ODG Helpdesk Tip: Three Steps to Help Optimize Return to Work (RTW)
August 18, 2021 | Categories: ODG by MCG
Quite often, stakeholders managing various aspects of workers’ compensation claims spend countless hours each day trying to do what is best for injured workers. However, knowing what is best can be elusive. Typically, claim managers focus on:
- Ensuring state government forms are filed in a timely manner
- Making three-point contacts and related calls as scheduled
- Analyzing claims compliance metrics
While these elements are important, they do not necessarily constitute the goals that measure a successful outcome for the claimant. Even when all of the above are completed perfectly, there could still be a poor outcome. In fact, numerous studies report early return-to-work (RTW) as a key indicator for good outcomes, while prolonged disability durations can have significant consequences to injured workers, including loss of productivity and quality of life. Some studies indicate the likelihood of RTW for an injured worker out more than twelve weeks is less than 50%, and this drops to almost no probability of returning to work in any capacity if out more than 12 months. With that said, ODG by MCG experts developed a simple three-step process for improving RTW that – if implemented appropriately – can help improve overall RTW durations.
Step 1: Set clear goals. A solid return plan always starts with setting expectations. This helps set a target for all to work towards as well as identify potential obstacles before they become major barriers. Without setting expectations there is no shared goal, nothing to align with, and no target to hit. Imagine playing a game and there being no instructions explaining the goals of the game or defining who the winner is. Do you just play until you get bored, who is the winner, and when do you know they won? Research shows that when there is a clear timeframe provided early in the claim, the actual RTW duration is consistently within this expected timeframe.
Step 2: Define what the claimant does for work. It is impossible to get someone back to work if you are not sure what they do in their job role. Knowing the claimant’s essential job functions, the nature of the injury, and how these pieces correlate will help create an effective RTW strategy. For example, for a claimant with an injured left ankle who sits at a desk and answers phones all day, there is a much greater opportunity to get them back to work sooner as opposed to the claimant working in a position that requires the operation of a foot pedal or prolonged standing or walking. The most effective way to ensure all stakeholders can make informed decisions regarding safe return to work options is to have an updated functional job description. These go beyond traditional job descriptions, even those that may provide some basic physical requirements, such as needing to lift up to 50 lbs. Instead, functional job descriptions offer a summary of key movements, essential physical requirements, and core functions of a job. When determining if a claimant with a low back injury who works at a factory and lifts bags of cement all day is able to return to work, it is important to know the claimant actually sits at a control panel, is required to monitor a robotic arm that does the actual lifting, and in fact, the claimant sits 6-8 hours a day, lifts no more than 10 lbs, and does no bending, crawling, or climbing.
Step 3: Collaborating and putting your strategy into action. The best strategy in the world is rendered useless if we do not actually put it into action. There are many stakeholders involved in a claim and ensuring each is aware and participating in the RTW plan is critical to success. By taking the key elements noted above, including the target RTW timeframe, the functional job description, and any related information and providing this to the treating provider, you are providing information that empowers the care provider to make a clinically informed decision. Even when the provider may not agree fully with the timeframe, there is still important information being conveyed, and when you are aware of the likelihood the claimant will not be able to RTW by the goal, you can update your strategy and proceed accordingly. This encourages a proactive approach to advocating for the claimant, as opposed to a reactive approach, and simply trying to put out a fire.
– Jamie LaPaglia, RN, CCM, ODG Manager of Implementation and Clinical Education
Image courtesy Shutterstock/Anothai Thiansawang
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