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In a time of rapidly rising production costs and a slumping economy, employers cannot afford to have injured workers off the job for extended periods. As a solution, many businesses are developing and maintaining return-to-work initiatives. These programs not only help employers lower workers' comp costs and reduce lost time, they also eliminate the possibilities for fraud and malingering by providing injured employees the opportunity to continue to do productive work while they are recovering.

Editors: Why are RTW programs so essential in today's workers' comp environment?

Editors: What common mistakes do employers make when implementing an RTW program or attempting to bring an injured employee back to the job?

Roth: Most companies do not have good return-to-work policies. For example, when an employee goes out with a workers' comp injury or illness, the employee is returned to the same job, which might have contributed to the initial injury. However, management is often not aware of what jobs affect what body parts.

In addition, local physicians and healthcare systems are often not familiar with the employee's job requirements. Therefore, it is easier for them to write work restrictions that might not allow the employee to be as productive as he can be.

Ergonomic workplace assessments and job safety assessments are essential parts of any good RTW policy. While the employee is off the job, trained personnel should visit the work site and evaluate which part of the methodology, tools or equipment affected the injured body part. The goal of the RTW policy should identify the injured body part and place the employee in a job that does not compromise that part.

When designing work methodologies, it is also important to distribute the musculoskeletal risks between a variety of muscle groups to eliminate the high-risk factors to one group of soft tissue: e.g., muscles, tendons, ligaments and nerves.

In addition, employers should familiarize local healthcare providers with jobs through video, or by inviting them to the facilities to observe the jobs being performed.

Editors: Why is close, regular communication with the injured employee and her physician essential?

Roth: When an injured employee is off the job for too long, the likelihood of return is diminished. Employers need to include regular communication in their RTW processes. It is imperative that all employees believe their companies care about them. Regular communication fosters good relationships between companies and their employees, making for a greater foundation for RTW.

When the supervisor or human resources person makes that phone call or sends a card or an e-mail message, the employee knows someone cares about his health. A visit to the home strengthens the relationship with the employee and indicates that the company wants him to return to work and cares about him. Assisting with transportation needs is another good way to maintain communication with the injured employee.

Editors: How should RTW be incorporated into a company's workers' comp program? In other words, what departments should be working together and how can all of a company's health, safety, ergo and comp elements join forces to work toward the common goal of bringing the injured employee back to the job?

Roth: Teamwork. First, common goals need to be established so a team can work together and be successful. For the integration of a successful RTW process into the existing workers' comp or human resources function, everyone who is involved must understand the process, agree to the need and set realistic goals for the RTW process incorporation.

It is crucial to work with the safety and health department, HR, supervisors and employee reps to identify jobs that are creating workers' comp claims and look at jobs that can be used in the RTW process. Buy-in and compliance with the RTW plan is also critical.

Now we really get to the "how to." Management must be committed to providing accommodations and assisting in the return to gainful employment. You also need written procedures which reinforce:

-- Roles and responsibilities for all parties to the process

-- Time frames for participation in the program

-- Rate of pay for transitional duty

-- Accountability for implementation

-- Consistent application of the protocols

-- A system to track outcomes

Editors: What are other critical elements for a successful program?

Roth: Critical elements of the program also include job descriptions that are current, compliant with the Americans with Disabilities Act and outline physical demands of tasks. It is also important to form a partnership with the injured worker's medical provider and your third-party administrator.

(This article originally appeared in Workers' Compensation Report, a newsletter put out by LRP Publications Inc., the parent company of Risk & Insurance®)

August 1, 2008

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