TRANSITIONAL WORK PROGRAMS

Lowering Workers Compensation Costs

&Improving Return to Work Rates

Marilyn Neuhausel MS, OTR/L, TWDOccupational Therapy Solutions, LLCMay 15, 2012

The Presentation Objective For you to leave with 2-3 concrete ideas that will improve your return to work rates after an injury has occurred.

The Financial Impact of Work Related Injuries

The Average Medical CostPer Lost-Time Claim

2012 Lost Time injuries

BWC sets $45,000 in reserves for each case

Carpel Tunnel Syndrome

Lost Time Average Costs

$7,675.03 $17,544.48

$19,060.09

Indemnity AverageCosts

$4,091.22 $15,797.47

$17,509.73

Total Cost $11,766.25

$33,341.95

$36,569.82

1st Year 3rd Year 5th Year

Based on Private & Public Employer Claims in Open MIRA II Status

Rotator Cuff Tear

Lost Time Average Costs

$ 15,097.70 $26,005.02 $34,381.31

Indemnity AverageCosts

$4,711.81 $19,394.63 $26,548.88

Total Cost $19,809.57 $45,399.65

$60,930.19

1st Year 3rd Year 5th Year

Based on Private & Public Employer Claims in Open MIRA II Status

Degenerative Thoracic or Lumbar Intervertebral Disc Disorder

Lost Time Average Costs

$ 12,467.20

$ 30,395.69

$44,332.25

Indemnity AverageCosts

$ 8,658.43

$24,035.89

$37,062.93

Total Cost $21,125.63

$54,431.58

$ 81,395.18

1st Year 3rd Year 5th Year

Based on Private & Public Employer Claims in Open MIRA II Status

The Old School Approach to

Managing Lost Time Claims The injured worker must

be 100% recovered before returning to work

The Old School Approach: Role of the Physician

The POR controls the length of time off work and the duration & the types of treatment

The Old School Approach : Impact on the Injured Worker

Their isolation from work affects the injured worker’s attitude, their physical condition, and their motivation for return to work

Physicians of Record SurgeonsRehab Specialists

Your MCO The BWCThe Ohio Legislature

Company CultureThe Supervisors The Union

Corporate PhilosophyGeneral Manager

Return to Work

Coordinator

Influences on Return to Work Rates

Destination Excellence: What Employers Will See From

BWC

oLess red tapeoMore consultative assistanceoThe injured worker is back to

work sooneroIncreased accountability

BWC’s Destination Excellence

Focus on Injured WorkersoDecrease in lost workdays

oDecrease in average claim costs

o Shorten the claim tails

oReduce Permanent Total Disability frequency

Transitional Work Bonus ProgramRewards companies that use their TWP (developed between 2001 and 2006) or plan to implement one in 2012. Previous grant recipients must show proof of the transitional work program use/updates

Back end bonus up to 10% off premiums

Must be current on premiums and no lapse >45 days

Private employers must have submitted the bonus application by May 25 , 2012

Public employers must submit the bonus application by October 31, 2012

Transitional Work Program Definition

A workplace program that provides an individualized interim step in the recovery of an injured worker with job restrictions.

Advantages of a

Transitional Work Program

The employer: Direct involvement in work return

The injured worker: At work while performing real job tasks

What if your Current Transitional Work Program is not Effective?

•Submit the application and have the BWC representative determine what needs to change to improve the program

•Confer with your MCO to ensure that all cases are managed well

Transitional Work Program: The Components

The Written Policy Entry, Exit and Extension Guidelines

The Timeframe: 45, 60, 90 days

Roles and ResponsibilitiesThe Essential Forms Methods of evaluation

The Job Analyses

Material handlingNon-material handlingPositional requirementsFrequenciesEnvironmental Exposures

List of Modified Duty Tasks

◦Involve the Supervisors◦Refer to the job analyses◦Sort the tasks according to physical demands

◦Get the union’s buy-in

Training

Build your RTW Team

Initial Treating Provider Field Case Manager

Managed Care Case Specialist

Physician of Record

The Union Rep

Onsite TW Therapist

Clinic Based Therapist

Surgeons & Physiatrists

The Supervisors

Return to Work Services: Enhancing your T W Program

Modified Duty Off-Site Program

Have your MCO arrange to use a non-profit organization for an injured worker who is medically stable, but has restrictions that cannot be accommodated

Usually lasts 90 days or less.

The injured worker is productive, maintains their “worker mentality”, and they heal more quickly.

Combining Modified Duty Off-Site & Transitional

WorkProgress from MDOS to TW as restrictions

are lifted

Divide the shift between TW & MDOS when you don’t have enough work for a full day or when POR has set a GRTW program

Move the IW from TW to MDOS if there is a set back or there is not enough work

Onsite Transitional Work Therapy

Address the Barriers

Use the job tasks to improve function

Must Show Progress

6-8 weeks in Duration

Teach body mechanics and safe work methods

Ergonomic Assessments

Reasonable Accommodations

Increase Productivity

Reduce Hazards

Fitness for Duty Functional Capacity Evaluations

Onsite at the Company or Offsite

Assesses the injured worker’s ability to perform the job tasks

Internet ResourcesJob Accommodation Network www.jan.wvu.edu

BWC Safety and Hygiene Department

www.ohiobwc.com

What if Return to the Same Job at the Same Company is Not Feasible?

Vocational Rehabilitation Options

Same Company/Different Job

Different Company/Same Type of Work

Different Company/Different Type of Work

In ConclusionBy using your transitional work program and RTW rehab services, you will decrease costs and significantly improve return to work rates

Your Questions

Difficult Cases??

Concerns??

Thank YouMarilyn Neuhausel, MS, OTR/L,

TWDOccupational Therapy Solutions,

LLCCell Phone : 419-366-6391E-mail: mneuhausel@aol.com