Rehabilitation Perspective

Author: | Tuesday June 20, 2006

Dr. Bruce Growick has extensive experience in rehabilitation of injured workers.

Rehabilitation Perspective

Employer-Based Rehab: The Wave of the Future!

By Bruce S. Growick, Ph.D
Because of the rising costs associated with workers’ compensation (WC) and the enactment of the Americans with Disabilities Act (ADA), employers now more than ever are taking control of their disability-related policies and costs. One of the best ways of accomplishing this task is to establish a company-based early return to work program (ERTW). An ERTW program will not only reduce WC costs, but also help you to comply with the ADA.

The following multiple part series will outline what an ERTW program is and why it is important; the steps in establishing a disability management team for an ERTW program; writing a policy and procedure manual for an ERTW; and start-up and implementation of an ERTW.

What is an ERTW and Why it is important
Although some aspects of an ERTW may vary from company to company, there are many basic premises that are common to all programs. The most important of which are time and conciliation.

In WC time is your enemy; the longer an employee is off-work, the more costly it is. Medical and lost-time costs continue to increase. Research has shown a significant relationship between time off-work and cost of a claim. The sooner you can intervene in a case, the better. And the best way to intervene is through an ERTW program.

An ERTW program provides an avenue for quick, in-house recovery for injured workers who might otherwise stay at home, or receive sporadic medical treatment.

An employer-based ERTW program provides options for injured employees while they are recovering. Employees are not disenfranchised from the worksite, and unnecessarily caught up in a morass of medical treatment. Modified work duties are provided to injured workers whose medical condition has stabilized while they are recuperating.

They continue to receive a salary with benefits, which in most all cases is more attractive than comp. But, more importantly, they continue to be connected to the worksite. Recovery time is inevitably reduced, and employer WC costs are less.

Moreover, a process for facilitating the return-to-work process is clearly defined. Most, if not all, “good” employees when provided with the opportunity to return gradually to the worksite will embrace it. A clear reduction in disagreements and adversarial claims are realized.

Injured employees have less reason to secure the assistance of an attorney when employers have provided a positive mechanism for early return to work. In the long run, not only are indemnity and medical costs less for employers with an ERTW program, but also are litigation costs. Fewer cases involve attorneys, and time and energy are appropriately placed in speedy recovery rather than litigation.

Of course both the company and the union (if there is one) need to be fully committed to the basic concepts of an ERTW program. The specifics of such a program need to be developed jointly, specified in the company personnel handbook, and codified in the management-labor contract. In this way, all parties know what is expected by whom, when and where.

Like all “terms of employment”, the corporate use of an ERTW program needs to be specified so that there are no misunderstandings or false expectations.

This is especially true when the ERTW process is also used to negotiate a reasonable accommodation under the ADA. With an ERTW process in place, a “good faith effort” by the employer can be clearly demonstrated and used in subsequent litigation defense if necessary.

Interestingly, the majority of discrimination claims under the ADA have been for injured workers who feel that their employer has not reasonably accommodated them.

A well-established and negotiated ERTW program can easily defuse any potential ADA claim by documenting what has been done to try to accommodate injured employees who cannot return to their same job. As with most employment litigation, justifiable intent coupled good documentation will prevail.

The particulars of an ERTW program are rather straightforward: it is a process by which injured employees who are medically stable can return to some modified work duty.

Unfortunately though, too many companies do not allow their employees to return to work until they are fully recovered. What is commonly known as the “all or nothing” rule in personnel handbooks. It means that employees cannot return to work until they are 100%, and can return to their pre-injury job. Realistically though, very few of us ever recovery so quickly from a major work related injury.

Recuperating at work while performing some meaningful activity related to the mission of the company is better and cheaper than staying at home. Remember, with WC, time off work is not only very costly, but it also discourages early return to work.

Some companies that are large enough even establish separate jobs and positions which constitute the ERTW program. If you have a product or process that you’ve been spending a lot of money out-sourcing, you can bring that endeavor in-house and set-up a separate transitional work center (TWC). This TWC can provide an additional incentive to developing an ERTW program by saving more money from the bottom-line. Otherwise, the modified duties of an ERTW can be distributed throughout the company wherever an extra pair of hands are needed.

The positions which make-up the ERTW are never full-time, permanent positions, or beyond the functional capabilities of the employees. They are only developed for the sole purpose of helping injured employees back to work sooner, and saving the employer money.

To establish an ERTW program, a corporate disability management team needs to be created that is empowered with the responsibility of developing it. In some cases, an outside consultant is necessary because of existing contentious relationships between management and labor, and because there are many inherent pitfalls and barriers to successful implementation. However, there are several generic steps that should be followed if employers are indeed interested in saving both money and good employees. These steps will be outlined in the next part of the series.

Ed. Note: Dr. Bruce Growick is an Associate Professor of Rehabilitation Services at The Ohio State University. He has published widely in the field of rehabilitation, especially in the area of rehabilitating injured workers. He is a Past President of the International Association of Rehabilitation Professionals (IARP). He is currently a vocational expert for various federal and state agencies, including local courts. For additional information, contact Dr. Bruce Growick, Ohio State University, 1945 North High Street, Columbus, Ohio 43210, (614) 292-8463, growick.1@osu.edu.