return to work & transitional jobs. © 2004 companion property & casualty group program...

Return To Work & Transitional Jobs

© 2004 Companion Property & Casualty Group

Program Goals

To lower workers’ comp claim costs

To reduce high workers’ comp insurance premiums


How to BeginKey components:1. A Written Return to

Work Policy

2. Job Analysis for All Problem Jobs

3. Transitional Work Options for Employees Returning with Temporary Restrictions


Return to Work Policy Statement

Put it in writing.

Apply it consistently.

Use it to guide decision-making.


RTW and Transitional Job Policy

Communicate the policy…– To employees– To supervisors– To healthcare

providers– To insurance

company or third party administrators


RTW and Transitional Job Policy

Emphasize your commitment to get injured workers back to work as soon as medically safe!


Job Analysis

Provide the treating medical provider with a job analysis of the injured worker’s job.

Focus on the physical and environmental requirements of their original job.


Transitional Work Options

Indicate your willingness to provide work that meets the employee’s physical limitations.


RTW & Transitional Job Policy

List some transitional work job options that can be considered.


Managing Your RTW Costs

Report claims immediately.

Use quality medical providers who share the company’s philosophy on RTW.

Return injured worker as soon as medically safe by providing transitional work options.


Select Medical Providers According to Local Laws Check your state

medical requirements.

Inform employees of the company-selected medical providers when they are ill or injured.


Sample Policy and Forms

Return to work (RTW) and Transitional Job Policy

RTW Agreement Job Analysis Form RTW Authorization Form


Focus on RTW

Provide the injured worker’s job analysis and Return to Work Authorization Form


Sample Return-to-Work & Transitional Job PolicyIf you become ill or injured as a result of a job-related accident, you will be missed by other employees working in your department. Employees have the responsibility to return to work at the earliest possible time, depending upon your physical abilities and/or restrictions.

The Company will actively seek to return disabled employees covered by workers' compensation to productive work as quickly as possible, in cooperation with the attending physician or health care provider.

If necessary, a temporary transitional job may be provided for you that is within your physical capabilities and consistent with company needs. Even working at a partial capacity will assist your fellow employees in completing the work. Efforts will be made to return you to your previous job, when possible.

Owner/Officer Signature_________________________________

Title__________________________________________________

Date__________________________________________________


Sample Return-to-Work AgreementEmployee:__________________________________

The Company agrees that the following represents the restrictions under which you are able, and have agreed, to return to work as of (date).

Those restrictions are:___________________________

The Company will not require you to perform any tasks beyond those restrictions. If you are asked to perform such a task by any of our employees or supervisors, please decline. They may not be aware of your restrictions.

By signing below, you agree and verify that you will not do anything beyond the noted restrictions either here at work, beyond the work site, at home or at recreation until such time as the doctor has removed the restrictions and The Company has been notified to that effect.

Signature - The Company______________________________Signature - Employee_________________________________Date - _____________________________________________


Sample Return-to-Work Authorization Form

The Company has a transitional work program which provides temporary jobs that injured employees should be able to safely perform during their recovery periods. Completion of this form will allow us to identify an appropriate assignment for this employee. Thank you for your cooperation and prompt response.

EMPLOYEE___________________________ EMPLOYER____________________________

EMPLOYER CONTACT PERSON ___________________________ PHONE______________

DATE ____________________ APPLICABLE SHIFT DURATION ______________________

DIAGNOSIS_________________________________________________________________

WORK-RELATED_____ YES _____ NO NON WORK-RELATED _____ YES _____ NO

TREATMENT _______________________________________________________________

DISPOSITION:RETURN-TO-WORK DATE (NO LIMITATIONS) ________________________

RETURN-TO-WORK DATE (WITH LIMITATIONS) __________________________________

UNABLE TO WORK FROM ___________________ TO _____________________________

PROGNOSIS _______________________________________________________________

REFERRAL TO: CONSULTANT -DOCTOR _______________________ DATE__________

PHYSICAL THERAPY__________________________ FREQUENCY___________________


Sample Return-to-Work Authorization Form (continued)

WORK RESTRICTIONS:

RESTRICTIONS APPLY TO: WORK______ HOME_______LEISURE______

DURING THE APPLICABLE WORKDAY, THIS EMPLOYEE CAN:

____SIT ____ HOURS;____STAND _____HOURS; _____WALK____HOURS

EMPLOYEE CAN:Never ___Occasionally___Frequently___Continuously__

Lift and carry:

___up to 10 pounds; 11 - 25 pounds ; ___26 - 35 pounds ;

__36 - 50 pounds ; ___ 51 - 75 pounds ; ___76 - 100 pounds

Reach above shoulders

Push/Pull

Climb

Crawl

Squat/Kneel

Bend/Stoop/Crouch

Balance

Twist upper body

Use hands dexterously


For More RTW Ideas & Information…

Visit the Companion website at www.companiongroup.com and click on the Loss Control tab.

Speak with your agent.

return to work & transitional jobs. © 2004 companion property & casualty group program...

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