Lessons learned from ADA case lead to disability management program

Since case management involves injured workers, it makes sense to include the employee in the process, right? That's part of the strategy behind a disability management program that's seeing the majority of injured workers return to employment.

By Nancy Grover

In effect at a California public agency for more than a decade, the program has returned about 95 percent of injured employees to the company each year -- including those with nonoccupational as well as occupational injuries. The head of the program says by taking a big-picture view, they can better control and manage employee absences and impact the bottom line.

Agency uses employee assistance program to improve return to work process (02/27/12)

Claims management track focuses on high-exposure claims, return to work (07/16/12)
Restrictions for low back pain patients often ignore medical science, expert says (11/21/11)
Answer to problems of an aging workforce: Maximize productivity, minimize risk (09/30/11)
Apportionment profoundly impacting comp system, says medical expert (09/30/11)

"When we all have a common goal and work together, positive outcomes are achieved," said Marcy B. Feuerstein, officer of employee benefits for the Imperial Irrigation District. "All participants working together as a team contribute to retaining valuable employees and to reducing the financial impact to the employee, the district, and the district's customers."

The program. IID employs some 1,400 workers who provide irrigation water and energy to most of the 150,000 residents in the Imperial Valley and also provide energy to a portion of Coachella Valley residents in California. The disability management program began in the early 1990s in response to a situation that Feuerstein says was not handled as well as it could have been.

"The very first ADA claim we had we learned a lot from because we were taken to court," she said. "We learned how to tighten our documentation and how to train our supervisors because, basically, one of the key reasons we did not do well in court was how the supervisor interacted with the employee."

Now, supervisors are trained and involved in the entire process. In any given year, there are about 100 workers included in the disability management program -- those injured off the job as well as those in the workers' comp system.

"We want to take control of all injuries and illnesses," Feuerstein said. "There is a financial impact to it. Temporary replacements are not familiar with the job. Replacements may become an additional loss to the company if the person is not properly trained."

The program consists of several phases, including:

Stay-at-work and/or return-to-work. Workers who can return to the workforce but not in their regular positions are given temporary transitional assignments. "Our temporary transitional assignments last for a total period of up to six months," Feuerstein said. "That gives them time to go through physical therapy, if they need to have surgery they get that done, and then we see where we stand."
Alternate job search. Once an employee reaches maximum medical improvement and cannot medically return to his usual job function, the company explores other possible open assignments.
Stay-at-work or return-to-work monitoring phase. For up to 60 days, a monitoring period is conducted to determine the appropriateness of a job reassignment, if one has been made.
Concluding the employment relationship. When no readily achievable accommodation is available, the person may be terminated from employment. A thorough review of the situation is undertaken by the disability management team in conjunction with in-house and outside counsel, human resources manager, workers' comp administrator, and an advisor on the Americans with Disabilities Act.
Final status meeting. A final meeting is held to confirm the success of the job accommodation process or to review the worker's final status and available benefits as employment with the district concludes.

A key component of the program is the regularly held interactive meetings with the injured worker, where his medical status is updated. Also included in the meetings are the employee's immediate supervisor, a company disability specialist, a recruitment and selection services representative, and Feuerstein. Others who may be included are the worker's spouse, bargaining unit representative, or the employee's legal counsel with advance written notice.

"We look at this as a whole program," Feuerstein said. "We want all parties sitting at the same table so we all have the same information."

Results. In any given year, there are about five injured employees who are released from employment despite the program. Feuerstein says they are employees who are unable to return "either by the severity of the injury -- usually they are totally permanently disabled -- or they have no transferable skills."

When the program was first developed, many injured workers had been off the job for several years. Now the longest an employee is out is generally two years.

"When we get to the point [the injured worker] is going to be released from employment, we've had some miraculous recoveries," Feuerstein said. "They become exemplary employees."

Developing the disability management process was not an overnight accomplishment. Feuerstein says it has taken several years of gaining the support of all involved to have a successful program.

"It's a process and like all processes there is a beginning and an ending," she said. "You are either successfully returned to work, successfully accommodated to another position, or released from employment."

Read more at the WorkersComp Forum homepage.

February 27, 2012

Newsletter Sign-up