A first-appointment transitional plan can help an injured worker before the claim is approved
By Adam King, BWC Public Information Officer
Constance was working a late shift when she slipped and fell. She jarred her arm and wrist trying to catch herself and twisted her back as she landed awkwardly.
The Ohio Bureau of Workers’ Compensation (BWC) legally can’t start helping Constance until the injury is reported and a decision is made on allowing Constance’s claim.
But if Constance’s employer has a transitional work program in place, the doctor can immediately assess how to get her back to work safely and as quickly as possible. The employer can act without waiting for the claim allowance.
That’s the message David Holdsworth and Kimberly Kremer, technical medical specialists at BWC, conveyed during their seminar to provider staff during BWC’s 2019 Medical & Health Symposium. Employers who are proactive improve their injured workers’ outcomes.
“In almost every instance, that is better for the worker,” Holdsworth said of immediately implementing a transitional work plan. “The longer they’re off work, the less likely they are to return. When they’re back on the job, it creates stability in their family, finances and self-esteem.”
More than 50% of injured employees off work for six months or more never return to their original job. Companies lose their entire investment in onboarding and training. That’s thousands to tens of thousands of dollars or more. It also can mean the loss of a valuable team member and co-worker.
Physicians, Holdsworth and Kremer said, play a crucial role, too. During a first visit, the physician should ask Constance if her employer has a transitional work plan. She might not know. She might not think it applies to her injuries. But having that initial communication can speed up the recovery process.
The physician determines whether Constance can safely return to work and in what capacity. Taking on temporary transitional work duties will allow her to heal as her capacity to work increases.
It turns out Constance’s employer has a transitional work plan in place and has already assessed the physical requirements for every job position. It’s an easy process for her employer to identify which work tasks Constance can perform based on her restrictions. The employer offers Constance the modified job duties and she accepts. She’s able to keep working even as her workers’ comp claim is under review.
Once BWC allows the claim, Constance’s physician has several more options to support her efforts to get her back on the job. These vocational rehabilitation programs include remain at work, job retention and return to work.
Remain at work: Constance has missed work, less than eight days, and is now back at work. But she’s experiencing difficulties and might lose more time. Constance, her physician or her employer can identify her job difficulties and ask the employer’s managed care organization (MCO) to request specialized services so she can keep working. Her physician sets her work limitations and rehab needs, and the MCO authorizes the services. These are usually on-site and can include transitional work therapy, physical evaluation or restoration, job modifications, tools and equipment and job retraining.
“One of the first services in remain at work might be transitional work services,” said Kremer. “A physical or occupational therapist comes to the job site to provide interventions that help the worker adjust to the job’s physical demands.”
Job retention: Constance has been off work for more than eight days (which makes her workers’ comp claim a lost-time claim. This means she is drawing temporary total compensation or salary continuation). She returns to work and is still having difficulty doing her original job. Her physician and employer identify her issues returning to full duty and ask the MCO for a vocational rehab referral. Constance must voluntarily agree to the interventions.
Return to work: Constance has not been able to return to work, and there’s a question whether her injuries will allow her to do her job. A vocational rehabilitation manager works with the MCO and BWC to see if Constance can return to her original job or modify her role within the company. If not, they will work with her to find a new employer where the goal is to restore Constance to a similar level of work and earnings. Constance doesn’t need to be at full health to be a return-to-work participant if she can benefit from the services and is likely to return to work as a result.
“At any stage of injury recovery, BWC’s vocational rehabilitation programs offer avenues for workers to achieve their original quality of life or close to it,” Holdsworth said. “Returning to work is critical to an employee’s well-being, and that’s why it’s important for the employer, physician and MCO to be strong partners in their recovery.”
For more information about these programs, email our Rehab Policy team at Policy.R.firstname.lastname@example.org or call our Customer Contact Center at 800-644-6292 and ask for Rehab Policy.