Dear Dr. X – I really don’t understand the note I received from your office, can the employee come back to work or not? What do you mean he has a five pound lifting restriction – he doesn’t lift anything all day!

This scenario plays out at countless companies on a daily basis, the frustration of getting treating physicians to join the return to work team. The key question for employers, did you explain your return to work goals to the physicians who treat your injured employees? Are we asking physicians to be mind readers? Or are we allowing our employees, who may have their own agenda, to determine their return to work options?

Workers Compensation is a team sport – everyone has to work for the same goal on the same team – unfortunately medical treatment often creates a disconnect between the goal of the employer – return to work; the goal of the employee – stay at home a little bit longer and the goal of the treating doctor – fill out volumes of paperwork so he or she can get paid and keep everyone happy in the process.

It is remarkable to review statistics that compare the length of time an employee is off work due to non-work–related injuries and the length of time they are off work due to a work-related injury. If you compare diagnosis, prognosis and treatment, the work-related disability statistics are significantly higher. If you remove the fact that the injury happened at work, most individuals would recover and resume their regular duties very quickly. Adding the workers’ compensation component creates a sudden extension of symptoms, treatment and a distinct delay in the amount of time required to return to an active lifestyle.

We all know that even when you are on a team, individuals play with their own self interest – this is no different in workers compensation. The significant difference between team sports and workers compensation – someone has to pay when treatment decisions delay the injured workers ability to access appropriate timely medical treatment or when the employer can not get appropriate information to get the injured worker back to work timely.

How do you get everyone to work on your return to work team?

The first step for employers – stop pretending that your goal is not getting the employee back to work as soon as possible – return to work is not a secret! Everyone who works for your company should understand your company’s return to work policy, the minute they start working for your organization. Keep the policy simple – “If you’re injured we will make every attempt to bring you back to work, until you are able to return to your pre-injury position.”

The second step – get the physicians who treat your employees to understand the same message. One of the realizations that most employers fail to acknowledge, they are not in the room when their employees seek medical treatment. Imagine yourself as the injured employee. What would you tell the doctor that would keep you off work? If you do not provide the treating doctor with adequate information to evaluate the employees ability to return to work – you’re giving the doctor a crystal ball, then complaining when he doesn’t see the same vision you do.

The third step – having a pre-determined injury management strategy that is consistent, cohesive and tactical. Everything starts on the ground floor; do your employees understand their role in the return to work process? Do you have a policy that you can follow every time an employee is injured? Or are you willing to cast blame on the treating doctor for your failure to plan for the inevitable injury that will occur at your company. Effective return to work programs start the day you hire your first employee not the day the file the Notice of Injury.

Forth step – understand your job site. If you don’t have clear job descriptions it is not the doctors’ fault that you don’t know what the employee did before the accident. Frankly, there is no excuse for not knowing the job demands and communicating that information to the treating physician. The job description dispels any myths or misinterpretations about the job requirements. A very specific job description is an essential part of the return to work process.

Every employee who sustains an injury with your company should take a copy of their pre-injury job description to the initial appointment. If the employee is referred to a specialist, a copy of the job description should be sent to that doctor. Provide an area on the Job Description Form that asks the doctor to confirm receipt and asks him or her to address the likelihood of the employee returning to this position immediately. If the employee can not return to the position immediately ask the treating physician to give you an estimated return date.  

Fifth Step – document and consistent follow through. Return to work should not be left up to your insurance carrier; it is the employers’ responsibility to make sure the employee returns to work or stays at work after the injury – not the adjuster, treating doctor or ancillary provider – it your job to make sure it happens. Use the restrictions given by treating physicians to as a tool to find the employee a job – focus on what the employee can do versus what the limitations are. Let’s not forget one other thing – human resources. Workers compensation does not mean employment rules go out the window your lack of HR polices is not the physicians fault. Follow through means that you get all the stakeholders on your return to work team to read the same playbook.

Finally, we have to stop accepting poor performance and rewarding the behavior with money. If you go into a department store and you get bad service, do you keep shopping there? Workers compensation is the only consumer based process that accepts mediocre service and rewards that type of service with a constant stream of business. What do I mean? For many years I worked as an adjuster and during those years I encountered numerous physicians who did not cooperate with my request for medical treatment status, refused to return my phone calls and admonish me to get the work status from the dictation attached to the bill. These physicians continued to stay on the approved provider list and year after year we sent them more patients or allowed the employee to select them, without doing anything to correct the disruptive relationship. Why did we do this? I guess we expected a different result – no we need to complain.

Employers have a responsibility to insure that their employees receive adequate timely medical treatment. Timely, is the key word – waiting weeks for treatment authorization can delay or eliminate the return to work options. Employers also have an expectation that treating physicians will make every attempt to work with the employer to safety bring the employee back to work.

Physicians we recognize that when you went to medical school they did not prepare you to handle the nuances of the workers compensation system, with a little effort we will educate you on the process, because we have to collectively work towards the same goal – getting the injured employees back to work successfully.

Clearly we have a lot of work to do to make this relationship productive.  Everyone has a vested interest in making sure injured employees receive exceptional medical treatment – that results in their rehabilitation from the injury and their speedy return to gainful productive employment. Treating physicians are the most important factor in the return to work process. The relationship that you develop with your authorized treating doctors will often determine if your employees return to work or remain off work. We have to make every effort to create a team that works towards the same goal.

National Return to Work Week Five Day Virtual Conference will bring together employers, employees, physicians, vocational experts, insurance, legal professionals and disability providers from around the country to share expertise, best practices and exchange information to increase return to work opportunities for ill, injured and disabled employees.

Conference topics include:

l        “Disability Management a Daunting Task” – Dennis Chandler – Company Nurse

l        The Flip Side – Does Attorney Representation Short Circuit the Return to Work Process – Attorney Michael Moebes, Esq.

l        Disability Management is a Team Sport – Who’s on Your Team? – Margaret Spence, CWC, RMPE

l        Physician Where Art Thou? – Dr. James Blumenthal, Physicians Health Centers

l        Creating a Positive Return to Work Experience – Job Accommodation Network (JAN)

l        Advocating for the Injured Worker – Carolyn Arumbula, Center for Injured Workers

l        Engaging Employees Who Have Disabilities – John Althoff – Assurant

The National Return to Work Week Virtual Conference is Free and can be accessed via www.nationalreturntoworkweek.org or directly on the BrightTALK network. Join us on May 11, 2009 for the 1st Annual National Return to Work Week Conference on the BrightTALK Network

About National Return to Work Week – This week highlights the impact of not implementing proactive stay-at-work or return to work programs for ill, injured or disabled employees. It is a full week of educational and best practices presentations aimed at bringing disability management to the forefront of the national employment retention discussion. National Return to Work will be celebrated annually during the second week of May. Visit our website: www.nationalreturntoworkweek.org for more information and to get involved.

Join my Free Weekly Webcast on Brighttalk – Tuesday’s 2:30 p.m. to 3:00 p.m. Eastern time.

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Let’s evaluate a typical hire for most companies:

There is an open position so you place an advertisement in the newspaper or online. Multiple resumes come in, you narrow your search to ten people, however only three people show up for the actual job interview. Of the three, you decide to hire Jack. After completing the background and reference checks, Jack is told to show up at 8:00 A.M. Monday morning and report to the HR Department to complete his paperwork.

Monday morning, here is the exchange that takes place:

“Hi, Jack. Welcome to the company. Fill out your paperwork, sit in the break room and watch the safety video and I will take you to work with Charlie, our senior employee. You will watch how Charlie does the job for two or three days, then you’re on your own. We are here if you have any questions. At XYZ Company, we have an open door policy.”

With this scenario, you are hoping that Charlie, your superstar employee, will pass down all of the requirements for the job. In reality, Charlie is frustrated because he has to train all of the new employees without any recognition, pay increase or bonus of any kind, and he passes down his bad habits, his frustrations and what I like to call his accumulated employee baggage to Jack. Before Jack has a chance to get his feet wet, he is already forming a negative opinion of your company. Before long, you are totally surprised because Jack is injured and out on workers’ compensation.

According to the Bureau of Labor Statistics, 13 percent of all injuries occur within ninety days of hire, 23 percent occur within the first four hours on the job!  These statistics highlight the one ingredient that is often missing for most employers – effective workplace training programs. Employers fail to understand that passing the torch is not training.

Employers often hire based on an unrealistic idea that all they need is a warm body in a position because “anyone” can be trained to do the job. This is the first mistake on the road to a workers’ compensation claim. It is essential that each job fit the worker and that each worker fit his or her job. What does this mean?

Employees must understand the specifics of each task you are asking them to do. Along with the specifics, they should be provided with appropriate safety training and the safety rules that apply to their job and their work areas. Employers, who have successful injury prevention programs, create a training matrix that outline the minimum safety training required for all positions. They use the matrix to implement training programs that are uniform, consistent and job specific. New employees immediately understand the importance of working safely and they understand the safety exposures within their work areas. 

In addition, employers with effective injury prevention programs spend the time to write detailed job descriptions, after they evaluate the essential and marginal functions for each job within their organization. They also take this process one step further and present the job description to the employee during the interview process.

Remember you are evaluating the candidate to determine if they meet the requirements for the job. During the interview you should ask specific questions based on the job description to make sure the candidate understands the job requirements. This process also allows the candidate to evaluate your company just as you are evaluating the potential employee. In today’s labor market, candidates want to know what you are expecting from them so they can make an educated decision before they accept your job offer.   

After presenting the job duties and selecting the candidate, it is your job to use the probationary, or introductory, period to train and evaluate the employee. This period is called the “introductory” period for a reason. Introduce the new employee to your work environment, job concepts and evaluate their performance, then determine if they are the right fit for the position.

As the employer, either you did not provide enough training and oversight to the employee or you hired the wrong employee to do the job or you kept the wrong employee too long. Most workers’ compensation claims can be traced to one of these HR decisions.

Employers must recognize that bad hiring decisions and improper training programs can increase the likelihood that an employee will be injured. Spend the money to train your employees correctly—from the beginning. If you evaluate the overall cost of one workers’ compensation claim—including: the loss of manpower, the administrative cost to manage an injured employee, the workers’ compensation premium cost and the overtime to cover jobs that would have been done by the injured worker—you will see the cost benefits of integrating an effective safety training program into your workplace.

Understanding the specifics of each task you are asking your employees to do is essential to preventing injuries. Training your employees, mandating that they follow appropriate safety procedures and providing ongoing educational opportunities is the key components of an effective injury prevention program.