TRANSITIONAL DUTY EMPLOYMENT

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TRANSITIONAL DUTY EMPLOYMENT

• A RETURN-TO-WORK CONCEPT FOR
• WORKERS COMPENSATION COST
• CONTAINMENT

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Transitional Duty Employment

• A process that facilitates returning injured
• employees back into the workforce in a safe
• and timely manner after a work-related injury.

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Transitional Duty Employment

• Injured employees are returned to work
• to perform meaningful, productive work and
• within safe parameters of his or her physical
  capabilities.

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Goal of Transitional Duty Employment

• Offer temporary transitional employment options
  that fit the injured employees specific
• capabilities.

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Objectives of Transitional Duty Employment

• Manage workplace injuries.
• Temporarily modify the employees job description
  to accommodate physical restrictions identified
  by the treating physician.
• Reduce workers compensation costs.
• Make workers compensation more effective.

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State of Louisiana

• Approximately 89,000 employees.
• 4400 active workers compensation claims.
• 960 of these paid compensation benefits on
  regular basis.
• 55 mil spent on workers compensation.
• Money comes directly from agency budgets.

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State of LouisianaPrior to 1999

• Injured workers cannot return to work unless they
  can perform full duty.
• Civil Service wont allow injured workers to
  return to work unless they are at 100 full duty.

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State of Louisiana

• ORM had to get legislative authority just to
  write
• a policy on return to work.

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State of Louisiana

• To make the legislative argument, ORM first
  worked a pilot program
• of Transitional Duty Employment at Pinecrest
  Developmental Center.
• A vocational rehabilitation counselor helped
  Pinecrest develop a
• transitional duty employment policy.
• The pilot was worked for one year.

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State of Louisiana

• Pinecrest was selected for the pilot program
  because
• They had the highest volume of workers
• compensation lost time claims.
• They had the highest workers compensation
  premiums.

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State of Louisiana

• Before the pilot program
• Pinecrest employees accepted the fact that they
  would
• not be allowed to return to work on any type of
  modified
• duty once released by the treating physician.

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State of Louisiana

• After the pilot was worked, Pinecrest employees
  were
• allowed to return to work, limited duty.

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State of Louisiana

• In the first six (6) months of the transitional
• duty pilot, Pinecrest saw a 15 reduction of its
• monthly indemnity pay-out.

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State of Louisiana

• At the end of one year of the transitional duty
  pilot,
• Pinecrest saw a 36 reduction of its indemnity
• pay-out.

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Statutory Authority for TDE

• R. S. 231547
• In 1999, the legislature passed Senate bill 689
  which gives
• ORM the authority to develop and administer a
  transitional
• duty program for State employees.

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Case Study

• INJURED WORKER

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Case Study

• Injured Worker got hurt on the job.
• She received conservative treatment with Dr. Mild
  for 2 months.
• Now Dr. Mild feels like Injured Worker can do
  something.
• Dr. Mild releases Injured Worker to return to
  work except she cant lift over 25 pounds.

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Case Study

• Injured Worker is so happy she can go back to
• work.

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Case Study

• Injured Workers supervisor does not allow her to
  return to work because she is not released to
  return to work full duty.

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Case Study

• Injured Worker just doesnt know what to do

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Case Study

• Injured Worker gives the bad news to her
  adjuster Keep sending me my checks!
• Develops renewed interest in
• Dr. Phil
• The Biggest Loser
• Casino Gaming

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Case Study

• Because Injured Worker is not allowed to work,
  restricted duty --
• Compensation benefits continue to be paid.

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Case Study

• Injured Workers doctor doesnt see what the big
  deal is.
• As her doctor, he knows Injured Worker can work.

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Case Study

• Injured Worker doesnt see what the big deal is
  either,
• she knows she can work.
• She can do everything her job requires her to do
  except the lifting.

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Case Study

• Sadly enough, Injured Workers supervisor doesnt
  
• see what the big deal is, either.
• After all, Injured Worker is being paid workers
• comp benefits anyway, right?
• Whats the big deal?!

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Case Study

• The big deal is
• Workers compensation benefits continue until the
  injured worker returns to work, or
• The injured worker is released to return to work
  regular duties by a treating physician.

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• THE ECONOMICS
• OF
• RETURN TO WORK

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The Economics of Return to Work

• A claim for a health care worker who hurts her
  back lifting a
• patient will cost the employer 5,150 with a
  return to work
• program.
• Without a return to work program the same claim
  will cost
• 29,250.
• This is a 72 difference.

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The Economics of Return to Work

• If Injured Worker is unable to return to her
  previous work earning the same wages or
• If she is unable to earn 90 or greater of her
  pre-injury wage...
• R. S. 231226 requires Injured Workers employer
  to provide rehabilitative services
• Job placement
  Retraining

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The Economics of Return to Work

• Rehabilitation of injured workers automatically
  adds 5,000 - 7,500 to value of a claim.
• Benefits continue to be paid during the
  rehabilitation process.

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The Economics of Return to Work

• At the end of the rehabilitation process, if the
• injured worker is unable to earn wages equal
• to 90 or greater of pre-injury wage, she is
• entitled to supplemental earnings benefits or
• SEB.

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The Economics of Return to Work

• SEB is based on 66 2/3 of the difference
• between
• the pre-injury wage and
• what the employee is now capable of earning.

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The Economics of Return to Work

• While this reduces benefits, benefits are still
  being
• paid.

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The Economics of Return to Work

• As long as an injured worker is off work,
  indemnity and
• medical benefits continue to be paid.
• These affect premiums.

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The Economics of Return to Work

• If the claim is settled, another 30,000
  50,000
• is added to value of the claim.

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The Economics of Return to Work

• If a claim is settled, in most cases,
  consideration
• must now to be given to a Medicare Set Aside
• which will significantly increase the settlement
• amount.

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Transitional Duty Employment

• The only way to stop indemnity payments
  altogether

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Transitional Duty Employment

• Return injured workers to work with the employer
• of injury on transitional duty.

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• BENEFITS OF RETURN TO WORK

• To the Employer

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Benefits of Return to Work

• Keep workers compensation costs down.
• Productivity increases and human resources are
  used to the maximum extent.
• Manage impact of workers compensation claims on
  premiums.
• Reduce the fiscal impact of workplace absences.

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Benefits of Return to Work

• Wage costs for substitute employees are saved.
• Work delays and business interruption are
  eliminated when an experienced employee
  returns to work.
• Creates goodwill and positive image with the
  public and employees.

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Benefits of Return to Work

• When an injured worker is sitting home watching
  Dr. Phil

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Benefits of Return to Work

• A commercial comes on that says Have you been
  hurt on the job? Call me, Im a lawyer, I can
  help. I can get you top for your claim.

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Benefits of Return to Work

• This is how he does it and employers help the
  injured workers attorney by not returning
  injured workers back to work light duty.

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Benefits of Return to Work

• Transitional Duty
• Light Duty
• Restricted Duty
• Modified Duty
• Temporary Assignment of Duties.

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Benefits of Return to Work

• Whatever you call it, just get em back to work!

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Benefits of Return to Work

• Transitional Duty Employment is an absolute must
• for keeping workers compensation costs down.

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Think About It

• Would you like for your employee to sit here?

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Think About It

• Or here?

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Benefits of Return to Work

• When an employee is sitting home collecting a
  comp check -

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Benefits of Return to Work

• The work piles up!!!
• Somebodys gotta do it or it doesnt get done.

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Benefits of Return to Work

• To the Employee.

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Benefits of Return to Work

• Return to work is an employee benefit.
• Employees will see workplace involvement in their
  recovery as an indication that the employer
  cares about their well-being and wants them back
  at work.
• Transitional Duty speeds up recovery time and
  helps to boost the injured employees self-esteem.

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Benefits of Return to Work

• Injured workers receive their regular pay instead
  of 2/3 of their average weekly wage.
• Return to work programs help reduce depression
  and alleviate emotional stress.
• Employees are able to maintain physical
  conditioning through work life discipline.
• Most employees want to be a part of the
  productivity process of the employer they work
  for.

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Successful Transitional Duty
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Successful Transitional Duty

• Focus on what the injured worker CAN do.

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Successful Transitional Duty

• Do not focus on what the injured worker cannot
  do.

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Successful Transitional Duty

• Transitional Duty Employment doesnt have to be
  nicest, coolest, best job you have to offer.

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Successful Transitional Duty

• Create a return to work policy.
• Announce the policy.
• Sell the policy as an employee benefit.
• Include return to work policy in personnel
  manuals and new employee orientations.
• Make policy accessible to employees through
  newsletters, etc.

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Successful Transitional Duty

• Designate one person to manage the program.
• Injured employees need to know that someone is in
  charge of return to work at the employer.
• Give the return to work coordinator the
  appropriate authority to administer job duties.

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Successful Transitional Duty

• Adopt an Empathy Program.
• Frequent contact with the injured worker helps to
  facilitate early return to work.
• Contact them within 24 hours of the injury and
  once a week.
• Assure your employees they are missed and explain
  their benefits so they will know they will be
  taken care of.
• These courtesies promote rapid return to work and
  counter
• negative feelings.

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Successful Transitional Duty

• Establish a guaranteed transitional duty period.
• Guarantee transitional duty for a set period of
  time based on the injury.
• Alter the length of time for transitional duty
  employment to conform to average diagnostic
  recovery time.

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Successful Transitional Duty

• Establish a guaranteed transitional duty period.
• The job should be open and available when the
  injured employee returns to work.
• Make sure ADA and FMLA guidelines are met if the
  injured employee is unable to return to work.

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Successful Transitional Duty

• Stipulate the goals of the transitional duty.
• Transitional duty should have therapeutic goals
  that have been agreed upon by the treating
  physician, the employer and the injured worker.
• Treating physician can help define the employees
  abilities to make sure transitional duty tasks
  are meaningful and promote recovery.

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Successful Transitional Duty

• Stipulate the goals of the transitional duty.
• Both the employer and the employee must adhere to
  physical restrictions identified by the treating
  physician.
• The return to work program is an employee
  benefit. It is a privilege. Employees are
  expected to be productive.

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Successful Transitional Duty

• Evaluate and Improve the program.
• Once the employee returns to work full duty, have
  an open discussion with the employee, supervisor,
  and physician.
• Find out how well the program worked.
• Solicit feedback on ways to improve the program.
• Ensure executive management has a buy in to
  return to work.

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Transitional Duty Works

• Effective in both public and private sector.
• Nationally, there is an 18 decrease in
  disability costs.
• 23 effective for ORM.
• Keep productivity and employee moral up.

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Transitional Duty Works

• Transitional Duty Employment is economical.
• Injured workers are returned to a productive
  lifestyle.
• Return-to-work makes good business sense.
• ITS A WIN WIN SITUATION.

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How the Transitional Duty Process Works
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How the Transitional Duty Process Works

• A copy of the injured workers job description is
  
• presented to the treating physician.

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How the Transitional Duty Process Works

• If the treating physician releases the injured
  worker to return to work at the job of injury,
  lost time benefits are stopped.

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How the Transitional Duty Process Works

• If the treating physician places restrictions on
• the injured worker based on the job description
• provided,
• The employer is contacted to determine if
  accommodations can be made to the injured
  workers current position.

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How the Transitional Duty Process Works

• If accommodations can be made to the injured
• workers current position
• The employer notifies the injured worker of the
  transitional duty position in writing.
• Utilize return receipt mail notification.
• Specify a return to work date.

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How the Transitional Duty Process Works

• The OFFER of employment is the most important
• part of the transitional duty process
• If the injured worker refuses the transitional
  duty employment offered by the employer
• Or if the injured worker does not return to work
  on the specified date,
• Lost time benefits stop.

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How the Transitional Duty Process Works

• Once the injured worker returns to work,
  transitional
• duty, lost time benefits can be stopped.
• If the injured workers current job description
  cannot
• be modified, lost time benefits continue.

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How the Transitional Duty Process Works

• If the treating physician will not release the
• injured worker to return to work, restricted duty
  
• to the job of injury but
• The injured worker can return to work, other
• employment,
• Vocational rehabilitation services will conduct a
  labor market survey to identify other employment.

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The Object of Vocational Rehabilitation

• If the injured worker cannot return to the job of
  
• injury at full duty or transitional duty
  employment,
• the objective of Vocational Rehabilitation is to
• Assist the injured worker in returning to work in
  a related occupation with another employer in the
  same field or to another field of employment.
• Or if necessary, onthejob training.

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The Object of Vocational Rehabilitation

• Vocational Rehabilitation should return the
  injured
• worker to work
• As soon as medically feasible after the injury
  occurs and
• With a minimum of retraining.
• Transitional Duty Employment is how this is done.

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Link to ORMs Transitional Duty Policy

• http//www.doa.louisiana.gov/orm/pdf/tranduty.pdf

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Contact Information

• Karen C. Jackson
• State Risk Claims Manager
• P. O. Box 91106
• Baton Rouge, LA 70821-9106
• 225-219-0168 (p)
• 225-219-0516 (f)

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Contact Information

• Debi Patt
• Cindy Macaluso
• Amanda Major
• State Risk Claims Supervisors
• P. O. Box 91106
• Baton Rouge, LA 70821-9106
• 225-219-0168 (p)
• 225-219-0516 (f)

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References

• www.sorm.state.tx.us
• www.returnetoworkmt.com
• Treating the Whole Elephant A Holistic Approach
  to Reducing Workers Compensation Costs by
  Rebecca Shafer

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