How effective is your tribal return-to-work program?

Evaluate and improve your injured worker’s return to the job


improve your injured worker's return to the job


Workers’ compensation insurance and loss experts agree: return-to-work (RTW) programs help employees get back on the job after an occupational injury or illness are a cost-saving and effective workforce management strategy. The key is creating and managing a truly effective tribal return-to-work program. Merely having a policy or occasionally being open to making a temporary duty offer is not enough.

However, as one IRMI commentary explained, risk managers must understand that not every temporary alternate work offer will save the employer money. A worker may reject her employer’s offer upon her doctor’s advice. Or a returning employee on light duty may be reinjured, resulting in his filing a second claim that could be even more expensive.

It’s important to evaluate your tribal return-to-work program on a cost-analysis basis, comparing year-over-year results of total claims, average claim duration, average claim cost and more, to see how your results are trending.

But many workers’ compensation advisors believe there are other metrics to consider as well. Before we dive into those benchmarks, we’re first going to lay the groundwork of best practices for a tribal return-to-work program.


Why your tribe needs a return-to-work program

Well-documented in their ability to reduce both the costs and the duration of workers’ compensation claims, RTW programs minimize the economic and human impact of disability. According to the New York Workers’ Compensation Board, an effective RTW program can save a company 35 percent in medical costs and 30 percent in lost time days.

Any delay is costly in the workers’ compensation system: The experience modification factor calculation is weighted so that the first $5,000 of every case counts the most. Any bottleneck can lead to a lost time claim which will exceed this $5,000 value. If you can operate your return-to-work program at a level where you routinely avoid lost time claims by providing modified work, you will see reduced workers’ compensation costs. The Dept. of Labor offers a return-to-work toolkit for employers that can help.

Consider the alternative of no RTW program: Your injured worker on medical leave is receiving close to their full salary with workers’ compensation benefits, yet contributing nothing to the company’s bottom line. You, on the other hand, will need to pay a replacement employee to do their job while they’re off duty. Essentially, you’re paying twice the salary for the one job. This likely will also result in increased premiums in the future, continuing for the three years of the experience period.

As a cost-saving measure, a RTW program can reduce your claim reserves – the amount of dollars set aside for future claims. Second, it can improve your experience modification rating, which impacts not only your rates but possibly your winning or losing a bid for future business.

A successful RTW program works hand-in-hand with your safety management system. Once an injury occurs, your tribal RTW is the next best way to reduce the human and financial impact of injury. It also assists in reducing the potential for secondary conditions – both physical and psychological – from developing, ranging from depression, anxiety, loss of motivation or confidence to substance abuse, weight gain and loss of muscle tone.

In a nutshell, a well-oiled RTW machine works to ensure employees recover faster both physically and psychologically and return to their full-duty jobs sooner, leading to improved morale, better performance and lower premiums for tribal employers.


Five factors of a tribal return-to-work program that contribute to its success

1. Your RTW program is part of a larger loss management program, not a free-standing plan. It’s step three in the process, after 1) accident reporting/ investigation and 2) medical treatment. This synergy is critical, because the medical providers you select must understand your business and work with you to determine the optimum temporary alternative work for the recovering employee. Your tribal company should have on file written job descriptions that detail physical requirements to provide the doctor, to help in the assessment.

Otherwise, doctors are on such tight schedules that, without knowing the physical requirements of both the injured worker’s permanent job and temporary role, the doctor may simply take the safe route of vetoing work of any kind.

2. Active communication with the doctor. Receiving up-to-date medical reports can help you place the injured employee more quickly into a temporary role. It’s best to have the employee either drop off the report personally after their visit or ask the doctor to provide you with updated reports. This allows you to make the offer of alternative work more quickly, in time to prevent a medical-only claim from becoming a lost-time claim.

3. Ongoing review of the modified work role. Ideally, the temporary job should last 30-90 days. Your plan should include a weekly review of the injured employee’s performance in their alternative role. That way, if the worker is struggling physically in the easier role, or has a bad attitude, adversely affecting those around him, you can catch it early and consider withdrawing the offer. It’s your call as to whether it’s more costly to keep the employee in the modified role or to place him back on benefits.

Of course, how the Oklahoma Supreme Court’s April ruling will affect workers’ compensation rates and return-to-work programs remains to be seen. In Maxwell vs. Sprint PCS the court ruled that it is unconstitutional to treat employees who’ve returned to work after an injury differently than those unable to return to work, meaning workers’ compensation benefits cannot be suspended for returning employees. They will receive both their regular pay and the benefits, according to the ruling.

4. Supervisor buy-in. Playing a key part in the success of your program, supervisors can help you not only establish job descriptions but also modified duty assignments. They monitor the employee’s healing progress and performance in the modified role. They also ensure that the injured worker doesn’t exceed work restrictions, possibly aggravating the injury.

5. Careful documentation of your RTW program will help in future litigation. First, you’re minimizing the risk of litigation from the present claim, because you can show the employee refused a reasonable offer to return to work – therefore he or she should not receive continuing benefits. “Without a job offer, the odds of having a judge remove an employee from workers’ compensation benefits are close to nil,” said the previously mentioned IRMI article. Additionally, when litigation does occur at some point, you have a track record to show your ongoing procedure of making good faith job offers, thereby greatly strengthening your case.

No doubt your tribal business will experience situations where a job offer does not result in net savings to the employer; however, that doesn’t mean your return-to-work program is not beneficial in general. Overall, they’ve been proven to save employers money and help them maintain a stable workforce. The long-term alternative? According to the Bureau of Labor Statistics, after six months, there’s only a 50 percent chance that your injured employee will return to work. After one year, the chances of a successful return to work drop to 25 percent.

Need help creating a tribal return-to-work program, or assessing your current program? Call our risk management team headed by Brett Barnsley, 509.591.5109.




Measuring the Value of Return-to-Work Programs in an Economic Recession, ” The Self-Insurer
Six Benchmarks for Evaluating Return-to-Work Programs
Return-to-Work Program Assessment
New York State Workers’ Compensation Board Return to Work Program
Workers Compensation Return-to-Work Programs: Cost Savers?