular job in a month, and that stretches to six weeks and then two months,” she says. “Employers struggle with that day-to-day decision of whether they can survive another month without Joe in that position. … But if they’re not holding that job open for Joe, they may be risking a potential disability claim when he is ready to return to work.” In her view, “it’s unfair that, for the most part, there are really not black-and-white [guidelines for] return-to-work programs.”
Wilke agrees, noting that even if a job is appropriate to a worker’s injury status and the worker agrees to do the job, the company can’t be complacent. “There are always pitfalls and mistakes,” he says. “You’ve still got to watch [injured workers] like you watch employees in the yard to be sure they’re working inside their medical restrictions. You’re responsible if they aggravate their condition or if they create another injury. So you have to say, ‘This might not be the most exciting job, but we need you to maintain these restrictions.’ Then you have to keep an eye on them to make sure they do that.”
Even with the restrictions and worries, the benefits of a return-to-work program far outweigh the drawbacks, sources say. Employers say it’s a valuable loss-control measure that can help contain workers’ compensation insurance costs by minimizing the time injured employees receive temporary income benefits. It also can reduce a company’s medical costs, minimize its expenses for temporary/substitute workers, and help it achieve maximum productivity from its existing employees. Getting an experienced employee back to work minimizes work delays and spares other workers from having to perform additional duties to compensate for the absent employee.
For injured workers, a return-to-work program can boost their morale and self-esteem; minimize stress, boredom, and depression related to their injury or illness; keep them engaged and connected with the workplace; shorten their recovery time; and provide full or partial wages that are likely higher than workers’ comp temporary income benefits.
For a company’s work force as a whole, a return-to-work program can show that the company cares about employees’ well-being and will help them return to productive work as soon as possible. Employees who are satisfied with their employer’s response to injury or illness return to work 50 percent faster with a 54 percent lower cost, according to research Mitchell cited in his testimony. That in itself is a powerful argument for return-to-work programs.
Kim Fernandez is a writer based in Bethesda, Md.