Injury and accident prevention is the best way to control workers’ compensation costs. However, when a claim does occur employers should have an established system to minimize their losses. This system should have a bias towards actions that will help control the medical costs and the administrative factors of a workers’ compensation claim. The way your company manages these has a direct impact on your end goal: returning the employee to work.

Sometimes, it is a challenge for the employer to realize both the monetary and intangible benefits provided by a strong Early Return to Work (ERTW) program. In the past, injured workers remained out of work until they were 100 percent recovered. This attitude will ultimately result in higher claims costs and future workers’ compensation premiums for the employer. Also, there is no incentive for the employee to return to “light duty”.

Medical Costs
Experience proves that medical costs associated with workers’ compensation claims are greatly reduced, and injured workers recover at a faster rate when they return to work.

Compensation Benefits
Return-to-work programs can reduce compensation benefits and associated costs by up to 70 percent, according to the National Council on Compensation Insurance, a national rating and data collection bureau that analyzes many factors, including medical costs. By providing a transitional work assignment to an injured worker, the employer can offset the workers’ compensation benefits that are paid.

Long-Term or Permanent
The risk of long-term disability due to a loss of conditioning and deterioration of muscle mass begins after only two weeks of inactivity. Statistics show that only 50 percent of injured workers actually return to their pre-injury jobs if they are off for more than six months. If the same injured workers are off for a year or more, only a 10 percent chance remains that they will ever return to work. An early return-to-work can also reduce or eliminate the risk of any long-term psychosocial and psychological factors.

Increased Productivity
No one knows your business like your own employees, so even with an injury they are better able to contribute to your company’s success than a temporary worker.

Reduced Employee Replacement Costs
Having an injured employee participate in transitional work assignments is more cost effective than hiring a new or temporary employee. Valuable time and other resources do not have to be shifted for interviewing, hiring or training.

Improved Employee Morale
Implementing a return-to-work program helps to alleviate stresses of job security and income, both of which can have an impact on the injured worker’s recovery time. A well-defined and written program lets employees know your company values them and is concerned about their well-being.

Transitional Assignment Can Reduce Compensation Losses
When an injured employee suffers a wage loss as a result of a temporary work restriction, Synergy may provide temporary partial disability payments. These payments are structured to not exceed the allowable limits set forth by your State.

An ERTW program should:
Promote prompt return to regular duty work
Promote more rapid medical recovery
Promote employee involvement/ engagement in ongoing business activities
Reduce employees’ stress and uncertainty regarding their futures with their companies
Reduce the chances of an injured employee becoming caught in a cycle of disability (adopting disabled lifestyle)
Reduce the likelihood of an injured worker seeking legal representation
Help maintain an injured worker’s family’s security
Improve employees’ morale
Promote better communication between employer and employee
Reduce costs associated with employee turnover (hiring and retraining)
Decrease risks associated with loss of institutional knowledge
Reduce incentives to file fraudulent claims
Be a key element in developing a comprehensive approach to proactive claims management

The major reason to institute a return-to-work program – it works!
More than 90 percent of companies that have ERTW programs report success. It is highly likely to achieve an average result, shown below:
35 percent reduction in workers’ compensation claims
17 percent reduction in lost workdays


How Early Return To Work Can Save Money

The example below illustrates how an ERTW can save money for your organization.

Tony is a welder who injured his arm in a work-related incident. According to the treating physician, he will be unable to perform his regular job duties for 8 weeks. The physician has indicated that Tony can return to “light duty” during this time period.

Costs associated with NOT bring returning employee to “light duty”:

Average Monthly Wage: $2,400
Monthly compensation paid by Worker’s Compensation Carrier (66 and 2/3%): $1,600

If Tony returns to a medically-approved transitional work position with his employer paying his normal hourly rate for even 20 hours per week:

Before implementing an ERTW program, you may need to ensure you have other company policies and procedures in place. This includes an accident reporting policy and provisions for choosing a company physician(s).
Once you have these policies in place, inform all employees of your policies and their responsibilities to follow them. Be sure to inform your designated occupational health clinic of your return-to-work program, as well as other requirements such as your PADT policy. Finally, inform your Synergy Claims Adjuster that you have these types of policies in place. Follow the steps below to implement your program:

Step 1:
Write a policy statement and identify a return-to-work coordinator. The policy statement should outline: Your company’s commitment to the return-to-work process A description of your company’s return-to-work principles The importance of safety in the workplace, the need to seek immediate medical care and the importance of returning injured workers to work.

Step 2:
North Carolina law permits an employer to send an injured worker for an initial evaluation of the injury and work status to a designated physician of the employer’s choice. Please contact your Synergy Claims Adjuster for assistance in choosing a designated medical provider or network of providers. Designating medical providers can drastically reduce your claims costs.

Step 3:
An employer’s ERTW policy and procedures should clearly define the responsibilities of: the injured worker, supervisors, the company’s return-to-work coordinator and the company’s Synergy Claims Adjuster contact.

Step 4:
The company should post a written summary of the policy and procedures to ensure all those affected are reminded of what part they play in the process.

Here is an example of a return-to-work process and how it works after your program is established.

1.	An accident occurs.
2.	The employee involved promptly reports the accident and injury to the immediate supervisor.
3.	If the injury is life-threatening or critical, initiate emergency medical treatment (call 911 or provide CPR as appropriate.) Contact the company’s medical provider or other occupational health clinic for guidance (work status, drug/alcohol testing, etc.) Be sure the injured employee follows up once he/she is stable.
4.	If the injury is not life-threatening, send the injured employee to the company’s designated medical provider or occupational health clinic for evaluation and/or treatment. At this time, conduct post-accident test.
5.	Conduct a thorough accident investigation to determine the causes of the accident. Complete a Supervisor’s Report of Injury, an Employer’s Report of Injury and an OSHA 300 Log form. Send a copy of the Employer’s Report of Injury to your Synergy Claims Adjuster.
6.	Communicate your organization’s ERTW policy and obtain the evaluating/treating physician’s opinion regarding the injured employee’s capability to return to work.
7.	Review the work status with your injured employee. Maintain regular communication with the injured employee.
8.	Inform your Synergy Claims Adjuster of the work status.
9.	If the worker is released to return to regular work, return the employee to his or her pre-accident position and tasks.
10.	If the individual is released to return to work with restrictions, determine if the injured employee is able to return to his/ her pre-injury position and tasks without accommodations.
11.	If accommodations to the pre-injury position are necessary, determine how the work schedule or duties can be adjusted.
12.	Determine what transitional work tasks are appropriate. If transitional work is not available in the same department, look at other departments, consider different shifts, or even paying the injured worker to work at a local volunteer organization (e.g., Goodwill, Salvation Army, etc.).
13.	Determine the work schedule, the rate of pay, to whom the injured employee will report, and a time period for the transitional work assignment. Communicate these expectations to your injured employee in writing and have the worker sign a statement agreeing to your expectations. Send a copy of this signed agreement to your Synergy Claims Adjuster (link to Claims Directory).
14.	If the injured employee refuses a transitional work assignment, inform your Synergy Claims Adjuster of the worker’s potential estimated earnings, had he or she accepted the position.
15.	Review the injured employee’s work status after each evaluation by the treating physician and determine an appropriate level of transitional work tasks. Communicate all details of a lost-time claim with your Adjuster.

Whenever possible, perform job assessments and develop transitional work assignments before an actual injury occurs. Completing a job analysis requires studying the mechanics of getting the particular job done. This includes measuring weights, distances walked, time spent sitting, standing, etc. The amount of detail required depends on how complex the work duties are and the type of information the medical provider needs to make an informed decision.

Here are some suggestions:

1.	Identify and summarize all job functions, including percentage of time spent at each task and educational or training requirements.
2.	Measure the physical demands.
3.	Measure environmental conditions.
4.	List work schedule, including hours and breaks

The employer can assist the attending medical provider by providing a copy of the task analysis of the pre-injury job and a job description of the modified work assignment. Send both descriptions to the attending medical provider along with the physician’s return-to-work recommendations form. Upon receipt of the recommendation, determine what the transitional job offer will encompass. Have the injured worker sign the transitional work agreement form either in person or send it via certified mail. You can then determine the transitional work available and finalize a return-to-work notice. Be sure the injured worker has completed a transitional work agreement form and that you retain the medical release form on file.

The purpose of the task inventory is to define all the tasks that are performed in a specific job. Listing each task helps the employer describe the steps required to complete a job. This form, when combined with a physical demands checklist, helps employers compose thorough job descriptions. The descriptions will help recruit employees and be a tool you can send to the physician when asking for his/her response in bringing an injured worker back to work. Having job descriptions available for the physician’s review is an essential tool.

To assist you with this process, Synergy has developed a Early Return to Work Program template, which can be downloaded and tailored to your organizational needs (template link – link to document entitled “Early Return to Work Program” in the RTW folder).

Once the medical provider approves the transitional work duties, provide a written notification to the injured worker of the transitional work assignment. Since the material is time-sensitive, the letter should be sent as certified mail, return-receipt requested. For your convenience, Synergy has developed a template letter (template link – link to document entitled “Early Return to Work Program” in the RTW folder), which can be used by your organization for this purpose.

State that the transitional work assignment will last until the treating physician releases the injured employee to a full work status. Send a copy of the letter and the return-receipt to your Synergy Claims Adjuster (link to Claims Directory).

Prior to notifying the employee of a transitional work assignment, discuss the claim with the your Synergy Claims Adjuster so he/she can coordinate the change in benefits, if any.

Return the “Notice of Modified Duty Available” letter to your claims adjuster if the injured worker has returned to work, refused the assignment or did not respond.

If an employee refuses to accept the offer for a transitional work assignment, Synergy may make an adjustment in compensation benefits based on what the injured employee would have earned during the period of the transitional work assignment or position. Synergy must have a copy of the written “Notice of Modified Duty Available” letter in the file in order to process this adjustment.

Employers may be flexible in the rate of pay and or work schedule that is offered during the transitional work period. However, you will experience greater, long-term savings if employees on restricted duty are paid their original wages. You may also contact your Synergy Claims Adjuster (link to Claims Directory) at any time regarding employee wages through the life of a claim.

The bulleted list below can be used as a checklist to ensure that your organization has all necessary items in place for strong, effective Early Return to Work Program.

	Our company has developed and implemented a written workplace safety and health policy.
	A return-to-work coordinator for the company has been assigned and is aware of his/her responsibilities.
	Management has endorsed a written Early Return to Work Program for the company.
	Synergy’s Claims Adjuster (link to Claims Directory) has been notified of our company’s transitional work program and has been informed who our return-to-work coordinator is.
	All levels of management within the company are aware of the Early Return to Work Program and are actively committed to it. Management training has been conducted.
	The written Early Return to Work Program emphasizes the need for injured workers to promptly report all work-related accidents and seek immediate medical evaluation and appropriate care. Workers also understand that the organization will make every effort to provide an opportunity for transitional work assignments.
	The goals of the Program are clearly communicated and defined to the entire company, employees and management.
	A mechanism is in place (such as a line item in the employee performance measurement) that provides accountability to all levels of management for effective results of the program.
	Possible transitional work assignments are identified and a list of these assignments has been created.
	A designated medical provider or other occupational/industrial health clinic has been designated in writing for evaluation of all employees’ work-related injuries and/or illnesses. All employees are aware of who this provider is as well as its location. Posters with this information are posted throughout the workplace.
	The company’s designated medical provider or other occupational/industrial health clinic has been notified of our company transitional work program and of positions that are available and/or the company’s willingness to accommodate work restrictions.