Disability Management Solutions

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Disability Management Solutions
Early and Safe Return to Work Programs- A Key
Element to your Success!
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Overview

• Financial Implications
• Why Early and Safe Return to Work Initiatives?
• 5 Steps to Managing Early and Safe Return to Work
  Programs
• Challenges Along the Way- Break out session
• Basic Tools in your toolkit
• How tools can assist you
• Questions?

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Financial Implications

• 1996- 2004 employers paid more than 12 billion in
  direct and indirect costs related to MSDs
• MSD are the most costly for Ontarios employers-
  1 reason for lost time claims reported to WSIB
• 27 million lost time days and a cost of more than
  3.3 Billion
• (WSIB financial report, WSIB, 2005)

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Direct and Indirect Costs

• Administering the claim
• Arranging RTW
• Finding and training replacement workers
• Lost productivity
• Overtime
• Legal Costs
• Equipment modification

4-10 times the Claims costs
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Additional Costs

• Human costs
• Effect on employee
• Effect on family
• Effect on friends
• Communities

Priceless
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Making a Difference
Injuries
Frequency
Duration
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Why Early and Safe Return to Work

• Timing is everything with respect to injuries
• If you get the timing wrong, it can increase the
  risk of injury becoming chronic and increase the
  duration
• Avoid the sick role behaviour
• We need to understand injuries, before we can
  look at ESRTW

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3 Stages of Low Back Pain

• Acute Stage up to 4 weeks after onset of
  symptoms
• Sub-Acute Stage from 4-12 weeks
• Chronic Stage greater than 12 weeks
• Vast majority will heal in acute phase
• Studies show that 10 will move on to chronic
  stage, and this is the stage that are most costly
  to you as an organization.

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Right after the Injury

• Encouragement for employees to continue their
  usual activities as much as possible is key in
  the acute stage
• Several studies show increased utilization of
  modified work can reduce the incidence by 50 and
  the duration by 40

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One to Three Months after the Injury

• Treatment should be more aggressive in this stage
• Intensive physiotherapy, supervised exercise
  prescription, and ergonomic intervention to
  prevent long term disability and promote timely
  return to work
• Studies show intensive intervention can reduce
  subsequent lost time by 50

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Chronic Stage

• More psychosocial issues in this stage, and
  therefore much harder to RTW
• Studies show co-ordinated multidisciplinary
  treatment that includes modified work or
  ergonomics gets more of these workers back to work

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What about LMR costs

• Frank to insert example of LMR and really why we
  cant afford to have early and safe return to
  work programs

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Initiative

• Goal is to reduce lost time injuries, and
  severity rates
• From the needs analysis, your Safety Group, has
  chosen Early and Safe Return to Work, as one of
  their key 5 elements
• Todays focus will be on helping you to get on
  track with this one element

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Managing Health and Safety

• There are 5 Steps to Managing Health and Safety
• We need to apply these 5 steps to all of the 5
  initiatives or elements that we will focus on
• 1. Set Standards
• 2. Communicate
• 3. Train
• 4. Evaluate
• 5. Acknowledge success make improvements

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Step One Set Standards

• Standards are written statements outlining your
  expectations, policies, procedures and workplace
  rules for early and safe return to work.

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Step 2 Communicate

• You need to communicate to ensure that all
  appropriate people in their workplace have a
  clear understanding of what is expected of them
• What are the employers responsibilities?
• What are the workers responsibilities?
• What is WSIB roles and responsibilities?
• Valuable resources to assist you
• http//www.wsib.on.ca/wsib/wsibsite.nsf/public/Emp
  loyersESRWEmployers

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Step 3 Train

• Training to ensure everyone is aware of the Early
  and Safe Return to Work Programs is imperative
• Dont forget about new hires, are they aware of
  the requirements of ESRTW
• What about re-training?
• Is your training documented?

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Step 4 Evaluate

• How well is my ESRTW program working?
• Observation
• Look for Trends
• Ask Employees
• Ask a third party to evaluate
• Useful tool
• http//www.wsib.on.ca/wsib/wsibsite.nsf/LookupFile
  s/DownloadableFileRTWSelf_AssessmentGuide/File/RT
  WSelfAssessment.pdf

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Step 5 Acknowledge Success and Make Improvements

• Based on your evaluation you will know if your
  program is working, or needs improvement
• Trying rewarding those who are making the program
  work

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What to do when an Injury Happens
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1. Safety Incident Report Form

• Employee reports injury
• Supervisor notified
• Supervisor reports to
• WC Designate
• Important to collect ALL
• details

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2. Functional Abilities Form (FAF)

• Need to obtain ASAP
• Every day lost is costly
• Building block for RTW
• Ensure information is
• complete

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FAF

• Remember at the onset of the injury, an FAF is
• going to go with employee so they can take to
• treating health practitioner (DIAGNOSIS)
• Usually a Family Doctor
• Can be emergency Doctor
• Can be Physiotherapist
• Can be Chiropractor
• Follow up is usually done with Physio
• or other health professional (MONITORING)

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Pitfalls.

• Watch out for..
• Subjective information vs. objective information
• Doctor commenting on job suitability
• Employee can not work on Line 1 Packaging
• Employee can not merchandise at store
• Doctors note Employee disabled until 2008
• Send Physical Demands (PDA) with FAF
• so doctors can understand the nature of the job

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3. Modified Return to Work Offer

• Filled out in conjunction
• with information from FAF
• Be creative
• Regular monitoring is
• crucial

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Physical Demands Analysis - Half of the puzzle

• Must look at the PDA and match employees
• abilities to the
• Make sure you look at all requirements, you
• may not think something is performed or
• performed at a different frequency
• Ensure you always check this

PDA
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Roles and Responsibilities

• Everyone has a key role
• play on the team
• Lets look at the roles
• and responsibilities as
• they pertain to modified
• work

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Immediately following the Injury

• Encouragement for employees to continue their
  usual activities as much as possible is key in
  the acute stage (BED REST CAN BE BAD!)
• Several studies show increased utilization of
  modified work can reduce the incidence by 50 and
  the duration by 40
• So encourage the workers they will not be harming
  themselves

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How to Build an Effective Return to Work Plan

• Match employee capabilities to job demands
• Focus on abilities not disability, develop a
  clear plan
• document
• set goals
• timelines
• progressive
• If modified work is required ensure it is
  transitional in nature- always set timeframes
• Monitor the success of the program and return to
  regular duties
• Ongoing process - requires follow up

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Red Flags-Things to Consider

• Medical information states totally disabled
• Worker believes pain equals serious damage
• Delays in expected Return to Work (RTW) date
• High rates of absenteeism
• Employment changes expected
• Slow recovery outside of normal
• Multiple extensions on dates of RTW
• No progress being made

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Being Creative

• Think outside the box!
• Sit/Stand stools
• Assistance with another person doing heavy
• aspects of job
• Job aids- insoles, braces, etc.
• Can the employee ice/heat/stretch

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Tools to Assist Employers

• Physical Demands Analysis
• Ergonomic Intervention
• Functional Abilities Evaluations
• Independent Medical Evaluations
• All tools necessary for employers to utilize in
  the ESRTW process

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Physical Demands Analysis

• An objective measurement which defines the
  physical, environment, and cognitive demands of a
  specific job. However, it does not consider an
  employees functional limitations in performing
  the job demands.

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Sample Report
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Why to use this assessment

• To objectively document the job requirements
• For treatment intervention so rehabilitation
  professionals understand the job requirements
• This is the key assessment for any return to work
  program, as you need to know the job requirements

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Ergonomic Analysis

• A comprehensive assessment of job requirements
  that may be contributing to injury/illness.
  Designed to minimize the risk associated with
  work activities, as it takes into consideration
  the employee performing the job
• Important to ensure successful RTW program

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Sample Report
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Why to use this assessment

• To determine if there are any environmental or
  design issues that may be aggravating or
  prevention an individual from returning to work
• Important to use when risk factors are identified
  to reduce or eliminate the chance for injury

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Functional Abilities Evaluations

• A measurement of the employees functional
  capabilities. Identifies functional limitations
  or barriers that may impede the employee
  performing work duties
• Critical to match the employees abilities with
  the PDA to determine a job match

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Sample Report
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Why to use this assessment

• To clarify an employees functional abilities
• Used before bringing an employee back to work, or
  in conjunction modified duties
• Used in conjunction with Independent Medicals

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Independent Medical Assessments

• An evaluation to obtain an independent opinion
  regarding an employees medical state. Provides
  a baseline or foundation from which to determine
  outcomes and implement further intervention if
  required
• Can be used in conjunction with an FAE if the
  injuries are physical in nature

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Sample Report
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Why to use this assessment

• To assist if an employee has not returned to
  work. Soft tissues injuries take 12-16 weeks for
  resolution, any longer may require evaluation.
• The longer away from work, the more likely the
  disability becomes permanent