Stay at Work/ Return to Work - safetyfestmt.dli.mt.gov
Transcript of Stay at Work/ Return to Work - safetyfestmt.dli.mt.gov
Stay at Work/Return to Work
Best Practices and Tools for Montana
WHERE TO BEGIN
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Despite our best efforts, employees get injured What do you do?
Effective RTW Strategy: Encourages communication between employer & injured employee Allows a skilled and experienced employee to continue working Keeps loss of productivity to a minimum Reduces the costs of training new employees Creates an opportunity to complete work usually left undone
How to create a successful RTW Program: Believe in the program – for your company and your employees Develop a written procedure for returning injured workers to workplace Designate a RTW lead
SUCCESSFUL RETURN TO WORK EFFORTS
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BENEFICIAL FOR EVERYONE
Program Benefits For Employers: Employers with fewer injuries pay less
Less time off work = less impact on your premiums Returning to work speeds an IW’s recovery Reduces the financial impact on worker Reduces physical & emotional health effects May reduce the risk of re-injury
Program Benefits for Employees: Keeps the employee active and speeds medical recovery Shifts focus from “dis-ability” to ability Provides a sense of job security Allows the employee to maintain contact w/ co-workers Shows you value your employee and their contributions to your
company
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KNOW ALL THE OPTIONS Informal Process:
Good communications exists between you and your employee Your employee is motivated to return to work or to keep working after an injury There is an agreement between both parties about IW’s abilities
Document Everything: Useful if your IW is not cooperating w/ your RTW efforts Use Medical Status Form to obtain work restrictions from healthcare provider Be specific and put in writing your light-duty job offer
RTW Options: Modified Work – an adjustment to the way a job is normally performed
Ex: Changing lifting requirements Part-time Work
Ex: Work restrictions only allow for ½ day of work Alternative Work – different job w/in your organization
Ex: Can be an existing job or an identified set of job tasks that you need done and no one has tackled
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MEDICAL STATUS FORM
Purpose of Form Facilitate communication between:
Worker with a work-related injury or occupational disease
The employer The healthcare provider
Provide necessary medical information to the insurer
An insurer can request additional info from healthcare provider, but the employer cannot
By law, the treating physician or designee is required to complete the Medical Status Form after each visit
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SAMPLE LIGHT DUTY JOB DESCRIPTIONJob Duties: In a dealer’s auto parts department, takes orders from customers, utilizing telephone, fax & Internet. Checks on availability and price of parts and advises customers. May write up order and invoice as appropriate.
Tools & Equipment: Telephone, computer, desk, chair, paper and pen or pencil
Frequency and Duration of Tasks: Worker can set task and speed level and has the flexibility to stand or sit as needed
Physical demands limited to the following:1. Frequent – Lift paper & writing implements weighing less than one pound2. Alternate sitting and standing as needed to write up orders and enter into computer3. Frequent – Hand and grasp writing implements to organize and record information4. Frequent – Fine finger manipulation to keyboard and organize paperwork
No additional demands will be required of the worker without approval of the attending doctor. Any reasonable accommodation can be considered.
Employer’s Signature:_________________________________ Date:____________________
Employee’s Signature: ________________________________ Date: ____________________
Seldom = up to 10% Occasional = 10% - 30% Frequent = 30% to 70% Constant = over 70%
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WHAT HAPPENSWHEN THINGS GO WRONG
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A TALE OF TWO INJURIES
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Tom:• 28-year-old construction worker• Suffered right ankle fracture 6 months ago• Sought care at local occupational clinic and completely recovered• Back to work with no issues• HAPPY PATH
John:• 28-year-old construction worker at same company• Identical injury and sought care at same clinic as Tom• 6 months later: out of work; can’t sleep; snapping at the family;
on anti-inflammatories and opioids and going for 3rd opinion• Someone thinks he may have CRPS (Complex Regional Pain Syndrome)
• DELAYED RECOVERY
PROBABILITY OF RETURNING TO WORKAFTER DATE OF INJURY - BY QUARTER
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90%
55%
32%
5%
Source: IAIABC Disability Management and Return to Work Committee 2016
NEEDLESS DISABILITY
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Definition: Time off work not really required by the medical condition itself Worklessness has number of consequences:
Financial impact to injured worker Economic toll to employer Social and emotional issues Tremendous health consequences
Increases in poor health, mental disorders and suicide 2-3X increase in poor health
heart disease, respiratory illness, lung cancer, etc 2-3x increase in mental health disorders 6x increase in suicide
INJURED EMPLOYEE PERSPECTIVE
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• I’m having a hard time sleeping
• I forgot our anniversary
• Covid-19
• The car needs a new suspension
• Bills are piling up
• Will I get fired?
IMPACT ON RETURN-TO-WORK
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Source: Injured Worker Survey, 2019
UNDERSTANDING DELAYED RECOVERY
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Biological Risk Factors:• Age• Gender• Comorbid conditions • Opioids
Work Risk Factors: • Heavy manual job • Workplace climate• Work overload and pressure• Long commute distance• Job satisfaction• Low social support• Dysfunctional family situation
Psychosocial Risk Factors:• Fear• Catastrophic Thinking • Recovery Expectation• Perceived Injustice
WHAT IS OUR ROLE?
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Employers/Manager/Supervisors: Identify and address barriers early on Functional approach Facilitate a return to preinjury function
Conversational Interview:• When do you think you’ll return to work?
• Follow-up question: Why do you think it will take xx weeks?• Why do you think this happened to you?• Is your pain sometimes more than you can bear?• How are you coping with the injury?• Anything you’re afraid of that we haven’t talked about?
SOURCES
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*Jurisic M, et al. The Personal Physician’s Role in Helping Patients with Medical Conditions Stay at Work or Return to Work, JOEM. 2017
*Waddell G, Burton AK. Is work good for your health and well-being? London: The Stationery Office, 2006.
*Gerdtham UG and Johansesson M. A Note on the Effect of Unemployment on Mortality. J Health Econ. 2003; 22(3): 505-518
*Comorbid Conditions in Worker’s Compensation. AMA Guides newsletter. 2019.
*Psychological Factors in Delay and Failed Recovery and Unnecessary Disability. AMA Guides Newsletter. 2019
Questions