An HVAC installer and a customer service representative both sprain their ankle...

(no this is not the start of a bad joke)...which one will return to modified duty sooner?

A.  The customer service representative

B.  The HVAC installer

C.  Neither because their employers only bring Injured Workers (IWs) back to work when they are "100%"

D.  Both have equal chances of returning to modified duty at the same time

The correct answer is D.  That is, if their employers have an effective modified duty program such as an ecovery Return to Wellness program.  Full duty releases may vary, but we're talking about modified duty.

Why don't the physical demands of the job make a difference?

You may think it is impossible for both of these IW's to return to modified duty at the same time based on what they are required to do in their occupations.  Wrong! The only true determining factors of when an IW will RTW are:

Biopsychosocial vs. Biomedical Models -- yes we're still talking about RTW

 Do you remember the movie Patch Adams, in which Robin Williams plays a doctor who treats ill children with humor and laughter?  Well, that's sort of what we're talking about.  His famous line in the movie was, "You treat a disease, you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome."

Up until the late 1970s, the biomedical model for the treatment of injuries and illnesses was the primary approach of many medical providers.   A change in the way medical providers approach the treatment of injury and illness has taken place since then, thanks to the biopsychosocial model.

Let's break it down:

Bio - meaning biological (study of life, functioning of living organisms)
Psycho - meaning psychological (thoughts, behaviors, emotions)
Social - relating to sociology (how we relate to society and groups)

vs.

Bio - study of life, functioning of living organisms
Medical - treatment of illness or injury

How does this relate to returning injured workers to work?

Top Reasons Physicians Keep Injured Workers Out of Work

In a 2000 survey of occupational health physicians, the folllowing list of reasons why physicians keep injured workers (IWs) out of work was provided:

• Physician does not want to force an unwilling patient back to work (most often cited reason)
• Solution:  If able to direct care, refer to objective physician
• Unequipped to determine the apporpriate restrictions on work activity
• Solution:  Ensure the IW is seen by the appropriate specialist for the injury (ex: orthopedic physician or podiatrist)
• Employer has a policy that prohibits light duty work
• Solution:  Employer should remove this policy and implement an ecovery Return to Wellness program
• No light duty available
• Solution:  Utlilze your Eastern Alliance Insurance service team to assist with developing modified duty and notify the treating physician that you offer light duty!
• Different versions of events (between employer and injured worker)
• Solution:  Have a Nurse Case Manager clarify that the RTW issue is what the IW can do as opposed to "he said" "she said" issues.
• There is too little information about what the pre-injury job to provide a release
• Solution:  Provide a pre-injury job analysis and/or a modified duty job analysis
• Conflicts of opinions between two physicians
• Solution:  The physician should take all medical records and objective medical evidence into consideration when determining an IW's ability to work.  Their opinion regarding work ability should be well-founded and objective!

Sources:

Article:  Christian, J. (2000) Reducing disability days:  healing more than the injury. Journal of Workers Compensation 9(30), 30-55.

Cited in:  Talmage, J. B., & Melhorn, J. M. (2005).  How to negotiate return to work in Talmage, J. B., & Melhorn, J. M. (Eds.),  A Physician's Guide to Return to Work (pp. 19-38). Chicago, IL:  American Medical Association

Upcoming Webinars for PA CE Credit

We are pleased to offer 2 FREE Webinars for CE credit

To register for the webinars, please review the flyer and complete the registration form.

April 18th:  Controlling Workers' Compensation Insurance Costs (1 CE credit)
10:00 a.m. - 11:00 a.m.
Presented by Matt Sinosky, Marketing Representative and Rob Reale, Director of Underwriting



April 19th:  Workers' Compensation and Return-to-Work: What, Why and How (1 CE credit)
10:00 a.m. - 11:00 a.m.
Presented by Sarah Tayts, Return to Work Specialist

We look forward to your participation!

Why offer RTW in a "Permanency" state?

A permanency state is a jurisdiction (state) that awards monetary compensation which reflects a functional loss of a particular body part (or parts).  Each state has a pre-determined method for calculating the amount (typically in weeks) of which a particular body part is valued.  In most instances, permanency evaluation is based on a percentage, or a number of degrees, of impairment.  Permanency is not valued until an injured worker is at maximum medical improvement (MMI). This is determined by a physician, who opines that the injured worker (IW) will no longer improve with additional medical intervention.

In permanency states, it is often assumed that the goal is to get the injured worker to MMI, get their rating, and get it resolved.  This is not always the best way to go.

The benefits of offering work as a therapeutic tool are illustrated by the following scenario:

IW sustains a shoulder injury requiring surgery.  MMI is projected 3-6 months from the surgery date.  The employer wants to hurry the claim along and get the IW's rating to close the claim.  The claim representative realizes that the IW's rating after 12 weeks post-op will be significantly impacted by the IW's inability to lift more than 25 lbs. overhead. The employer states they cannot permanently accommodate these restrictions. The claim representative has a discussion with the employer about bringing the IW back to work modified duty.  The IW returns to modified duty and receives the benefits of being physically active at work (within the prescribed restrictions).  As the IW continues to work, their restrictions become less stringent.

After working for another 3 months, the IW is deemed at MMI and receives their permanency rating, which is now based on the IW's ability to lift 50 lbs. overhead.  The increased lifting ability significantly reduces the amount of the IW's permanency rating.  This also reduces the Employer's claim costs, provides a productive employee, and increases morale around the workplace.  The IW improves physically, returns to earning their pre-injury wages, is motivated by their increased physical abilities and feels like a valued member of the workplace.

How is this not a win-win for everyone involved? 

Need to start a Return to Wellness program in your workplace?  Visit Eastern Alliance Insurance Group's website to download a RTW program or a guide to build your own.