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Office of Risk Management Annual Conference
TRANSITIONAL DUTY EMPLOYMENTTRANSITIONAL DUTY EMPLOYMENT
A RETURN-TO-WORK CONCEPT FORA RETURN-TO-WORK CONCEPT FOR
WORKERS’ COMPENSATION COSTWORKERS’ COMPENSATION COST
CONTAINMENTCONTAINMENT
Office of Risk Management Annual Conference
Transitional Duty EmploymentTransitional Duty Employment
A process that facilitates returning injured A process that facilitates returning injured
employees back into the workforce in a employees back into the workforce in a safe safe
and timely manner after a work-related and timely manner after a work-related injury.injury.
Office of Risk Management Annual Conference
Transitional Duty EmploymentTransitional Duty Employment
Injured employees are returned to workInjured employees are returned to work
to perform meaningful, productive work to perform meaningful, productive work andand
within safe parameters of his or her within safe parameters of his or her physical capabilities.physical capabilities.
Office of Risk Management Annual Conference
Goal of Transitional Duty EmploymentGoal of Transitional Duty Employment
TemporaryTemporary transitional employment transitional employment options options
that fit the injured employee’s specific that fit the injured employee’s specific
capabilities.capabilities.
Office of Risk Management Annual Conference
Objectives of Transitional Duty Objectives of Transitional Duty EmploymentEmployment
Manage workplace injuries.Manage workplace injuries. TemporarilyTemporarily modify the employee’s position or modify the employee’s position or
job description to accommodate physical job description to accommodate physical restrictions identified by the treating physician.restrictions identified by the treating physician.
Reduce workers’ compensation costs.Reduce workers’ compensation costs. Make workers’ compensation more effective.Make workers’ compensation more effective.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
Approximately 89,000 employees. Approximately 89,000 employees. 4400 active workers’ compensation claims.4400 active workers’ compensation claims. 960 of these paid compensation benefits on 960 of these paid compensation benefits on
regular basis. regular basis.
$55 mil spent on workers’ compensation. $55 mil spent on workers’ compensation. Money comes directly from agency budgets. Money comes directly from agency budgets.
Office of Risk Management Annual Conference
State of LouisianaState of LouisianaPrior to 1999Prior to 1999
Injured workers cannot return to work unless they can Injured workers cannot return to work unless they can perform full duty. perform full duty.
Civil Service won’t allow injured workers to return to Civil Service won’t allow injured workers to return to work unless they are at 100% full duty.work unless they are at 100% full duty.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
ORM had to get legislative authority just to ORM had to get legislative authority just to write write
a policy on return to work.a policy on return to work.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
To make the legislative argument, ORM first worked a pilot program To make the legislative argument, ORM first worked a pilot program
of Transitional Duty Employment at Pinecrest Developmental of Transitional Duty Employment at Pinecrest Developmental Center.Center.
A vocational rehabilitation counselorA vocational rehabilitation counselor h helped Pinecrest develop elped Pinecrest develop
transitional duty policy. transitional duty policy.
The pilot was worked for one year.The pilot was worked for one year.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
Pinecrest was selected for the pilot program Pinecrest was selected for the pilot program because:because:
They had the highest volume of workers’ They had the highest volume of workers’
compensation lost time claims. compensation lost time claims. They had the highest workers’ compensation They had the highest workers’ compensation
premiums. premiums.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
Before the pilot program…Before the pilot program…
Pinecrest employees had accepted the fact that Pinecrest employees had accepted the fact that they they
would not be allowed back to work.would not be allowed back to work.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
After the pilot was worked, Pinecrest employees After the pilot was worked, Pinecrest employees were were
allowed to return to work, limited duty. allowed to return to work, limited duty.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
In the first six (6) months of the In the first six (6) months of the transitionaltransitional
duty pilot, Pinecrest saw a duty pilot, Pinecrest saw a 15%15% reduction reduction of itsof its
monthly indemnity pay-out. monthly indemnity pay-out.
Office of Risk Management Annual Conference
State of LouisianaState of Louisiana
At the end of one year of the transitional duty pilot, At the end of one year of the transitional duty pilot,
Pinecrest saw a Pinecrest saw a 36%36% reduction of its indemnity reduction of its indemnity
pay-out.pay-out.
Office of Risk Management Annual Conference
Statutory Authority for TDEStatutory Authority for TDE
R. S. 23:1547R. S. 23:1547
In 1999, the legislature passed In 1999, the legislature passed Senate bill 689 Senate bill 689 which giveswhich gives
ORM the authority to develop and administer a ORM the authority to develop and administer a transitionaltransitional
duty program for State employees.duty program for State employees.
Office of Risk Management Annual Conference
Case Study Case Study
INJURED WORKERINJURED WORKER
Office of Risk Management Annual Conference
Case StudyCase Study
Injured Worker got hurt on the job.Injured Worker got hurt on the job.
She received conservative treatment with She received conservative treatment with Dr. Mild for 2 months. Dr. Mild for 2 months.
Now Dr. Mild feels like Injured Worker can Now Dr. Mild feels like Injured Worker can do something.do something.
Dr. Mild releases Injured Worker to return to Dr. Mild releases Injured Worker to return to work except… she can’t lift over 25 pounds.work except… she can’t lift over 25 pounds.
Office of Risk Management Annual Conference
Case StudyCase Study
Injured WorkerInjured Worker is so happy she can go back to is so happy she can go back to
work.work.
Office of Risk Management Annual Conference
Case StudyCase Study
Injured Worker’s supervisor does not allow Injured Worker’s supervisor does not allow her to return to work because she is not her to return to work because she is not
released to return to work full duty.released to return to work full duty.
Office of Risk Management Annual Conference
Case StudyCase Study
Injured WorkerInjured Worker just doesn’t know what to just doesn’t know what to do…do…
Office of Risk Management Annual Conference
Case StudyCase Study
Injured Worker gives the bad news to her Injured Worker gives the bad news to her adjuster: “Keep sending me my checks!” adjuster: “Keep sending me my checks!”
Develops renewed interest in: Develops renewed interest in:
Dr. PhilDr. Phil
The Biggest LoserThe Biggest Loser
Casino GamingCasino Gaming
Office of Risk Management Annual Conference
Case StudyCase Study
Because Injured Worker is not allowed to work, Because Injured Worker is not allowed to work, restricted duty --restricted duty --
Compensation benefits continue to be paid.Compensation benefits continue to be paid.
Office of Risk Management Annual Conference
Case StudyCase Study
Injured Worker’s doctor doesn’t see what Injured Worker’s doctor doesn’t see what the big deal is. the big deal is.
As her doctor, he knows Injured Worker As her doctor, he knows Injured Worker can work.can work.
Office of Risk Management Annual Conference
Case StudyCase Study
Injured Worker doesn’t see what the big deal is Injured Worker doesn’t see what the big deal is either,either,
she knows she can work.she knows she can work.
She can do everything her job requires her to do She can do everything her job requires her to do except the lifting.except the lifting.
Office of Risk Management Annual Conference
Case StudyCase Study
Sadly enough, Injured Worker’s supervisor Sadly enough, Injured Worker’s supervisor doesn’t doesn’t
see what the big deal is, either.see what the big deal is, either.
After all, Injured Worker is being paid workers’ After all, Injured Worker is being paid workers’
comp benefits anyway, rightcomp benefits anyway, right??
What’s the big deal?!What’s the big deal?!
Office of Risk Management Annual Conference
Case StudyCase StudyThe big deal is: The big deal is:
Workers’ compensation benefits continue until the Workers’ compensation benefits continue until the injured worker returns to work, injured worker returns to work, oror
The injured worker is released to return to work The injured worker is released to return to work regular duties by a treating physician.regular duties by a treating physician.
Office of Risk Management Annual Conference
THE ECONOMICS THE ECONOMICS
OF OF
RETURN TO WORKRETURN TO WORK
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
A claim for a health care worker who hurts her back lifting A claim for a health care worker who hurts her back lifting a a
patient will cost the employer patient will cost the employer $5,150 $5,150 with a return to with a return to work work
program.program.
Without a return to work program the same claim will cost Without a return to work program the same claim will cost
$29,250$29,250..
This is a This is a 72%72% difference. difference.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
If Injured Worker is unable to return to her previous work earning the If Injured Worker is unable to return to her previous work earning the same wages orsame wages or
If she is unable to earn 90% or greater of her pre-injury wage...If she is unable to earn 90% or greater of her pre-injury wage...
R. S. 23:1226 requires Injured Worker’s employer to provide rehabilitative R. S. 23:1226 requires Injured Worker’s employer to provide rehabilitative services: services:
Job placement RetrainingJob placement Retraining
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
Rehabilitation of injured workers Rehabilitation of injured workers automatically adds $5,000 - $7,500 to automatically adds $5,000 - $7,500 to
value of a claim.value of a claim.
Benefits continue to be paid during the Benefits continue to be paid during the rehabilitation process.rehabilitation process.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
At the end of the rehabilitation process, if the At the end of the rehabilitation process, if the
injured worker is unable to earn wages equal injured worker is unable to earn wages equal
to 90% or greater of pre-injury wage, she is to 90% or greater of pre-injury wage, she is
entitled to supplemental earnings benefits or entitled to supplemental earnings benefits or
SEB.SEB.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
SEB is based on 66 2/3 of the difference SEB is based on 66 2/3 of the difference between: between:
the pre-injury wage andthe pre-injury wage and
what the employee is now capable of what the employee is now capable of earning.earning.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
While this reduces benefits, benefits are still While this reduces benefits, benefits are still being being
paid.paid.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
As long as an injured worker is off work, As long as an injured worker is off work, indemnity andindemnity and
medical benefits continue to be paid.medical benefits continue to be paid.
These affect premiums.These affect premiums.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
If the claim is settled, another $30,000 – If the claim is settled, another $30,000 – $50,000 $50,000
is added to value of the claim.is added to value of the claim.
Office of Risk Management Annual Conference
The Economics of Return to WorkThe Economics of Return to Work
If a claim is settled, in most cases, If a claim is settled, in most cases, consideration consideration
must now to be given to a must now to be given to a Medicare Set Medicare Set Aside Aside
which will significantly increase the settlement which will significantly increase the settlement
amount. amount.
Office of Risk Management Annual Conference
Transitional Duty EmploymentTransitional Duty Employment
The only way to stop indemnity payments The only way to stop indemnity payments altogether …altogether …
Office of Risk Management Annual Conference
Transitional Duty EmploymentTransitional Duty Employment
Return injured workers to work with the Return injured workers to work with the employeremployer
of injury on transitional duty.of injury on transitional duty.
Office of Risk Management Annual Conference
BENEFITS OF RETURN TO BENEFITS OF RETURN TO WORKWORK
To the EmployerTo the Employer
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Keep workers’ compensation costs down.Keep workers’ compensation costs down.
Productivity increases and human resources Productivity increases and human resources are used to the maximum extent.are used to the maximum extent.
Manage impact of workers’ compensation Manage impact of workers’ compensation claims on premiums.claims on premiums.
Reduce the fiscal impact of workplace Reduce the fiscal impact of workplace absences.absences.
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Wage costs for substitute employees Wage costs for substitute employees are saved.are saved.
Work delays and business interruption Work delays and business interruption are eliminated when an experienced are eliminated when an experienced employee returns to work.employee returns to work.
Creates goodwill and positive image Creates goodwill and positive image with the public and employees.with the public and employees.
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
When an injured worker is sitting home When an injured worker is sitting home watching watching Dr. Phil …Dr. Phil …
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
A commercial comes on that says: “Have A commercial comes on that says: “Have you been hurt on the job? Call me, I’m a you been hurt on the job? Call me, I’m a
lawyer, I can help. I can get you top $$ for lawyer, I can help. I can get you top $$ for your claim.” your claim.”
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
This is how he does it and employers help This is how he does it and employers help the injured worker’s attorney by not the injured worker’s attorney by not
returning injured workers back to work returning injured workers back to work light duty.light duty.
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Transitional Duty Transitional Duty
Light Duty Light Duty
Restricted DutyRestricted Duty
Modified Duty Modified Duty
Temporary Assignment of Duties.Temporary Assignment of Duties.
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Whatever you call it, justWhatever you call it, just get ‘em back to get ‘em back to work!work!
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Transitional Duty Employment is an absolute Transitional Duty Employment is an absolute must must
for keeping workers’ compensation costs down.for keeping workers’ compensation costs down.
Office of Risk Management Annual Conference
Think About It Think About It
Would you like for your employee to sit Would you like for your employee to sit here?here?
Office of Risk Management Annual Conference
Think About ItThink About It
Or here?Or here?
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
When an employee is sitting home When an employee is sitting home collecting a comp check -collecting a comp check -
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
The work piles up!!!The work piles up!!!
Somebody’s gotta do it or it doesn’t get done.Somebody’s gotta do it or it doesn’t get done.
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
To the Employee….To the Employee….
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Return to work is an employee benefit.Return to work is an employee benefit.
Employees see workplace involvement in their Employees see workplace involvement in their recovery as an indication that the employer recovery as an indication that the employer cares about their well-being and wants to get cares about their well-being and wants to get them back to work.them back to work.
Transitional Duty speeds up recovery time and Transitional Duty speeds up recovery time and helps to boost the employee’s self-esteem. helps to boost the employee’s self-esteem.
Office of Risk Management Annual Conference
Benefits of Return to WorkBenefits of Return to Work
Injured workers receive their regular pay instead Injured workers receive their regular pay instead of 2/3% of average weekly wage.of 2/3% of average weekly wage.
Return to work programs help reduce depression Return to work programs help reduce depression and alleviate emotional stress.and alleviate emotional stress.
Maintain physical conditioning through work life Maintain physical conditioning through work life discipline.discipline.
Most employees want to be a part of the Most employees want to be a part of the productivity of the company they work for.productivity of the company they work for.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Focus on what the injured worker Focus on what the injured worker CANCAN do. do.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Do not focus on what the injured worker Do not focus on what the injured worker cannot do. cannot do.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Transitional Duty Employment doesn’t Transitional Duty Employment doesn’t have to be nicest, coolest, best job you have to be nicest, coolest, best job you
have to offer.have to offer.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Create a return to work policy.Create a return to work policy. Announce the policy.Announce the policy. Sell the policy as an employee benefit.Sell the policy as an employee benefit. Include policy in personnel manuals and new Include policy in personnel manuals and new
employee orientation.employee orientation. Make policy accessible to employees through Make policy accessible to employees through
newsletters, etc.newsletters, etc.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Designate one person to manage the Designate one person to manage the program.program.
Injured employees need to know that someone is Injured employees need to know that someone is in charge of return to work at the employer.in charge of return to work at the employer.
Give the return to work coordinator the Give the return to work coordinator the appropriate authority to administer job duties.appropriate authority to administer job duties.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Adopt an Empathy Program.Adopt an Empathy Program.
Frequent contact with the injured worker helps to Frequent contact with the injured worker helps to facilitate early return to work.facilitate early return to work.
Contact them within 24 hours and once weekly.Contact them within 24 hours and once weekly.
Assure employees they are missed and explain their Assure employees they are missed and explain their benefits so they will know they will be taken care of.benefits so they will know they will be taken care of.
These courtesies promote rapid return to work and These courtesies promote rapid return to work and countercounter
negative feelings.negative feelings.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Establish a guaranteed transitional duty Establish a guaranteed transitional duty period.period.
Guarantee transitional duty for a set period of Guarantee transitional duty for a set period of time.time.
Alter length of time to conform to average Alter length of time to conform to average diagnostic recovery time.diagnostic recovery time.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Establish a guaranteed transitional duty Establish a guaranteed transitional duty period.period.
The job should be open and available when the The job should be open and available when the injured injured employee employee returns to work.returns to work.
Make sure ADA and FMLA guidelines are met if Make sure ADA and FMLA guidelines are met if the injured employee is unable to return to the injured employee is unable to return to work.work.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Stipulate the goals of the transitional duty.Stipulate the goals of the transitional duty.
Transitional duty should have agreed upon Transitional duty should have agreed upon therapeutic goals.therapeutic goals.
Treating physician can help define the Treating physician can help define the employee’s abilities to make sure tasks are employee’s abilities to make sure tasks are meaningful and promote recovery.meaningful and promote recovery.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Stipulate the goals of the transitional duty.Stipulate the goals of the transitional duty.
Both the employer and the employee must Both the employer and the employee must adhere to any physical restrictions.adhere to any physical restrictions.
The return to work program is an employee The return to work program is an employee benefit, a privilege. Employees are expected to benefit, a privilege. Employees are expected to be productive. be productive.
Office of Risk Management Annual Conference
Successful TransitionalSuccessful Transitional DutyDuty
Evaluate and Improve the program.Evaluate and Improve the program.
Open discussion with employee, supervisor, Open discussion with employee, supervisor, physician when an employee returns to full duty.physician when an employee returns to full duty.
Find out how well the program worked.Find out how well the program worked.
Feedback on ways to improve the program.Feedback on ways to improve the program.
Ensure executive management has a “buy in” to Ensure executive management has a “buy in” to return to work. return to work.
Office of Risk Management Annual Conference
Transitional Duty WorksTransitional Duty Works
Effective in both public and private sector. Effective in both public and private sector. Nationally, there is an 18% decrease in Nationally, there is an 18% decrease in
disability costs.disability costs. 23% effective for ORM. 23% effective for ORM. Keep productivity and employee moral up.Keep productivity and employee moral up.
Office of Risk Management Annual Conference
Transitional Duty WorksTransitional Duty Works
Transitional Duty Employment is Transitional Duty Employment is economical.economical.
Injured workers are returned to a Injured workers are returned to a productive lifestyle.productive lifestyle.
Return-to-work makes good business Return-to-work makes good business sense.sense.
IT’S A WIN – WIN SITUATION. IT’S A WIN – WIN SITUATION.
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
Before the treating physician is ready to release Before the treating physician is ready to release the the
injured worker to return to work, obtain a copy of injured worker to return to work, obtain a copy of the the
job description to present to the treating job description to present to the treating physician.physician.
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
If the job of injury falls within the restrictions If the job of injury falls within the restrictions thethe
treating physician is ready to release the treating physician is ready to release the injuredinjured
worker, benefits can be stopped.worker, benefits can be stopped.
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
If the treating physician still places restrictions If the treating physician still places restrictions
on the injured worker once he has reviewed on the injured worker once he has reviewed thethe
job description, job description, The adjuster will contact the employer. The adjuster will contact the employer. Determine if accommodations can be made Determine if accommodations can be made
to the injured worker’s current position? to the injured worker’s current position?
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
If accommodations can be made to the If accommodations can be made to the injured injured
worker’s current positionworker’s current position
Benefits stop. Benefits stop.
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
If the treating physician If the treating physician will notwill not release the release the
injured worker to return to work, restricted duty injured worker to return to work, restricted duty
to their job of injury but theto their job of injury but the
Injured worker can return to work, other Injured worker can return to work, other
employment, employment,
Vocational rehabilitation services will be Vocational rehabilitation services will be initiated. initiated.
Office of Risk Management Annual Conference
What Does the Claims Person Do?What Does the Claims Person Do?
Calculate what 90% of the injured worker’s Calculate what 90% of the injured worker’s pre-injury wage will be.pre-injury wage will be.
Advise counselor to only identify those jobs Advise counselor to only identify those jobs that will place injured worker within 90% of that will place injured worker within 90% of pre-injury wage. pre-injury wage.
Office of Risk Management Annual Conference
The Object of Vocational RehabilitationThe Object of Vocational Rehabilitation
Assist the injured worker in returning to the same Assist the injured worker in returning to the same position;position;
Assist the injured worker in returning to modified Assist the injured worker in returning to modified position with his current employer;position with his current employer;
Assist the injured worker in returning to a related Assist the injured worker in returning to a related occupation with another employer in the same field occupation with another employer in the same field
or if necessary, on–the-job training.or if necessary, on–the-job training.
Office of Risk Management Annual Conference
The Object of Vocational RehabilitationThe Object of Vocational Rehabilitation
Vocational Rehabilitation should Vocational Rehabilitation should
return the injured worker to work with a return the injured worker to work with a minimum of retraining, minimum of retraining,
as soon as possible after the injury occurs. as soon as possible after the injury occurs.
Transitional Duty Employment is how this is Transitional Duty Employment is how this is done.done.
Office of Risk Management Annual Conference
QuestionsQuestions
Are there any questions?Are there any questions?
Office of Risk Management Annual Conference
ReferencesReferences
www.sorm.state.tx.uswww.sorm.state.tx.us
www.returnetoworkmt.com
Treating the Whole Elephant: A Treating the Whole Elephant: A Holistic Approach to Reducing Workers’ Holistic Approach to Reducing Workers’ Compensation Costs by Rebecca Compensation Costs by Rebecca ShaferShafer