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Early Return to Work. Remain at Work Services Transitional Work Vocational Rehabilitation. Question…. Which type of injury is most costly to an employer? A severe traumatic injury to an employee involving multiple fractures; or,

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Early Return to Work

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Early Return to Work

  • Remain at Work Services

  • Transitional Work

  • Vocational Rehabilitation


Which type of injury is most costly to an employer?

  • A severe traumatic injury to an employee involving multiple fractures; or,

  • A mild injury to an employee diagnosed as a low back sprain/strain.

The Importance of Early Return to Work

“…medical care costs correlate not with the severity of diagnosis, as might be predicted, but the length of time workers remain out on disability.”

Disability Management

Akabas, Galvin and Gates

The American Management Association

Indirect Cost Of Lost Time

Is Four Times the Direct Cost






Direct vs.Indirect Costs

  • Medical costs

  • Compensation costs (insured costs)

  • BWC claim reserves

  • Hiring replacements

  • Training replacements

  • Overtime (lost work)

  • Legal expenses

  • Product/tool damage

  • Production delays

  • Loss of business (customer good will)

Cost Impact of Early Return to Work

Reduce payment of lost-time compensation

  • Direct impact on reserves

  • Indirect impact on premiums

  • Helps improve your safety and financial goals

  • Benefits employer and employee

Reduces costs

Reinforces management’s commitment to employee welfare

Improves morale/company loyalty

Maintains quality/production

Enhances ADA compliance

Increases safety and prevents future injuries (i.e. ergonomic improvements)

Benefits Of Early Return to Work Programs

Benefits to the Injured Worker

  • Recovers more quickly

  • Experiences a smoother transition back to regular duty

  • Receives a full, regular paycheck

  • Jobs skills stay current

  • Maintains work relationships

  • Problems related to inactivity decrease

Remain at Work

Services to injured workers with Medical Only Claims to prevent Lost Time

Goal of Remain at Work

Injured Worker has a Medical Only Claim.

Injured Worker is experiencing difficulty at work due to the allowed condition.

The employer, injured worker or physician has identified the difficulty.


Transitional Work

What is Transitional Work?

  • Work-site program for workers with physical restrictions

  • Focus on progressing the worker to a specific job

  • Program is time limited and individualized

Transitional Work Program

  • May include progressive conditioning, on-site work activities, and education for safe work practices.

  • May include job modification or alternative work assignments.

Light duty is opened ended

No therapeutic goals defined

Transitional work has a starting and ending date

Offers work hardening or other therapeutic benefits

Light Duty

Transitional Work

Responsibilities of employer or employee are not outlined

No alternative plan if light duty fails

Responsibilities are clearly defined in writing

Alternative plan will be developed

Transitional Work

Light Duty

Buy-in by top management

Labor/employee involvement

Commitment for openness


Policy that is logical and fair

Philosophy needed

Transitional Work Program Basic Elements

  • Corporate analysis

  • Labor/employee involvement

  • Policy / Procedure

  • Functional job analyses

  • Program evaluation mechanism

BWC’s Transitional Work Employer Grant Programs

  • Transitional WorkGRANT$for employers with 50 or more employees

  • Transitional WorkGRANT$ EZ for employers with 1-49 employees

Information on BWC’s Transitional Work Grant Programs

  • www.ohiobwc.com >Ohio employers >Transitional WorkGRANT$

Vocational Rehabilitation

Vocational Rehab Eligibility

  • Lost time claim

  • Continued physical restrictions

  • IW is not working and on compensation on date of referral such as TT, NWWL, PTD, Salary continuation in lieu of TT

Vocational Rehab Eligibility-cont’d

  • IW at MMI or received a PPI award and not on comp (lost time claim, continued physical restrictions)

  • Job Retention-IW is working but has a previous lost time claim, continued problems related to allowed condition(s) of claim documented by POR and employer

The Return to Work Hierarchy (OAC 4123-18-05)

Injured workers return to work as follows:

  • Same job, same employer

  • Different job, same employer

  • Same job, different employer

  • Different job, different employer

  • Skill enhancement, short-term training may help at any step in return to work.

What strategies do we use at each step of the hierarchy?

  • If returning to same job, same employer?

  • If returning to a different job, same employer?

  • If returning to same job, different employer?

  • If returning to a different job, different employer?

Questions about early return to work and remain at work programs?

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