Transitional Duty Helps Control Workers? Comp Insurance Costs

Often when a business wishes to reduce its workers’ compensation insurance costs, the focus on reducing the number of accidents takes precedence. Encouraging the use of safety equipment and changing procedures to further reduce accidents are important steps to take.

Along with reducing the frequency of claims, it is important to prepare your company to reduce the severity of larger claims. The cost of the severity of claims is seen more directly in organizations participating in a loss sensitive program. But, as stated in the past, the ability to control losses, regardless of a company’s size, will allow greater opportunities for reducing costs of workers’ compensation programs. One useful method to reduce the total cost of larger incidents is to enact a ‘Transitional Duty’ or ‘Return to Work’ program.

                      Regardless of how much employees and management are committed to safety, by the law of averages a company will experience claims involving lost time from work. One of the most effective methods to control lost time is to have a committed return to work program fully supported by management.

                      In order to effectively establish a return to work program, contact your insurance carrier. They can provide you with guidelines applicable to your individual states as workers’ compensation laws vary by state. In fact, they may already have job descriptions you can modify for your type of business.

                      Once you have established return to work guidelines, they must be communicated effectively to employees. Depending on the size of your company, put the information in with each paycheck or require employees to meet with human resources personnel to review the information. Have employees sign a document stating they have been informed of the policy and understand the guidelines; the signed document should be a part of their personnel files. There are several methods to communicate guidelines to your work force; these are just two.  

                      It is important for employers to stay in contact with an injured worker. Call the employee. Make sure they are getting the medical care they need. Ask if their family needs any assistance. These simple steps, coupled with a return to work program, will let your employees know that you care and want them back to work as soon as possible. Employees will be encouraged to return to work and discouraged from taking legal action against the company.

                      It is also important for management to participate fully in the Transitional Duty program. Each department should provide a rudimentary list of responsibilities and tasks. As every injury is unique, the working restrictions will also be unique. To help develop custom transitional work, have an active list of current duties. The company will have to identify what light duty work is available for the claim adjuster to give to the treating doctor or nurse case manager so that they can check off what duties the injured employee can do.

As has been stated before, there is a level of subjectiveness involved in a doctor’s decision to deem an injury a permanent disability verses a temporary disability. Though the existence of a ’return to work/transitional duty’ policy will not ensure a decision to deem an injury temporary, getting an employee back to work can be a major influencing factor. It cannot be stressed enough that management needs to fully support the return to work program.

Another important aspect of this program is that management applies it equitably among employees. Do not play favorites or deny transitional duty because you do not particularly like an employee. It is also crucial to fully cooperate with the adjuster and nurse case manager in providing job descriptions for the treating physician. They are the key to getting the employee back to work.

                      Also, providing light duty to injured employees in effect allows you to pay an employee to do something rather than paying them to sit at home.

                      The transitional work program will also help reduce litigation. Giving an injured employee light duty work will get them back in the habit of working and reduces the frequency of seeing attorney advertisements while they are out of work.

                      Transitional duty work is unstructured. The allotted tasks do not need to have anything to do with the work a person was hired to do. It is often joked that injured employees are encouraged to ‘get better’ after a couple weeks of counting paper clips. An employee can be assigned to clerical work, phone activities, mail delivery, window washing, etc.

                      To assist in developing a custom transitional duty work plan for an injured employee, it is helpful to ask about other job skills and abilities as part of the interview process. Include questions such as, “What other equipment can you operate? Can you type? Are you computer literate?” This questionnaire should be included with the medical questionnaire. One of the additional benefits of gathering this information is the potential of discovering untapped skills from your employee pool that can be of great assistance to your company.

                      Once an employee has been injured, initial medical treatment has been completed, and the managing medical professional has approved of transitional duty, your company should mail a certified letter to the worker stating that he or she must contact the employer by a specified date. The letter should state that the worker’s failure to contact the employer regarding transitional duty could affect future benefits. The injured employee has the right to decline transitional duty for his own reasons, but that decision will relieve you and the insurance carrier of the responsibility to pay salary or wages.

                      A common question asked by companies reviewing the viability of developing a transitional duty/return to work program is, “If I bring back an injured employee, can’t he just injure himself more?” This is a real concern, and one that should be considered closely. When an injured worker returns to transitional duty that is suited for his condition and does not put him at risk to injure himself further, the company will reduce long term workers’ compensation claim costs.

                      Another benefit of having a functional transitional duty program is that you see the injured employee all day long. Typically there is no need for an adjuster to hire a private investigator to counter fraudulent claims of lingering injuries. There is no need to chase down a claimant, looking to catch them moving furniture or mowing lawns, if they are work.

                      Also, in many states you are required to reach a set percentage of the injured employee’s original salary or wages. In Florida, for example, if an injured employee is given transitional duty while recovering and earns 80% of his pre-injury salary, they are no longer eligible for salary compensation from workers’ compensation insurance.

                      With the cost of workers’ compensation insurance rising steadily and the accessibility of loss sensitive programs tightening, every step you can take to reduce workers’ compensation claim costs will greatly benefit your bottom line. But more important than reducing your insurance costs year to year is striving to pay less for your insurance than your competition.

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Sean Lahey

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Pallet Enterprise November 2024