Sarasota, FL (WorkersCompensation.com) – Getting injured workers back to function as soon as possible is a win-win for everyone. The longer a worker is out of work, the less likely he is to return. Modified duties can accommodate work restrictions for employees who are able to do some, though not all of their pre-injury tasks.
But what happens in situations where lite duty is not possible? What can employers/payers do to help the affected workers and keep claims moving forward? Experts say a carefully constructed non-traditional lite duty program offers the same benefits to the injured worker and the organization.
“One of the benefits of lite duty, ultimately, is it really helps facilitate the recovery while working modified duty,” said Bobbie Doyle, director of Telephonic Case Management for Genex. “And it’s a successful form of occupational therapy.”
Working modified duty at the employee’s actual company is typically the best option, since it keeps the person in his familiar work environment. But traditional lite duty work may be unavailable; for example:
- If the employer refuses to accept injured workers back until they are 100 percent recovered
- The worker’s tasks cannot be modified
- Seniority prevents an injured worker from moving into another position
- The employer has no control over the work, such as a staffing company
“Accommodations for restrictions may be challenging for some,” Doyle said. “This is where non-traditional options can be an enormous benefit.”
Non-traditional lite duty is an off-site, employer sponsored program, typically with a non-profit or volunteer organization. These provide opportunities for injured workers who otherwise might end up on long-term disability.
“We saw numerous claims where the injured worker was being taught by the claim process to be disabled,” said Kathleen E. Peck, a risk management consultant. “The result was these people became deconditioned couch potatoes over time, developing consequential injuries.”
Speaking during a recent webinar on How to Achieve Light Duty When Light Duty is Not an Option, Peck discussed her work with a particular company and described one claim in which an initial knee strain claim morphed in several additional injuries. After the right knee was repaired, the worker needed treatment for a left knee injury, then for a back injury, and finally for carpal tunnel release due to his use of a walker while recovering from the other injuries.
“What we were running into were claims that were excessive, they were long term and people were abusing [the system],” Peck said. “So what we were trying to accomplish was, how do we get people back into their work life, their actual work experience.”
The company was mainly concerned about its legacy claims. Peck said there were thousands of temporary total claims.
“Temp total was being paid, as a result reserves were going up, we were doing the claim reviews, [and in] talking to legacy programs [we said], ‘what’s your plan of action?’” she said. “Plans of action were poor. Plans of action were ‘well, we’re waiting for the next office visit to see if we can get a full duty work release.’”
The employer was frustrated with the carrier, expecting it to do a better job of managing claims. The carrier was frustrated with the employer, expecting it to contribute more to the claims management process and help return people back to work.
“The claims process was broken, essentially, between us the insured/the employer, and our carrier, TPA programs,” Peck said. “We determined that we needed to impact the process; we needed to have some form of lite duty return-to-work.”
Creating a Non-Traditional Lite Duty Program
An important element of any lite duty work is that it is ‘occupational therapy,’ rather than having people sit at desks doing busy work. It needs to be meaningful and effective.
“I’ve got people typically working in a light industrial setting requiring them to lift 50 pounds or more on a daily basis, and putting them into an office environment and sitting at a desk in a sedentary capacity is not moving them back to their traditional light industrial setting,” Peck said. “So what we were looking for was a program that is keeping them up, keeping them moving, using their work restrictions in a safe capacity and getting them reconditioned, rehabilitated and back to regular work.”
Setting up a non-traditional lite duty program starts with identifying and partnering with non-profit and/or volunteer organizations willing to work with the company. For multi-state companies, partnering with a vendor that specializes in non-traditional lite duty opportunities is an option.
Persuading injured workers to accept non-traditional lite duty positions may require time to explain the process. Some workers, for example, are averse to working with a ‘volunteer’ or ‘non-profit.’
“We explained, ‘I have to offer you this lite duty job. You don’t have to take it, you have free choice. But if you decide not to accept this job offer this could have an impact on your benefits.’ Kind of, ‘it’s our understanding you might not be entitled to further indemnity benefits,’” Peck said. “’I would highly recommend you call your adjuster to have them explain to you how this may or may not impact your work comp benefits.’”
The impact of using a non-traditional lite duty program can be seen in the numbers. Peck said the company with which she was working saw legacy claims improve with a closing ratio of 81 percent to 84 percent; overall reserves decreased, and there were more settlements and closed claims. Nearly half the employees referred to the program achieved full duty work release within 44 days.
“Another interesting component that developed within the process overall is that 7 percent of our employees had a miraculous recovery,” Peck said. “These folks received a lite duty job offer, and as soon as they got the job offer and they did not want to go to work in a non-profit environment they ran, literally, back to their doctor’s office and begged for the full duty work release to be able to go back to their regular job, driving forklift or whatever it was they were normally doing.”