Return To Work Programs Save Money

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1 Return To Work Programs Save Money Presenters: Andrea Hiltbrunner, Claims Director, Everest National Ins. Co. Ronald Adler, President-CEO Laurdan Associates, Inc. Hosted by: Phaedra Buxman Aspen Risk Management Group, Inc. HRCI Certification This webinar has been approved for 1.0 (General) recertification credit hour toward PHR, SPHR, and GPHR recertification through the HR Certification Institute. Please be sure to note the program ID number on your recertification application form. For more information about certification or recertification, please visit the HR Certification Institute website at

2 Disclaimer The information presented in this material has been developed from sources believed to be reliable. It is presented for informational purposes only and should not be constructed as legal, professional or business advice. Everest National Insurance Company and its affiliates accepts no responsibility for the accuracy or completeness of this material. It makes no representations or warranties of any kind herein and disclaims all such representations and warranties. Neither Everest National Insurance Company or its affiliates will be liable for any damages alleged to be caused by the information contained herein. It recommends you consult with legal counsel and/or other professional persons before applying this material. This information is solely for illustrative purposes and does not constitute a contract. Only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions. Benefits of a Return to Work Program Rising Claim Costs: What studies show Savings You May Be Missing Out On: Does Return to Work really save claim costs? What is Modified Work? What is a Return to Work Program? Elements of a Successful Return to Work Program

3 Webcast Objectives Properly manage return to work programs Generate and institute appropriate policies and procedures Understand the connection between laws and insurance Coordinate Workers Comp, FMLA, and the ADA Manage discipline and terminations practices Polling Question 1 Do you have a process in place to return injured workers to work as they recover? Yes No

4 Why Early Return to Work? The longer an injured employee is on disability, higher the claim costs. Additional costs include lost productivity, overtime, decreased morale, increased premiums, costs of rehiring/training WCIRB Report on 2012 CA WC Losses: Projects Average Cost Lost Time Claim - $84,500 Indemnity claim frequency increased 3.3% accident year 2012 (compared to 2011) Projected indemnity frequency for first 6 mos. 2013, 6.2% higher than 2012 Temporary disability accounted for 47.9% of total indemnity paid $3.2 billion (40%) of total loss payments were for indemnity benefits ($3 billion CY 2011) 1) Medical only to lost time conversions increased 12% since 2009 Need to return injured employees to work for a speedy recovery! Workers Compensation Research Institute (WCRI) Unnecessary Litigation In Workers Compensation Claims Process : Training & Communication, Analysis of Changes in Indemnity Claim Frequency National Council on Compensation (NCCI)-Workers Compensation Temporary Total Disability Indemnity Benefit Duration-2012 Update Workers Compensation Insurance Rating Bureau Report on 2012 California Workers Compensation Losses and Expenses Polling Question 2 How successful is your company in returning injured workers to work as quickly as possible while they are recovering? Very - Most of our injured workers are back to work Good - We are able to bring back some back to work Poor - We are unable to return injured workers to work

5 Costs of Waiting for 100% Recovery vs. Early Return to Work Likelihood of full recovery, physically & emotionally, is improved with early return to work in some capacity Failure to return to work results in higher risk of poor recovery, mental illness/depression Injured employee off work for six mos. reduces the chance he/she will return to work by 50% Case example (CA benefits) Tim is a welder who injured his low back at work. Physician states off work 8 weeks Average Weekly Wage: $800 Compensation Rate: $ Weeks Off Work: $4, (Tax Free) Tim returns to modified work full 40 hours, save $4, Tim returns to modified work 20 hours per week, saves $2, (wage loss) What is Modified Work? Temporary placement of an employee in either a modified version of their usual job or a transitional position until they are able to perform regular work Focus on what the employee CAN do when identifying modified duties Employees offered modified/transitional duty return to work twice as often as those who are not Modified Duty Perform essential job duties of regular job on reduced hours schedule Performs some of the essential job duties of regular job on regular schedule Transitional Duty Performs some essential job duties of regular job and some different tasks on regular or reduced schedule Performs different tasks that typically are not a part of the regular job duties

6 Polling Question 3 What are the major obstacles preventing you from returning injured workers to work while they recover? Our jobs are too demanding Our workers refuse to return until cleared by their doctor We do not have an effective process in place We are too busy to effectively manage this process We are concerned about worker re-injury What is a Return to Work Program? Policy statement explains your company s return to work program to workforce visit Everest Loss Control website for sample Develop return to work process and procedures Create detailed job descriptions for every position Establish working relationship with CA MPN/PPO medical clinic Make provider aware you have a return to work program Provide job descriptions

7 What is a Return to Work Program? Assign a return to work coordinator Identify responsibilities of employees, management, medical provider-teamwork Every employee should know what to do if an injury occurs Further samples for policy statements-letter to physician-rtw plans, visit Return To Work In Action Injury occurs, new claim is reported timely, immediate medical care is provided, thorough accident investigation is conducted Communicate company s RTW policy and obtain evaluating/treating physician's opinion regarding ability to return to work Consider accompanying injured employee to medical provider Ensure physician views job description so appropriate RTW can be evaluated When physician communicates with both injured worker and employer, likelihood of return to work improves

8 Return to Work in Action Develop an individual return to work plan Ensure injured employee & supervisor understand modified position Monitor return to work with injured employee ensuring work is not conducted beyond restrictions Meet regularly with injured employee, document Employer, Injured employee, physician- all must work together Effects of an Early RTW Program NCCI studies show RTW programs can reduce compensation benefits by as much as 70% Encourages physical/mental healing Enables employee to remain productive Increases employee morale, let s workforce know they are valued Reduces the costs of employee replacement, training and lost productivity

9 Early RTW Programs Work and Can Save You Money With rising claim costs, increasing claim frequency as well as climbing duration of disability, it is imperative to develop a Return to Work program. A Return to Work program will not only save claim costs, help maintain production, save retraining costs, but will also improve employee morale. A successful program requires commitment from management and everyone. Return To Work Programs Save Money Ronald Adler, President-CEO Laurdan Associates, Inc. 18

10 Disclaimer The material presented in this presentation represents the views of the speaker and is not intended to provide legal or tax advice as to any of the subjects mentioned, but rather is presented for general information only. You should not rely on this general information to address specific circumstances. You should consult knowledgeable legal counsel or other knowledgeable experts as to any legal or tax questions you may have. 19 Agenda Coordinating workers comp, FMLA, and the ADA: Key elements of workers comp, FMLA, and the ADA Coordinating your policies and compliance with these laws Managing discipline and termination practices: Importance of job descriptions Importance of performance management Documentation, documentation, documentation 20

11 Polling Question 4 Since the following laws all impact your return to work programs, which one do you find the most difficult to work with? Workers' Compensation Family Medical Leave (FMLA) Americans with Disabilities Act (ADA) Coordinating Workers Compensation, FMLA, and the ADA: Purpose: Workers Compensation: Provide sure, prompt, income and medical benefits to work-related accidents victims or their dependents, regardless of fault Encourage return to work as soon as advisable NOTE: The longer an employee is out of work the more difficulty the employee has in returning to work. 22

12 Coordinating Workers Compensation, FMLA, and the ADA: Purpose: Family and Medical Leave Act (FMLA): Confers right to take time off for various statutorily protected purposes specifically the serious health condition of the employee that renders him/her unable to perform the functions of his/her position. Provides a total of 12 workweeks of unpaid leave 23 Coordinating Workers Compensation, FMLA, and the ADA: Purpose: Americans with Disabilities Act (ADA) Definition A physical or mental impairment that substantially limits one or more major life activities, such as caring for one s self, performing manual tasks, etc A having a record of such impairment Being regarded as have such impairment 24

13 Coordinating Workers Compensation, FMLA, and the ADA: Purpose: Americans with Disabilities Act (ADA): Prohibits discrimination of the basis of disability Imposes an affirmative duty to engage in a process of providing reasonable accommodation 25 Coordinating Workers Compensation, FMLA, and the ADA: Employment Thresholds: Workers Compensation: Virtually all employers FMLA: 50 or more employees in a 75-mile radius ADA: 15 or more employees 26

14 Coordinating Workers Compensation, FMLA, and the ADA: Other Critical Issues: Protects employment No retaliation Implicates hiring practices Impacts recordkeeping 27 Managing Discipline and Termination Practices Liability starts when a person is hired Requirements of the job and discipline and termination decisions must be job related and based on business necessity. 28

15 Managing Discipline and Termination Practices Importance of job descriptions in discipline-termination actions Current and accurately describe essential functions Describe special working conditions and requirements Identify specific physical and mental requirements Specifically indicates if on-site attendance is required 29 Managing Discipline and Termination Practices Importance of performance management in disciplinetermination actions Emphasis on job related performance and conduct Re-emphasizes expectations Identifies action Indicates consequences 30

16 Managing Discipline and Termination Practices Documentation, documentation, documentation Importance of personnel action forms Requests for time off Warning notices Maintaining personnel files 31 Polling Question 5 As a result of this presentation, I am going to: Prepare / review our job descriptions Write to my Congressman Review our human resource practices Work with medical providers on our return to work program Strengthen communications with injured workers and providers

17 Questions on today s session? Presenters Contact Information: Andrea Hiltbrunner, Claims Director, Everest National Ins. Co. Ronald Adler, President-CEO Laurdan Associates, Inc. HRCI Information In order to obtain your 1.0 (General) recertification credit hour toward PHR, SPHR, and GPHR recertification: Visit Title of the Presentation: Return To Work Programs Save Money The Program ID is:

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