Industrial athletes: Dip your toe in the pool before diving in to RTW

In his blog post, Dr. James Butler of Orthopedic Associates of Evansville, Indiana, writes: 

“30 years ago, as a young physician I was taught, as many of our parents were, that if you have an injury you must have complete rest.  We have discovered over the years that that is a fallacy and leads to other problems.  I often joke with patients that as a young doc we used to hospitalize patients with back pain and put them in bed for a week or two at a time, and many of them are still there.  The sports medicine specialists were in the forefront of changing that idea.  They began treating their athletes by resting only the injured part while continuing to actively use the rest of the body.  They found that people healed quicker, and were back in the game sooner.  Well, we have finally realized that workers are just a different type of athlete, an “Industrial Athlete” and they also need to be kept with their team while healing so they can get back up to bat again sooner.” 

Work must be a component of any injured worker’s recovery. 

Maybe you are an employer who wants a healthy, productive employee back to work or you're the spouse of an injured worker who wants things at home to return to the way things used to be. Maybe you’re a physician who wants to help your patient recover and achieve the best possible outcome.  Graded work exposure may help you attain these goals by making work a part of the recovery process.

What is graded work exposure?

It’s a predetermined plan agreed upon by an injured worker’s occupational therapist and the injured worker’s supervisor that returns injured workers to job duties in which the hours and duties are gradually increased until the injured worker can return to their pre-injury duties. 

An example is when an injured worker returns to work four hours per day, five days per week for two weeks.  After two weeks, the injured worker’s hours are increased to 6 hours per day for two weeks, and then eventually eight hours per day.  Graded work exposure may involve the injured worker only performing certain aspects of their job that are more physically challenging for just a portion of their day.  Graded work exposure can be particularly helpful for injured workers who question their ability to return to their pre-injury job, or are fearful of getting injured again.  Making progress toward goals through graded work exposure can help both employers and injured workers restore their confidence in the injured worker’s physical abilities. 

In a 2000 study conducted on therapeutic return to work (TRTW), researchers found that work rehabilitation programs that linked graded work exposure with traditional physical therapy for chronic low back pain resulted in 93% of participants working at two-year follow up.  More telling of the success of this program is that none of the participants reported back pain recurrence from working during the period of the study (p. 59, 2000). Of those participants who underwent traditional functional restorative therapy, 73% of participants were working at two-year follow up.  Participants in the TRTW group also indicated lower average disability scores, lower average pain intensity scores, and lower scores on fear avoidance beliefs measures (p. 60, 2000).

Speaking of industrial athletes…

Do you remember the first time you jumped off the diving board?  Your thoughts preceding that jump probably focused on every time you nearly drowned before that.  You’re teetering at the edge of the fiberglass board hoping that you won’t sink like a rock, hoping that someone will come to your aid if you suddenly swallow half the contents of the pool, and hoping that it will all be worth it.  The people on the side of the pool are telling you to just do it already, to trust them -- they’ve done it a hundred times before and it will be great.  Something tells you to linger on the board just a little longer, inch a little closer to the edge, and that you’ll decide when you’re ready.

Returning injured workers to modified duty requires trust.  Employers and injured workers are concerned about re-injury.  There may be doubts in either party’s minds about whether or not the return to work will, well, work.  These feelings of anxiety, uncertainty and doubt are also experienced by employers and injured workers who are contemplating a return to work after a work injury.  No matter how many times a doctor tells an injured worker or an employer they can do x, y and z, they haven’t seen it done yet and they aren’t really sure of the outcome. Without an attempt no one will ever know. 

When planning the return of an injured worker, focus on setting it up for success and consider graded work exposure as an option. 

References:

Durand, M. J., & Loisel, P. (2001). Therapeutic return to work:  Rehabilitation in the workplace. Work, (17), 57-63.

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!

Changing discourse by changing the injured worker's course

This week's post was inspired by another blog (Managed Care Matters) as two quotes in an April 10, 2013 post hit on two very important points when discussing RTW:

"... 'there’s no condition so disabling that there isn’t someone in the US with that condition working full time today.'”

and...

"You don’t get better and go back to work, going back to work is a part of getting better!”

Disability means different things to different audiences.  According to the U.S. Social Security Administration a person is "disabled" based upon their inability to work and if:

oYou cannot do work that you did before;

oWe decide that you cannot adjust to other work because of your medical condition(s); and

oYour disability has lasted or is expected to last for at least one year or to result in death.

Here's an experiment for you to try at home.  Ask someone what they think of when they first think of a disabled person.  I would be inclined to state that their initial response includes some description that focuses on the physical abilities or limitations of the person rather than the limitations placed on their ability to earn wages.  Now, ask someone what they think of when they think of someone out of work due to a work-related injury.  Was their response the same?  I'd be inclined to state that their response related to the monetary impact.

Why?

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.

RTW and Off-site Employees -- we have a solution!

One of the greatest challenges of returning injured workers who reside a considerable distance from the office is just that...the distance.  Employers often express their inability to offer any type of modified duty in their office because their employees live 50+ miles away and it wouldn't make sense to bring them into the office.

Here are some options to overcoming these challenges:

·    If the injured worker typically drives to the office location for his/her regular work day, then it isn't unreasonable to ask them to report to modified duty at the office.  Instead of asking them to work 4 hours per day, have them work two, 8 hour modified duty shifts.  The benefits are still there -- the injured worker maintains a connection to the work habit, they are able to engage in the social interaction that work provides, and it may help keep them focused on their recovery. 

·    Consider a transitional duty! For more details, check out our post on using NFPs as a RTW option.  Our partners can place an injured worker in their local community, as close to their home as possible.  This could be an excellent option for travelling nurses, home health aides, sales people, truck drivers, and any other employee who lives a considerable distance from the office where modified duty isn't feasible.  This may also be an excellent choice for injured workers who are given driving restrictions but are encouraged to gradually increase their driving time and distance.

·    Are there any aspects of their job (or other jobs within your organization) that can be done remotely?  Is it a simple matter of getting them access to work from home?  Many companies who employee telecommuters have software that can monitor productivity.  Another option would be to complete customer satisfaction calls, schedule appointments, place inventory orders, create hazardous material sheets (most often-cited OSHA violation), create safety training materials, etc. Read the BLS report on telecommuting here!

While these suggestions may not resolve all of your RTW challenges, we hope that they are options that you may have not considered previously.  As always, we're here to listen to your RTW challenges, and provide a solution that is right for your unique situation.

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!