Labor Intensive

Kirk Hansen Alliance of American Insurers Downers Grove, Ill. and Daniel G. Price Allied Waste Indus

ALLOWING INJURED EMPLOYEES to gradually return to work can take the sting out of workers' compensation costs while maintaining an employee's dignity. Consequently, more companies are establishing return-to-work programs that provide injured workers the support and assistance they need to return to work as soon as medically possible.

A successful return-to-work program must be tailored to the company. A good program should emphasize strong communication at all levels and ease injured workers back into their jobs through modified duties while gradually increasing workload. Managing early and safe returns to work is an effective strategy to reduce lost workdays and improve overall productivity. But no matter how a program is structured, the advantages are universal.

Employees who return to work faster tend to recover more quickly and more fully than those who stay at home. An effective and comprehensive program can reduce medical expenses by 29 percent and reduce indemnity costs by 49 percent, according to a survey conducted by Watson Wyatt and the Washington Business Group on Health, Washington, D.C. The survey also says organizations that do not have return-to-work programs for disability and workers' compensation injuries typically have absence rates as high as 5.3 percent. If a company implements return-to-work programs, the absence rate is 1.4 percent.

Return-to-work programs also provide less obvious benefits. According to a Feb. 24, 2003, article by Betsy Robinson published in The National Underwriter, the direct and indirect costs of absenteeism range from 12 percent to 18 percent of payroll. Returning employees to work saves on costs related to: recruiting, hiring and training replacement workers; paying for benefits for absent workers; and the continuing administrative tasks related to prolonged workers' compensation claims. If an employee is on workers' compensation disability benefits, the employer is likely still paying Federal Insurance Contributions Act (FICA) payments on behalf of the employee and payments into health and pension plans. Some estimates place the indirect costs of workers' compensation at three times as much as the direct costs.

The longer an employee is out on disability, the less likely the employee will return to work. According to an April 10, 2003, BestWire article, Gregory J. Crabb, of Hartford Insurance Co., Hartford, Conn., says that after six weeks of disability, injured workers have a 50 percent chance of ever returning to work. When injured employees are disabled for a full year, there is only a 1 percent to 2 percent chance that an employee will return to work at all.

Additionally, psychological effects of injuries can complicate the recovery process. Workers who remain on disability are subject to a condition called “disability syndrome,” which results in a depression that exacerbates the physical pain and causes an inability to return to work even when it is medically feasible. With such a condition, the employee tends to magnify the physical pain until it becomes an immovable obstacle to going back to work. A return-to-work program can prevent the employee from settling into such an unhealthy cycle.

Most employees want to get back to work because workers' compensation disability payments amount to much less than full paychecks. A past survey performed by Waste Management Inc., Houston, of its injured workers demonstrated that 34 percent of its employees believed they could have returned to work sooner than their original release. The workers only stayed out of work because their doctors had instructed them to do so. If more aggressive return-to-work practices had been employed, most of those workers would have returned in a more timely manner.

Although the benefits of return-to-work programs mostly outweigh the drawbacks, companies have some biases to overcome. Morale problems could arise if coworkers feel that an injured worker is taking advantage of them. For example, an injured employee's coworkers could have concerns that their own positions might be eliminated to accommodate the modified duties offered to injured workers. Also, coworkers who have to pitch in to compensate for the loss of the injured worker might suspect the injured worker is malingering. They might harass an injured worker performing modified duties if they believe the injured worker is being paid for not working.

When an employee returns to modified duty in the workplace, it is best to avoid using the term “light duty,” which suggests the injured employee is performing work that is easier than the employee's coworkers. A better term is “transitional duty,” which suggests the process of transferring the employee from modified duties to full duty. It also is imperative that transitional jobs add value to the organization.

Return-to-work programs can result in up to a 40 percent reduction in lost workdays. Benefits from an effective return-to-work program include happier, more productive employees; retention of experienced employees; and reduction of malingering and fraud. When properly administered, these programs benefit both haulers and employees.