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Programs aid returning employees

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by Sean Kliethermes

SBJ Contributing Writer

An on-the-job injury can be expensive for both employers and employees.

Employers must deal with the loss of a trained worker and the accompanying loss of production and production quality, as well as the expense and paperwork of a prolonged medical claim. The employee must deal with the physical hardships brought about by the injury and the mental stress of inactivity and becoming disassociated with the workplace.

Return-to-work programs can help to alleviate these problems. According to Cora Butler, provider network manager for Missouri Employers Mutual Insurance, a return-to-work program gets injured employees back in the workplace performing useful, transitional functions within the limits of that employee's capabilities until the employee can resume his or her old responsibilities.

Essentially, employers and employees have three options, Butler said. One option is for the employee to return to his or her old position, with some modifications in the job duties to accommodate the injury.

As an example of this type of accommodation, Butler said that simply altering the ergonomics of the employee's workstation, perhaps by installing a different footrest or a different chair, might allow the employee to resume duties within the limitations imposed by the injury.

She said that Americans with Disabilities Act guidelines requiring a reasonable accommodation may apply.

Another option is for the employee to be temporarily moved into another position with essential job duties within the employee's capabilities. For example, Butler suggested that a package-delivery employee whose injury prevented him or her from lifting and delivering heavy packages might be temporarily assigned to a job sorting lighter packages for delivery by someone else.

Another option is for the employer to create a temporary make-work position for the injured employee. Butler cautioned, however, that employers need to ensure that the make-work is still useful to the company and is not demeaning to the worker. Otherwise it could have negative consequences for the mental health of the worker, as well as legal ramifications for the employer.

Butler stressed that the key to successful return-to-work programs is cooperation between the employer, employee and the employee's physician. It is essential for management to listen to the recommendations of the physician for the safety of the worker. In addition, the employer needs to consider the input of the worker when designing transitional duties.

"One of the keys is that the employee still feels like a valued employee," Butler said.

The benefits of initiating such programs are considerable. Besides the financial savings the employer receives, the transition back into the workplace is easier for the injured worker, Butler said.

There may also be a therapeutic benefit for the employee, considering that functional capabilities may be lost during an extended absence from the workplace. In addition, injured employees may begin to see themselves not as workers, but as patients. This increases the difficulty of getting readjusted to the work force and increases the likelihood of future problems, Butler said.

Returning to work on a temporary, structured program makes it easier for the employee to avoid the "extended sick role," she said.

Butler also noted that having an established return-to-work program may discourage workplace fraud. If employees know they will be encouraged to return to work as quickly as possible, they may be less inclined to fake an injury.

Guidelines for setting up a return-to-work program can be formal or informal, depending on the size and structure of the company, Butler said. Small businesses may be largely on their own, but larger corporations might have such programs already established. Managers would be wise to consult with corporate counsel before initiating such a program.

But whatever the business setup, there are some essentials to designing a successful program, Butler said.

First of all, the program must be thought out thoroughly in advance, and it must be progressive; the program must eventually lead to the employee's return to his or her original duties.

The physician must be involved at every step, Butler said. Ideally, the physician should examine the work site to get a feel for the activities going on there. This will be easier if the physician works for the company on a regular basis.

It is also essential that parameters be set for the employee's duties. It must be specified what the employee is to do and for what time period, Butler said. As the employee's capabilities improve, the job parameters must reflect this so the employee can be transitioned back into his or her old duties as soon as it is safe.

It is also essential that the employer stay in touch with the employee and check up on how they are doing, Butler added.

Furthermore, employers should be careful to consider relevant governmental guidelines, including those provided by the ADA, Equal Employment Opportunity Commission and Occupational Safety and Health Administration. In addition, all injured employees must be treated consistently, Butler said.

This partnership between health care provider, employer and employee can ensure that re-injury does not occur and the employee's rights are not violated.

Butler offered the example of an employee who was injured by a saw at a woodworking company near St. Louis. The employee looked around the workplace and suggested that he might be able to conduct a telemarketing survey the company was thinking of undertaking. It worked out well and "the employee took the lead," Butler said.

Although return-to-work programs can make a workplace injury less of a trial for both employers and employees, Butler said that the first consideration of the employer should be to try to prevent injuries in the first place.

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