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Return-to-Work Program

As an employer, a proactive return-to-work program can provide you with effective tools associated with injuries or illness by providing the opportunity for injured workers to return to the workplace as soon as it is medically appropriate. A return-to-work program (RTW) also provides a mechanism for employers to encourage employees to return to work as soon as possible after injury or illness. National statistics indicate that a return to work program is a valuable loss control measure that helps control workers’ compensation costs.

Every state agency is required by the Texas Workers’ Compensation Act (Labor Code, Title 5, Subtitle A, Section 412.051) to develop, implement, and maintain a program designed to assist employees who sustain compensable injuries to return to work. Such a program should include appropriate, detailed procedures that identify specific responsibilities and actions that should be taken by designated return-to-work coordinators, supervisors, and employees. It has been evidenced and observed that a good return-to-work program can have significant cost savings for an agency. In terms of statewide savings, this can mean millions of dollars saved. That is just one of the many positive outcomes, not to mention a more vibrant and productive workforce.

In 2023 the Texas Department of Insurance, Workers’ Compensation Research and Evaluation group conducted an analysis of RTW patterns of injured employees receiving Temporary Income Benefits (TIBs) in the Texas workers’ compensation system. The report shows two types of RTW rates: initial RTW (percentage of injured employees who returned to work for first time after their injury) and sustained RTW (percentage of injured employees who returned to work and stayed at work for three consecutive quarters after their injury), between 2007 and 2020. The report reflects lower RTW rates both sustained and initial in 2019 then recovering in 2020. The variance may be due to work interruption in early 2020 due to COVID-19. The complete report can be viewed https://www.tdi.texas.gov/reports/wcreg/documents/rtw2023.pdf.

Managing employees with injuries or illness often involves having an understanding of behavioral forces that motivate an employee to be a productive participant in the workforce. The longer an employee is unable to work, the more difficult it becomes to return to full duty employment. Factors such as fear, depletion of financial resources, decline of self-image or self-esteem, and lack of knowledge about the worker’s compensation system may present barriers to an employee returning to work. Employees who return to work in a modified or alternate duty capacity are likely to recover more quickly and with less impairment. In addition, these employees are less likely to become treatment dependent.


Goals

The primary goal of a return-to-work program is to assist employees who sustain an injury or illness to safely return to work at the earliest medically practical time in a temporary(modified or alternate duty) assignment.

By allowing an employee to perform modified duties, the employee is allowed to remain a productive member of the workforce while he or she recuperates. Other important goals of an effective return-to-work program are as follows:


Objectives

  • Maintain company objectives and productivity.
  • Encourage safety and prevention of injury.
  • Provide reasonable work opportunities when possible to enable injured workers to return to a work level as close as possible to their pre injury productivity and earnings.
  • Avoid re-injury through work assignments and effective monitoring.
  • Employer should demonstrate concern for the injured worker and fulfill obligations to the employee.
  • Assist the employee to return to their normal work environment in an expedient manner.
  • Return the employee to a work level as close as possible to pre-injury earnings and productivity.
  • Ensure that the employee’s return to work is in compliance with all requirements of the Americans with Disabilities Act, Family Medical Leave Act, and the Texas Workers’ Compensation Act, as appropriate and necessary.

Benefits

Benefits to the Employer-Direct Savings

  • Worker’s compensation costs are reduced when temporary income benefits cease.
  • Productivity increases and human resources are used to the maximum extent.
  • Medical costs are reduced and recovery time is shortened.
  • Wage costs for substitute employees are saved.

Benefits to the Employer-Indirect Savings

  • Recruitment and hiring costs for new or substitute employees can be saved.
  • Work delays and business interruptions are eliminated when an experienced employee returns to work.
  • Co-workers are not required to perform extra duties to compensate for the absent employee.
  • Goodwill and positive image with the public and employees are created, as the employer is perceived as a caring employer.
  • Communication and relations between employees and management are enhanced.

Benefits to the Employee

  • Employees remain active and mobile when returned to the productive workforce, and recovery time is shortened.
  • Full or partial wages are earned bringing the injured worker’s income closer to pre-injury wages than workers’ compensation temporary income benefits alone.
  • Self esteem, morale and personal security are maintained or restored through gainful employment and a productive life style.
  • Stress, boredom, and depression of the injury/illness and being out of work are reduced or eliminated.
  • Physical conditioning through a work life discipline is maintained, and the chances of returning the employee to work permanently are improved.

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Frequently Asked Questions (FAQ)

(Q) What are alternative work assignments and job modifications?
(A) When possible, job tasks should be assessed and a possible list of work assignments should be created before they are actually needed. These assignments may include full or part time work and should have time limits. These alternative work assignments must be meaningful and productive. Demeaning or “make work” assignments will defeat the purpose as this could be seen as punishment.

(Q) What are some keys to making a light duty program successful?
(A) The key to success is involving everyone and making light duty a team effort. Follow up is also an important key to making the program a success. Stay in contact with the employee every day and have an injury coordinator who makes certain that the restrictions under which an employee is operating are communicated to the supervisor. It should be emphasized to the supervisor the importance of making sure the employee does not violate the restrictions. This can just make the injury get worse. Part of the program is an insistence that employees on restrictive duty visit the doctor every few weeks to monitor their progress.

(Q) Why is it so important to get them back to work?
(A) The Menninger Foundation, a medical research center in Topeka, Kansas has data that clearly shows the longer a worker stays away from the workplace, the greater chance he or she will never return. The study shows that there is a 60 day window for workers to return to work. After that a significant number never return. Over time workers can develop “disability dependence- a mindset of being sick.” A quick return-to-work, even with modified duty, is much better for the employee. The employee recovers more quickly, is less apt to get out of shape, is able to maintain wage stability, and stays connected to the workplace.

(Q) How can a program be evaluated to show that it is a good return-to-work program?
(A) Good return-to-work programs should do the following:

  • return injured workers back to meaningful work within 24 hours of most injuries.
  • be relatively easy to administer.
  • avoid keeping employees in temporary assignments indefinitely.
  • provide supervisors with a clear idea of what can be done by the injured employee instead of what can’t be done.
  • a successful return-to-work program should also be able to reduce your overall workers’ compensation losses by at least 10% and as much as 30. Benchmarking systems should be instituted to measure the effectiveness of the program.

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