Uncovering commonly overlooked RTW options by inspecting the way we view inspections

Sometimes it may seem as if there is a bureau or a department to regulate just about every business these days.  In all fairness, these regulations are for good reason and we're thankful that there's someone there to do it.  With regulation come rules.  With rules come inspections.  The good news is that these inspections can be a fantastic source for productive and meaningful return to work (modified duty) opportunities.

Restaurant Inspections

Hopefully your restaurant is not worthy of Chef Ramsey and his camera crew.  If it is, well, you’re dealing with more than just RTW problems and I’m afraid our blog can only address so many issues in 500 words or less.

Restaurant inspections are conducted by various regulatory bodies at the state level to determine if a restaurant is operating within approved food-safety guidelines, has appropriately trained staff, among other requirements.  Many newspapers, as well as online sources, publish the health inspections of restaurants and other food service locations.  Copies of inspection reports are available by request from the agency responsible for completing the inspection.  The point is, this information is, for the most part, easily accessible and can have an incredibly positive or negative impact on your restaurant’s reputation (and subsequent sales).

Common injuries in the restaurant industry include cuts and lacerations, slips/trips/falls, and lifting injuries to the back.  The resulting work restrictions can include limited use of the involved body part such as:  no use of the right hand, no lifting greater than 10 pounds, must be able to sit most of the shift.  The old adage goes, “If there’s time to lean, there’s time to clean.”  Meaning, if you’ve got time to lean on the counter, you’ve got time to wipe said counter, polish said glasses on the counter, or refill said condiment containers under said counter – it’s like the military – there’s always something that needs to be polished, painted, or wiped down.

Restaurant inspections are based off of the codes in place.  Check with your local health department or state agency to see if they have any check list resources to help ensure your restaurant’s operations meet or exceed the standards.  Not only is it a good business practice, but it’s a great resource for modified duty.  A clipboard allows for ease of use.  Even if it is the injured worker’s dominant hand, they can probably check a box under “yes” or “no” with their non-dominant hand.  Most importantly, the work is meaningful, productive, and serves a legitimate business purpose.  This is the best kind of modified duty you can find!

Other types of inspections

 

Long term care facilities have many requirements to meet when it comes to Medicare compliance.  OSHA has numerous requirements related to various aspects of your business.  These include material safety sheets (are yours updated to meet the Globally Harmonized standards/hazardous communications documentation requirements).  Are your eyewash stations up to par?  (More importantly, does everyone know what the standards for an eyewash station are?)  When was the last time your fire extinguishers were inspected?  Are all of your crew members’ step ladders safe and free of cracks or damage?  Are your company vehicles properly maintained for safe operation?  Ask your Risk Management Consultant to help you identify some issues that OSHA may be concerned with and implement a checklist/maintenance system for compliance.  Use that checklist system as part of your modified duty options.  While it may not yield months of modified duty options, it will help you get an injured worker working and hopefully help prevent future injuries or citations.  The goal of course is to make your workplace safer, not just to avoid the citations.

I’m sure there are various other types of inspections that your business may face – be prepared and help return an injured worker to meaningful, productive modified duty.

Complimentary Webinar: Using Not-for-Profit Organizations as a RTW option

Are you or your clients interested in learning about a new and innovative RTW solution?  Sign up for a complimentary webinar being offered by Eastern Alliance Insurance Group's Return to Wellness Specialist, Sarah Tayts. 

WHO:     This presentation is open to all EAIG agency partners and EAIG clients.  Please feel free to forward this post via email to anyone you believe would benefit from attending this presentation.  You can do this by clicking on the envelope icon located at the bottom of this post, or simply copy/paste the URL to this post into a separate email.


WHAT:     The presentation will highlight how to strategically use NFPs to solve even your most challenging RTW situations, as well as address the most common questions regarding the process. 

WHEN:     Wednesday, December 4, 2013 @ 10 am EST

HOW:     Register for the webinar by clicking here and completing a basic registration form.  For more information on how to get the most out of the GoTo Webinar session, you can click here to view a brief PowerPoint tutorial.               

In the past, this presentation has been very well attended, so be sure to register now to reserve your spot!

Why do some claims go sour?

No matter how you’re connected to a workers’ compensation claim, you probably share the same goal as everyone else:  to get an injured worker prompt, appropriate medical care and return them to work.  You want to get on with business and life as usual. 

Anecdotally speaking, the overwhelming majority of claims follow a fairly smooth path.  An injury occurs, it gets reported, and the injured worker seeks medical treatment.  After a few weeks of treatment, the injured worker is released to return to work without restrictions.  Any required state forms are signed and returned.  After paying any outstanding medical bills that may drift in, the adjuster reviews the file and determines it is appropriate for closure.  

I’d venture to say that this scenario is not what typically comes to mind when discussing workers’ compensation claims.  Maybe it’s the attorney commercials, maybe it’s the horror stories from your neighbor or distant relative, or maybe it’s because something simply went wrong in the course of a claim that resulted in a negative impression of the system. 

What causes some claims to go sour while others resolve without issue?

Information asymmetry due to weak communication.

Communication, by definition, is an exchange of information between people. 

In a workers’ compensation claim, there are a lot of people, all with asymmetrical quantities of knowledge, experience, and information.  Workers’ compensation is a system that has been historically filled with distrust.  Not to mention, a workers’ compensation claim impacts people on a very personal level.  When you combine the number of people involved with the emotional impact a work injury can have, it’s almost like a keg of gun powder and it must be handled with care and respect. 

Throughout the claim process, there are numerous potential “breaking points.”   I’d be willing to bet most of them revolve around communication.  Appropriate communication can quell the symptoms of information asymmetry and has great potential to prevent claims from going sour.

Some of these breaking points are provided below, with a simplified version of a solution, focused on communication and empathy.

Problem:  The injured worker receives a collection agency notice because of an unpaid bill.  I put this one at the top of the list, as it is one of the simplest problems to prevent.

Solution:  Injured workers should not ignore a bill or invoice.  If an injured worker receives a bill it does NOT always mean the insurance carrier denied it.  It may be that they didn’t have the correct billing information, it got submitted to personal health insurance, or to the wrong insurance carrier.  A simple fix is to call the billing number on the invoice, and update them with the correct insurance information.  Waiting until a collection notice is received makes it more difficult for the workers’ compensation carrier to get an appropriate bill and medical records to make sure it is related to the accepted injury to review it for payment.

Problem:  The injured worker doesn’t receive their wage replacement check on time.

Solution:  Someone can contact the injured worker to let them know it will be late.

Problem:  The injured worker hasn’t heard from their employer for weeks.  They’re starting to wonder if they still have a job.

Modified duty job offer letters communicate more than just RTW details

Return to work date, restrictions, hours, wages…

These are important elements of a modified duty job offer letter.  A modified duty job offer represents much more than a letter – it sends long lasting messages about an employer’s relationship with their employees, particularly in a time of stress or uncertainty.

If I get hurt, my employer will work with me to bring me back to work.

When employers offer modified duty, it demonstrates that they are willing to make some accommodations for someone who wants to work.  Involving the injured worker in the return to work (RTW) conversation is an important step – after all, they are the ones who are doing the work.  Listen to the injured worker’s complaints.  Consider altering their assignments or scaling back their hours if indicated.  Not every RTW will be a success the first time around.  Instead of throwing in the towel, talk to the claim representative, nurse case manager, and ask them to address this with the treating physician. 

My employer offers modified duty, so getting injured at work does not equate to sitting at home.

This is an incredibly important message.  Employees learn from what they see happen with other injured workers.  While the overwhelming majority of claims are legitimate, there are a sometimes people who wish to file an illegitimate claim or “build” their legitimate claim.  Having a strong RTW program that consistently gets injured workers back to work can help eliminate the motivation for filing illegitimate claims or exaggeration of existing claims.  Modified duty job offers shorten the time and injured worker will be out of work.

Have an injured worker out of work? The meter is running.

If you're an employer with an injured worker who is currently out of work, the temporary total disability (TTD) meter is running!  Whether it's staring at the meter at the gas pump, silently praying that it will soon stop, or imagining dollars going out the door everytime the air conditioning kicks on and you see your electric meter hypnotically spinning in circles...cha-ching, cha-ching, cha-ching, most of us have at least felt the pain at the pump or cringed when reviewing your summer-time electric bills.

We can blame the meteorologists and global warming, or grumble about the price of oil, but it's unlikely that we're going to stop using gasoline or electricity.  The same goes for workers' compensation (WC) insurance.  It's a requirement for the overwhelming majority of employers, and while there's little you can (legally) do to avoid having WC coverage, there are many ways to avoid overpaying.  Don't worry, you won't have to start biking to work or start adopting the ways of the Amish life.

One of the most influential ways to reduce workers' compensation claim costs (and resulting impact on premium calculations) is to offer modified duty.  If you have an injured worker who has restrictions that you [think] you cannot accommodate, the TTD meter is running.  As a claim representative I was often outraged at the number of employers who didn't seem to be alarmed by this statement:  "Each week that you do not offer modified duty, your policy is paying out $422 per week!  Over the course of 12 weeks, that is $5,064!"  It's not Monopoly™ money, it's real claims dollars.  Dollars paid to an injured worker, who is capable of performing productive work. 

Out of sight, out of mind? 

RTW at a Not-for-Profit: An Injured Worker's Experience

As you may have heard, Eastern now offers another innovative RTW solution -- transitional duty at local not-for-profit organizations (NFP).  Sure, we can say it's a great idea, that it helps injured workers recover and stay connected, but what does an injured worker have to say about working at a not-for-profit as part of their recovery from a work injury?

We are fortunate to have worked with an injured worker who was willing to give us his opinion and tell us about his transitional duty experience while working at an NFP.  Joe* sustained a shoulder injury, which required surgical intervention and left him with very challenging restrictions that his employer could not accommodate.  Joe's employer agreed to pay him to volunteer at a local Goodwill store while he recovered, and eventually transitioned him back to his pre-injury job.

Without further ado, we give you Joe's story, in his own words:

What type of work did you perform as transitional duty? 

“The type of work I did was a little bit of everything, what I did most of was what Goodwill calls purging. I just went through the clothes on display the racks and pulled out the old items and took them to the back to be sent to the main distribution center in Indy. I also sorted clothes and different items as they came in and put them out on the display shelves for sale.”

As an injured worker in this program, how did it benefit you?

“My biggest benefit was making new friends and having something to keep me busy during my recovery.  My overall impression is that this is a good program for someone that will be off work for more than a couple weeks. It got me out of the house and gave me something to do besides sitting around being bored. I met a lot of good people and had fun doing it.”

RTW and Seasonal Workers: Bring them back or risk paying them all year long

It's that time of the year again...your neighbor is fertilizing and seeding their lawn to ensure that their lawn invokes feelings of grass envy throughout your neighborhood, you're waking up to the sound of birds chirping in the trees as opposed to snow plows scraping the streets, isn't Spring a wonderful time of the year?

Soon we will start to see the landscaping trucks on the streets at the crack of dawn and workers spreading shovelfuls of recycled and dyed pieces of wooden pallets, known to the consumer as mulch.  What did you think I was going to say?  College students will be returning home to look for summertime employment, hoping to secure that sought-after summertime gig that pays more than minimum wage in an attempt to offset the rising prices of bee---I mean...books.  Everywhere you look, people are starting their spring projects, building patios, planting gardens and getting those home repairs they've put off until warmer weather.

But, if you're a seasonal employer you're probably not thinking of gladiolas and grilling, you're thinking about starting up business again and getting back to work! 

Why worry about WC at a time like this?  There are several reasons.

Helping injured employees recover faster while helping your community!

We are pleased to announce our strategic partnership with two not-for-profit placement coordination firms.  Eastern has partnered with Re-EmployAbility, Inc. and Transitional Work Solutions to provide yet another innovative solution to RTW challenges. 

We realize that even when employers are on board with offering modified duty to their injured employees, locating suitable work can sometimes be a challenge.  We see this new tool as a temporary solution in cases where employers can accommodate medium duty (for example), but are unable to provide work that is within the proscribed sedentary restrictions.  This is where our strategic partners come in.  They help locate suitable work with a local not-for-profit organization where the recovering employee can volunteer their time, while being compensated by their pre-injury employer.  The employee receives the psycho-social and physical benefits of volunteer work, while the community benefits as well.  The injured employee recuperates while making the transition back to work with their pre-injury employer. While it is not a 'fix-all' solution, we're very excited to add this resource to our collection of RTW tools.

Interested in learning more about our not-for-profit partners?  You can learn more about Re-EmployAbility, Inc.'s Transition2Work program and Transitional Work Solutions by visiting their websites, or ask your Eastern Claim Representative about it today! 

Stay tuned for more information regarding this exciting new tool!

Small Businesses Yield Big Opportunities for RTW

Initially, one may think that developing modified duty jobs for small businesses is extremely challenging, if not impossible.  It's not as daunting as you may think.  We've seen many small businesses successfully implement modified duty jobs to reduce and help control their claims costs.

That is not to say that small businesses do not have their challenges.  Often times it is the owner who has to play multiple roles in the organization, wearing the Human Resources hat one hour and the Accounts Payable hat the next.  Typically, smaller companies have less experience with losses or work accidents.  Just like many other businesses, small business owners are faced with budget constraints, creating the perception that they cannot "afford" to offer modified duty work.  From a WC cost savings perspective, employers cannot "afford" to not offer modified duty work.  Pardon the double negative.

Research has shown that smaller companies have many unique attributes that they can leverage to achieve successful return to wellness outcomes (Andersen, Kines & Hasle, 2007):

· Employees are often responsible for multiple tasks that may be outside of their "normal" job description.  They pick up and fill in as needed to ensure that things get done.  Maybe there isn't a designated person to clean the break room, but one person naturally takes care of it.  These "extra" duties are often a trove for modified duty opportunities.  Make a list of these duties and start your modified duty tasks bank.