Sarasota, FL (WorkersCompensation.com) – If a nurse at Ohio State University Medical Center injures himself at work, and another trips over a baby gate at home, each claim is treated the same. The institution’s Integrated Absence Management and Vocational Services Team jumps into action with the goal of helping the nurses recover and return to their jobs.
“There is no difference in how we apply our policies and benefits for transitional work, leave policies, or the accommodation process,” said Suzanne Slusher, Disability Program manager for the OSU. “Both have access to our onsite physical therapist and our vocational rehabilitation specialist.”
Coordinating the processes for occupational and non-occupational injuries has increased efficiencies and led to significant savings for the facility. Slusher outlined how the program works and the results, during yesterday’s webinar, Occ or Non-Occ, Does it Really Matter? produced by the Disability Management Employer Coalition.
The reporting and management of injuries is in many ways the same for occ- and non-occ injuries. Early reporting and thorough information is crucial to a successful outcome for both.
“The sooner it’s reported, the sooner management of the claim can begin,” said Derek Stern, director of Workforce Reporting and Insights for Unum. “It also allows benefits to [go] to the person sooner.”
Contact with the injured person is also vital, whether the injury occurred at work or elsewhere. Communication is key to better outcomes.
“Oftentimes we’ll talk to supervisors and nobody wants to remain in contact with the employee. That is something we really discourage,” Stern said. “We want everyone to remain in touch with the employee, whether on workers’ compensation or disability leave. It helps them feel connected to the workplace.”
A simple phone call or a card that expresses concern and well wishes can go a long way to making the person feel missed in the workplace. That can pay off in dividends when returning the person to work.
“Also, you can get valuable information in the conversation,” Stern said. “Maybe [the person] is feeling concerned about returning to work and you can alleviate those concerns. Use the conversation to reassure them it will be a good reentry into the workplace.”
Stern points out that the communication should involve all stakeholders in addition to the injured worker, such as the carrier. If the injured worker has returned to the workplace, for example, it’s important to ensure the carrier knows.
“Don’t assume anything,” he said. “Make sure you are reaching out to make sure everybody is aware of the information they need so the claim or leave can be managed appropriately.
Communication and coordination among the various departments involved has been instrumental in OSU’s successful absence management program. The process has been streamlined so each person has a specific role and all are kept in the loop.
The school and medical center have 48,000 employees. The IAMVS’ Leave Administrator is the first person involved when an employee is injured.
“Prior to having the Leave Administrator on the team, the units were responsible, so you can imagine with so many departments and employees it could sometimes be days, weeks or months before we’d be notified an employee was off work,” Slusher said. “Centralizing that process has cut down that amount of time for us to know, which cuts down the time for someone to reach out to the employee.”
The Leave Administrator notifies the Claims Manager and/or Disability Program Manager for follow-up as appropriate.
“The Claims Manager makes the initial contact with the injured person, whether it’s an occupational or non-occ injury,” Slusher said. “That person decides if it’s a workers’ compensation claim or not. They approve or deny claims, treatment, etc.”
The Claims Manager may triage the case to the Disability Program Manager and/or Leave Administrator, depending on work restrictions and expected time off. The Disability Program Manager continues communicating with the injured worker to ensure she understands the process and her options, and acts as a liaison between the employee, department, physician and third-party administrator. The onsite physical therapist and vocational rehabilitation specialist may also become involved.
Getting the injured employee back to work is part of the coordinated effort among all stakeholders. The most effective and quickest way is through transitional work, during which the person’s medical restrictions are gradually reduced and their job functions increased.
“Transitional work is not light duty,” Stern said. “The idea is to progress the employee back to their regular function within a set period of time. Also, make sure the work is meaningful.”
Stern recommends formalized policies and procedure be established with input from employees and management. Time frames should be established, generally from 30 to 90 days, or possibly 120 days.
“Set the time frame so you encourage the return to work,” Stern said. “You have a time for it to end so the employee knows there is a goal for them to recover to full function. It also helps to alleviate somebody getting into a situation where they are working [in a transitional job] for 5 years.”
Work restrictions typically prohibit the injured person from doing 10 to 20 percent of his job. “But if you can bring him back doing 80 to 90 percent of his job it will help ensure a more successful recovery and an opportunity to transition back to regular function much sooner,” Stern said.
OSU credits its integrated absence management program for 26 percent savings from 2012 to 2018. Fiscal year 2019 saw an average reduction of 31 percent in self insured workers’ compensation lost time claims. An average 15 percent decrease in reporting lag time for non-occupational claims has also been seen. The early intervention has also led to decreases in short-term disability incident rates that are 28 percent lower than the benchmarks. OSU’s long term disability closure rates based on successful return to work were 65 percent more favorable than benchmarks.
“Savings are due to the fact that we have so many services provided in-house, such as a physical therapist and vocational rehabilitation specialist,” Slusher said. “Going self insured (which the facility did in 2013) allows faster claims decisions and treatments to employees. [Since] Claims Managers have to follow the same rules turning around claims decisions, we have found doing it in-house speeds up the process and we typically get decisions turned around pretty quickly. We’ve had employees tell us they appreciate that the process moves faster.”