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1997Workers' Compensation TRANSITIONAL DUTY PROGRAM a Return - To - Work Strategy p R M A A service program of the Public Employer Risk Management Association, Inc. Albany, New York I May 2, 1997 This publication is intended for general information purposes only and is not intended to provide legal advice. If you have questions about particular legal issues or about the application of the law to specific factual situations, pER�VL4 strongly recommends that you consult your attorney. .0 Transitional Duty Program Table of Contents Overview - What's it all about?......................................................................... I. Introduction - What is Transitional Duty? ............................................. II. Value of a Return -to -Work Strategy....................................................... III. Historical Perspective - What's happened before! ................................... IV. Communication Tools - Who is involved? ............................................. V. Position Descriptions - What skills does the job require? ........................ VI. Implementation - Fitting the pieces together! ......................................... VII. Training - How do we know what to do? .............................................. VIII. Conclusion - Wrapping it up!................................................................ Appendix A Sample Policy Statement Appendix B Sample Transitional Duty Assignments Appendix C Sample Transitional Duty Procedure Appendix D Transitional Duty Quick -Reference Appendix E Resource Information 11 1 1 , 4 6 7 9 10 A-1 B-1 C-1 D-1 E-1 4 OVERVIEW - What's it all about? This booklet provides information about Transitional Duty return - to - work programs. These programs, an important part of workers' compensation disability management, offer the opportunity for significant savings in workers' compensation claims costs. The modest costs of a Transitional Duty program generally are offset by claims costs savings alone. With the information provided in this booklet senior management of a municipality or local public entity can establish a Transitional Duty program. The necessary steps to establish an effective program and the benefits, from both a human resource and financial perspective, are identified. Of course, the decision to implement the program rests solely with senior management. Only with the continued support of senior management will the' program succeed. Keep in mind that implementation of an effective Transitional Duty program can earn significant points towardsyour PER. A safety discount during the annual Loss Control Program Evaluation process. The Transitional Duty strategv described in this booklet uses a team of in-house personnel and outside consultants. The consultants include PERNIACARE Nurse Patient advocates, Claims Case Analysts and Loss Control Representatives. In-house personnel may include members of the safety and health committee, the safety coordinator, the risk manager, human resources personnel. department supervisors. and the municipal claims administrators. PERMA will provide the nurse/patient advocacy service. medical provider assistance, case management, utilization review, and the overall assistance to your organization for implementation of the Transitional Duty program. I. INTRODUCTION - What is Transitional Duty? A Transitional Duty program is a return -to -work program designed to return the injured employee to the workplace as soon as medically reasonable to do so. The program objective is to transition the employee back to his or her regular job and responsibilities. This reduces the amount of time the employee is out of work and, thus, workers' compensation costs. These programs are not intended to force employees back on the job before they have recovered from the injury or have completed necessary rehabilitation programs. A Transitional Duty program is designed to break the standard employee disability cycle by rehabilitating and returning the injured employee to productive work in the shortest possible time. Obviously, the nature of some injuries precludes the employee's return to active work. Many Transitional Duty programs include a component to identify- such employees and to target those cases for early settlement and closure. II. VALUE OF A RETURN -TO -WORK STRATEGY There are several reasons for implementing Transitional Duty programs into your workplace: • Reduction of Workers' Compensation indemnity costs by decreasing the length of the disability. (Transitional Ditty is employment, so its wages are not charged as workers' compensation indemnity. Thus, Experience iifodification can be favorably affected). • Reduction of Workers' Compensation medical costs. • Compliance with the Requirements of the Americans with Disabilities Act (ADA). • Employee productivity is enhanced while injured employees are recovering from their disabilities. • Accelerated reintegration of the injured employees into a full performance mode. • An enhanced ability to achieve quality and productivity goals. G Improvement in employee morale. Employees, while receiving continuous medical rehabilitation, feel positive about their contributions at work, even with limited capacity. Workplace injuries and the costs associated with them, including worker's compensation, amount to a serious problem for municipalities and local public agencies of all sizes. The employer does have some opportunity to control costs when it comes to the length of time an employee is out on temporary disability. Employer promoted Transitional Duty programs, which if incorporated into policy and practice, have been proven successful in reducing loss cost. Ideally, when a Transitional Duty program is implemented. the process intervenes in the employee disability cycle and returns (transitions) the employee to productive work in the shortest possible time. A well integrated Transitional Duty program can shorten disability time and reduce related time and related costs significantly. By restoring an injured worker more quickly to full productivity, successful programs have reduced total workers' compensation indemnity costs 20 to 40% and reduced medical and rehabilitation costs as well. • A reduction in medical costs can be achieved by implementing a Transitional Duty program in concert with a Safety and Health Committee. While the Americans with Disabilities Act (ADA) was enacted to prevent disability - based discrimination, it has hail profound impact on workers' compensation and workplace issues. As of the summer of 1995, the Equal Employment Opportunity Commission had a backlog of over 100.000 ADA cases. The highest portion of this growing avalanche of ADA claims is based upon current employees and return -to - work issues, not traditional disability issues or new hires. The ADA has forced employers to get their houses in order, not through checklist compliance, but culturally, through the use of proven integrated disability management strategies. (Thus, it would also be beneficial to address off -the -job injuries in your Transitional Duty program.) Although a recovering employee may not be able to perform al the tasks of his/her pre -injury job, the employee who returns to work before total recovery from all injuries may be able to perform a significant portion of the function of the job. This situation is obviously an improvement over either not having any tasks performed, having to hire a temporary worker. or scheduling high-cost overtime to other staff members to perform the necessary functions. y Organizations using Transitional Duty programs have kept recovering employees productive, avoiding the "disability" mental attitude that often keeps employees from ever fully recovering from their injuries. The program's emphasis on communication with the injured employee helps that person to realize that it's important to be at work -duty assignment. It also will provide co-workers with a every day, even if only on a light positive message about the value of individual workers to the municipality. III. HISTORICAL PERSPECTIVE - What's happened before? Reduction of severity is a primary goal of a Transitional Duty program. The majority of injuries suffered by municipal employees are not serious or life threatening. When an injury occurs, the employee is sent by management to the designated initial medical care provider (or, the employee's own provider choice). The doctor determines the extent of injuries, treats the problem, and writes a release. If the injury is not serious enough for the doctor to recommend home rest, the doctor may write a partial release, specifying the limitation under which the employee can return to work. Without any guidelines from the employer, the doctor is dependent on the injured worker's explanation of tasks available in the workplace. Then the employee goes back to the workplace to submit the release to a supe^d!sor. Many previous municipal policies may have stated that the employee was not allowed to work unless he or she had a full release from the doctor. Although there was an informal effort to bring injured employees back to work on a modified basis, managers and supervisors tended to follow the established policy as a safe course of action. This policy, however, may have lead to abuse. Injured employees told the doctors that there was no modified work available, and they would have to return to their original job that would require then to lift 100 pound items. Thus, with no formal communication between the doctor and management, and no transitional duty job descriptions, the employee usually was allowed to stay home and collect disability. In many cases, the longer employees were on disability, the less likely they were to return to work at all. Published studies indicate that after six month, only 5 percent of injured employees return to work. Additionally. many municipal employers pay salary continuation, or 100% of normal payroll, when a person is injured on the job, Therefore, there was little incentive to recover quickly and return to work. • Insurance industry standards indicate that only 5% - 10% of claims filed are fraudulent when first filed, but the incidence of fraud jumps 50% when malingering is considered. • The idea that the system can be abused as such can spread fast among employees. If an employee wants to abuse the system, he/she can net the same or more income on temporary disability as they can by working. This system was also responsible for some employees telling their doctors that their employer did not have any transitional duty work they could do and, therefore, they should stay home on temporary disability. The employer was paying the employee and receiving nothing in return, causing a significant drain on municipal assets and productivity. IV. COMMUNICATION TOOLS - Who is involved? A. Reporting Claims Immediate reporting of employee injuries to PER:v1A is essential for an effective program and cost containment If the employee requires medical care and/or will not be returning to work on the nest scheduled shift, fax a completed copy of the Quick - Fax Report to PERYL4 at (518) 458-7811. Section "c" will provide basic information for Transitional Work assignment review by the PER -NIA Patient Advocate!!- arse. Prompt reporting allows PER -MA to properly document Files, mase required reports and conduct anv necessary investigations and follow-up. PERSIA statistics have proven that early immediate reporting has decreased the costs of claims by as much as 40% due to early intervention by our Nursing staff. Reporting among team members must be prompt also. Each member of the Transitional Work Team has a specific responsibility, and all must be informed in order to return the employee to maximum productivity. Prompt action must be taken on the following: • A medical determination of the employee's capabilities and restrictions. • Arrangements by the supervisor for work site accommodations consistent with the medical prognosis to facilitate a return -to -work. • Monitoring the employee's condition by PERRNIACARE staff and medical care providers to allow gradual increases in physical capacity (physical demand) until the employee is back at his/her regular job or placed in an alternative position. • Documentation of all activities by PERNIACARE staff of both the employee and the employer in the event of controversy. 9 B. Communication with the Physician Coordination and communication with the employee's treating physician is a key element in the effectiveness of a Transitional Duty program. The medical care provider plays the dominant role in determining the employee's medical condition, capacity to perform work, and the restrictions to be observed. Physicians are required to provide the employer and PERMACARE with a written post -injury report stating the employee's work restrictions. This report allows the employer and PER:VIA to take the necessary action to modify the employee's duties to comply with the restrictions. Close communication between the employer and medical care providers is equally important. Job descriptions should not be left to employees to orally describe - - - employees may tend to overstate their job. The exact nature of the job can be communicated to the physician with a detailed, but not too lengthy. position description. In more severe injuries. videos or visits to the job site by the physician. (and communication with PER ACARE representatives. and PERSIA Loss Control staff) can improve the physician's knowledge of the employee's original position with any proposed alternative job. A Vocational Specialist can also provide a Vocational Assessment of the transitional as well as full time assignments. As the employee's condition progresses through the healing process and the employee continues with medical treatment, communications must be continuing and concise. This will allow appropriate changes in the Transitignal Duty assignment(s) until the employee is back to regular duties. Any question on medical restrictions must be resolved through immediate communication between the municipal injury coordinator, supervisor, nurse patient advocate, and physician. C. Communications with PERINIA PERvIACARE representatives must be fully informed of the injured employee's job requirements and restrictions. In less serious injury claims. the employer should be able to return the employee to work in an ordinary manner. More serious injuries will require greater involvement by PER-NIACARE representatives. Injuries that involve home or hospital confinement, referrals to specialists, or other complications, require closer communications between PERNIA and the employer. The claim representative or nurse patient advocate will be in touch with the medical care provider to learn the earliest possible date the employee can return to modified or transitional duty work. The Transitional Duty team will coordinate the job modification process. Team members will monitor treatment, therapy, or work -hardening in order to prepare the employee to return to work, or to continue working. Loss Control and claim personnel will be available to provide any necessary assistance. 10 In all cases and all phases of the program, PERIMA and the employer Transitional Duty team members must be kept fully aware of developments and the employee's progress toward full recovery. D. Communications with the Employee For the program to be successful, employees must be fully informed of the management's concern for their welfare before an injury evens occurs. They should understand that as a part of their employee benefits, a Transitional Duty program is in place. Employees should be provided with instructions and brochures that indicate: • How to immediately report an injury • How to get appropriate medical treatment • The employer's program to provide the employee with transitional or modified work in order to quickly return him/her to a productive capacity. • The employee's responsibility to cooperate in the recovery process and return to work. • Transitional duty will be limited to the time for which it is medically necessarv. In actual disability cases, communication between the employee and the employer should be documented. Periodic meetings between the disabled employee and the members of the team should be held to review the employee's progress and to resolve any difficulties that arise. With close communications between the employee and the employer, all parties will know what is expected of them to make the program work properly. V. POSITION DESCRIPTIONS- What skills does the job require? Perhaps the most important element in implementing a Transitional Duty Program is the creation of a "job analysis" which provides a position description and task assessment for each employee. All jobs should be evaluated for component tasks and broken down further by other various details such as weights lifted or moved, range of motion, environmental conditions, or ergonomic positions required. The Quick -Fax Report Functional Capacities Form can assist in this process. Listed for each position, are tasks -that are done in ffiekplace under normal circumstances. Niany of these tasks could be performed by even someone who has been severely injured. None of the tasks are "make-work", which eliminates the potential criticism that Transitional Duty is less productive. From the job analysis, various Transitional Duty positions or task groups can be developed to accommodate the employees needs, making this a flexible system in which the task groupings are building component of the Transitional Job. As the employee recuperates, his or her job can be restructured and gradually made more challenging until the employee is fully recovered and has Transitioned back to the full job responsibilities. Detailed job descriptions and associated analyses should be written and contained in manuals or training documents. (Assistance in developing these descriptions can be obtained by consulting the U.S. Department of Labor specifications, published in the Classiftcation of Jobs :Wanual Dictionary of Occupational Titles. This material can be supplemented with photographs and/or video tapes of the workplace and of the employees performing these transitional tasks. These job analysis documents can be useful tools for training. placement of future injured employees; assistance to the Transitional Duty Team (of medical care provider, specialist physicians, claims analysts. and nurse -patient advocates) and for compliance with requirements of the Americans with Disabilities Act (ADA). VI. IMPLEMENTATION - Fitting the pieces to tether An effective Transitional Duty Program requires a set of policies and procedures hat facilitate post -injury management of the injured employee during every step of rehabilitation. It require excellent communications. cooperation, and coordination between the employee, management, PER - MA and medical care providers. The following steps are required for implementation of a Transitional Duty Program: • Develop and issue a policy statement. There must be a commitment to the Transitional Duty Program at all levels of your management, even individual supervisors, who are key individuals in work assignment. To facilitate the delegation of authority, senior management should issue a statement of policy. Since policy statements can only motivate so far, all levels f management must support the program through demonstration on a continuous basis. (A sample policy statement has been provided in Appendix A). 1? The policy should emphasize'Me program is administered on a case-by-case basis, is for temporary assignment, and must establish specific maximum timeframes (Usually, twelve weeks is suggested). • Appoint a coordinator to explain the program to management and to get a commitment to change policy. if necessary. This coordinator should interact with PERNIA representatives as needed. The coordinator should review the program with all departments and management, and should be part of the Transitional Duty Team. • Record every task the management thinks could be done by an injured employee and incorporate those into the job analysis. Solicit priority tasks that the department managers want done, but never seem to address. Emphasize the program's design to benefit the department managers. Obviously, a "buy -in" by management is critical to success. (Appendix B has sample transitional dutv tasks for various positions). • Create transitional job and task description manuals. Include step-by-step procedures for managers and supervisors to follow when an employee is injured. Create accurate job descriptions! A thorough job description should identifti- all requirements of a position. including specific skills, education, experience and phvsical demands. The information can come from records. observations, and interviews with managers. and the employees who perform the tasks. The job description can help determine if the injured employee is able to return to the same job and can guide placement in other positions, when necessary. • Conduct a task assessment. Evaluate all specific elements of a given job, including workstation design and job functions. Problem jobs can be identified, along with opportunities for job redesign and alternate or transitional work responsibilities. The task assessment allows job requirements to be matched with physical capabilities. A written summary is useful to give to the treating physician for help in determining work readiness and work restriction. • Allow department managers to meet with the doctors supplying workers* compensation medical services. Perhaps give the doctors a tour of your workplace so they become better acquainted with the environment. • Develop a communication plan. Transitional work requires a communications strategy. When the employee is out of work the PERSIA Nurse Patient Advocate will contact the injured employee within 24 hours of the injury to check on the emplovee's condition, the extent of injury, and when he or she can return . This is time to express genuine concern. In on-going cases, the PERNIA Nurse Patient Advocate and/or the manager/ supervisor can make periodic calls. A caller should be sensitive to each employee's situation. 13 Prepare a procedure that details the steps that will be taken after an accident occurs. Having a plan prepared in advance assists all members of the transitional duty team by identifying their duties and responsibilities should the need arise. (A sample procedure has been provided in Appendix C.) The claim representative also has an important role to play in this process and should be alerted to injuries that involve home or hospital confinement, referrals to specialists, or to other complications that require attention. The nurse patient advocate will stay in touch -- with the medical caregiver to determine the earliest possible date the employee can return to transitional duty - - and will work with members of the team to coordinate. In some cases, the injured employee may benefit from occupational rehabilitation to strengthen or retrain the individual for return to work. A manual laborer who injures his or her back, for example, may be able to return to the job if he or she learns new lifting and materials -handling techniques. Practicing those techniques will ingrain them and will build up strength. Once back on the job, the injured employee and the supervisor need to work together to increase the e ^ Foye. s c._pabilities o pre -in, sry leve s. O..- communication with the transitional duty team members is essen�-[ until the ems' )ye-, reaches the best possible outcome for his or her case. VII. TRAINING - How do we know what to do? The following training outline by assigned roles assumes that the Transitional Duty Program is new to the participants. If there is prior experience by the participants in similar programs, less training may be appropriate. Senior management should assess the training needs. These activities should be documented by human resources. A. Employees 1. New hires should be provided with an orientation discussing the following items: a. Introduction to the Transitional Duty Program. b. Training aides, videos or photographs of sample Transitional Duty Tasks. c. Discussions or meetings with previously injured employees who have successfully used the program. d. Review of the process, and the team involved. e. Question and answer session with management and human resources representative. 2. Periodic refresher training discussing the following: a. Regular updates or items of interest from the Transitional Duty Team. 14 b. Publication of success stories. c. Information on wellness programs available through the municipality or available through other area service organizations. 3. Injured employees should be provided with the following: a. Medical care guidance. Brochures available from PERMA outlining the post- injury recovery process. b. Review of the Team members who will be contacting the injured person. c. Post trauma training (in conjunction with the medical care provider). d. New tasks/transitional task training. e. Training with regard to changes in regular job functions. B. Supervisors and'Managers 1. Transitional Duty purpose and process. 2. Transitional/modified task identification. VIII. CONCLUSION - Wrapping it up! By following the information and using the sample materials provided in this booklet. a municipality can establish and implement a successful Transitional Duty Program. After implementation of the program. the benefits of increased productivity and lower workers* compensation insurance costs will accrue to the emplover. The savings can be identified easily. and directed back to other areas of municipal needs. 15 APPENDIX A SAMPLE POLICY STATEMENT Transitional Duty Program 16 Sample TRANSITIONAL DUTY PROGRAM POLICY STATEMENT In the effort to create an environment that will facilitate employee recovery from injury or illness, and to improve operational efficiency of the Municipality, a program of Transitional Duty is hereby established. On a case-by-case basis, this program covers all Municipal personnel who sustain a work related disabling injury subject to the following guidelines: the disability must be a temporary condition, and the employee must have Transitional Duty capacity as determined by his/her treating physician. Such employee may be given a Transitional Duty assignment(s) consistent with his;her physical abilities and any limitations imposed by the treating physician. Each case will be independently evaluated by the Transitional Duty Team at least every thirty days for progress. The Transitional Duty Assignment will not last more than twelve weeks. This program may also apply voluntarily, on a case-by-case basis, to employees who have sustained disabling injury or illness from non job related activity, if and when Transitional Duty tasks become available; with work-related injuries receiving priority if transitional duty work is limited. It is the goal of the Municipality, with the cooperation of all departments, to locate and assign Transitional Duty, when feasible, according to the following guidelines: 1. The approved physician shall be encouraged to release temporarily disabled employees to a transitional duty work status and describe the employee's capacities in sufficient detail to enable the municipality to determine a suitable work or task assignment. 3. The employee's regular work division shall attempt to locate or design a wort: assignment within the capacities described by the physician. 3. If the usual work division is unable to assign suitable work, other divisions within the department shall be contacted to determine if a suitable work assignment exists. 4. If no suitable temporary assignment is available within the department, the Chief Administrator shall be contacted in order to consider other alternatives. The Chief Administrator will attempt, when feasible, to coordinate and effect a temporary re -assignment of the employee on an inter -department basis. The department of which the employee is regularly assigned will continue to provide regular wages. 5. Upon release to regular work without restrictions, the employee shall be returned to his/her permanent work unit and his,her regular position. 17 APPENDIX B SAMPLE TRANSITIONAL DUTY ASSIGNMENTS Transitional Ditty Program SAMPLE TRANSITIONAL DUTY ASSIGNMENTS 18 PUBLIC WORKS EJTPL0YEES: Inventory tool, equipment and parts Inventory street and traffic signs Perform clerical duties Answer telephones, dispatch messages Perform custodial duties at the garage Run errands, deliveries, mail runs Supervise part time or temporary workers Supervise community service people Attend safety training programs Present safety programs, talks Repair water meters Inspect roads, streets, culverts, sidewalks Pothole inspection and reports Inspect road signs, signals CUSTODIAL/aVLAIV TEi'V,41YCE WORKERS: Sweep, wash floors Vacuum rugs Install shades Empty wastebaskets Dust and clean furniture Clean bathrooms. offices Outside housekeeping Wash. clean windows Painting OFFICEIADMINISTRATIVE WORKERS: Light maintenance, housekeeping Make construction signs Flagman as needed Issue trash permits Recordkeeping Painting, light carpentry work Clean vehicles Routine vehicle maintenance Litter collection at public properties Clear brush. branch overhangs Grass mowing, trimming, weeding Miscellaneous sweeping, cleaning Substitute erossina guard Safety Inspections Minor electrical work Minor plumbing work Cut grass Substitute crossing guard Inventor• tools, equipment, parts Attend safety programs Present safety programs. talks Conduct safety inspections Answering phones Safetv training, inspections Selling, issuing permits Cleanina Collect tax bills Filing PARKS and RECREA TION WORKERS: Train summer help Attend safety training Provide safety presentations, talks Painting General cleaning, sweeping Cleaning windows Answering telephones POLICE OFFICERS: Dispatch, desk assignment Maintain criminal records General filing Records retention compliance Update emergency contact files Microfilm documents Conduct inventories Process impounded vehicles Perform fingerprinting Write reports Research issues Grant proposal research and writing Vehicle transfer for maintenance FIRE DEPARTVIENT PERSONNEL: Test hoses Inventory equipment, spare parts Inspect equipment, supplies Maintain, clean and repair equipment and parts Present public safety talks at schools Mark and stencil hydrants 19 Supervise part time and summer workers Customer service, ticket booth Direct parking traffic, flagman Assist residents using parks Assist residents at seniors center Safety inspections, pool inspections Telephone investigation Bad check complaint investigations Attend training programs Conduct training programs Present public safety lectures Community relations programs Conduct traffic and speed surveys Road inspections Complaint handling Data entry Take statements in office Substitute crossing guard Conduct building inspections Assist in training Attend training programs Station housekeeping, maintenance Clerical, administrative duties Assist fire marshal's office Dispatch til APPENDIX C SAMPLE TRANSITIONAL DUTY PROGRAM PROCEDURES Transitional Duty Program 21 Sample TRANSITIONAL D UTY PR OGRAM Procedures An injured worker who is considered by administration to be a likely candidate for Transitional Duty will be so identified to the Chief Administrator. The Chief Administrator will communicate in writing with the candidate's treating physician, the claims analyst or a nurse patient advocate. A list of typical Transitional Duty jobs will be included with the letter. The doctor will indicate which jobs may or may not be within the physical capability of the worker. The doctor will also be requested to list any limitations. such as the number of hours per day. and anv other restrictions that may apply. The injured workers' medical treatment, such as prescribed physical therapy and visits to the doctor, will have priority over all other activities. After the treating physician agrees to a transitional duty regimen. the injured worker will meet with the Chief Administrator who will arrange the Transitional Duty schedule and activities consistent with the medical release and capacities. Adjustments to the work schedule and type of modified duties will be made as dictated by common sense and the circumstances of each injured person. There may be instances where a doctor may agree to a limited or trial period of transitional duty. Administration will react accordingly to the treating physician's instructions. After the treating physician determines that the injured person is cleared for normal duties. the employee will be taken off the Transitional Duty assignment and returned to his/her normal job. WORKING WITH MEDICAL LIMITATIONS It is essential that transitional work be assigned only upon proper medical authorization. This presumes good rapport between the municipality and the physician. The physician needs to know the policy regarding Transitional Duty and the degree of accommodation best be accomplished by discussing the matter that the Municipality will make. This can with the doctor before asking him/her to put it down on the Transitional Duty Evaluation. The Municipality needs to know, in writing, the specific limitations in regard to lifting, bending, standing, contact with various substances. etc. The administrator, in turn, must understand these limitations and live by them, enforcing with discipline.. if necessary. Re-injury during modified duty is not common but is quite possible if limitations are ?1 ignored. Unless limitations are clearly understood by the employee and the administrator and are adhered to, there is great potential for creating ill will. e' 1 1 :4 Isimm1 The employee may not be psychologically or economically coerced to return to work, so the Municipality may have to take further initiative. Any forced effort, however, should be supported by a doctor, the Municipality, the nurse - patient advocate, and the claim analyst, in writing! It is suggested that staff be offered a position at the same rate of pay. If the staff member refuses to accept the position, refusal must be placed in writing to the above mentioned personnel. Refusal to return to a physician authorized restricted duty position could result in discontinuing disability payments. Work assignment and supervision must also be more exacting in forced situations. The rehabilitation results of restricted duty are generally considered positive. The following procedures will be used in identifying and/or creating transitional dut% positions and assignments: 1. The treating physician will notify the Chief Administrator when an injured employee may be able to return to a transitional duty assignment. The date that the employee can return and work capacities will be ascertained by the Chief Administrator at that time. ' 2. Notification of the above will be given to the department head. supervisor, or designee, by the Chief Administrator. I The department head, supervisor, or designee. will advise the Chief Administrator of the transitional duty assignment, or that there are no positions available within the department at this time. 4. In the event that a transitional duty assignment is made, the Chief Administrator will obtain the treating physician's approval of the transitional duty job description. 5. In the event that a transitional duty assignment cannot be made within the employee's regularly assigned department, then the Chief Administrator and the Director of Personnel will make a transitional duty assignment within any department that has a job position that would meet the requirements of the job restrictions. This department would be responsible for the direct supervision of the assigned employee and shall furnish the department head and/or supervisor of the employee's regularly assigned department all documents pertaining to that employee; time, attendance and performances in accordance with existing personnel regulations. 23 6. The injured employee wi.1 be evaluated by the treating physician, on regularly scheduled intervals. to be determined by the treating physician, in cooperation with the Chief Administrator, and in compliance with existing policy. .. IM -MO 6- I .. 11FR - RE: Transitional Duty Program Dear Doctor: ( tunieipalitv) has a program of Transitional Duty assignment for qualified persons who have sustained a work related injury as provided for under the State of tie«- York Workers' Compensation Law. is being treated by you for such an injury. If you feel he/she has a minimal work capacity. please indicate which Transitional Duty assignments may or may not ba attempted, and list any work limitations you feel appropriate. As the treating physician. your judgments are paramount. You may alter the Transitional Duty assianments or the hours of activity as you feel appropriate at any time by notifying US. Attached is a list of Transitional Duty assignments with a description of each activity. Please indicate by initialing those assignments which are acceptable to you, and list any limitations or concerns you have. Please return the attachment to the Chief Administrator of (ylunicipality) Sincerely, ?4 DOCTOR'S FORM TRANSITIONAL DUTY EVALUATION The (Municipality) requests that the information below be completed by the attending physician pertinent to the capabilities of our employee as a result of his/her accident on The employee's job description is attached for you to review in order to determine if: A. The employee can return to work with no restrictions to the performance of his/her duties. B. The employee can return to work with limited restrictions to the performance of his/her duties. C. The employee can return to work and perform tasks checked on the form entitled "Transitional Duty" tasks. D. The employee may net return to work until released from doctor's care. If there are any questions at all, please call the Chief Administrator of (Municipality) , at n T 25 DOCTOR'S CERTIFICATE FOR WORK AUTHORIZATION Employee's Name: Department Employed by: Employee's Occupation/Job Title: Physician's Name: Date of ExanvTreatment: Date of Accident: Nature of Injury/Diagnosis: Treatment Administered: Medication Prescribed: How Long Have You Been Treating, Employee? Could Any Other Prior Injuries in Your Records Have Contributed to This Problem? 0 Yes 0 No Restrictions on Employee's Activity: Date Disability Begins: No Disability or Time Lost. Disability Begins: _/_/_ Can Employee perform duties of a less strenuous nature than normally assigned in his,'her line of work? 0 Yes 0 No After reviewing the job description and "Transitional Duty" tasks employee can: A. Return to normal duties with no restrictions. 0 Yes 0 No B. Can return to duties of job with restrictions noted. O Yes O No C. Can return to work and perform tasks checked on the form entitled "Transitional Duty" tasks. 0 Yes 0 No D. Cannot return to work performing any task until released from Doctor's Care. 0 Yes 0 No Date Employee can return to work. Follow-up visits - scheduled. NOTE: The employee will be receiving Workers' Compensation payments. It is requested that Follow up visits be scheduled so as to run concurrent with the expected healing progress of the employee's injury in order for the employee to return to his/her normal duties, if possible, in the most timely method possible. 1, , hereby authorize the release of the above information and any medical records and information related to the above request to (Municipality) and its authorized representatives. Employee's Signature Date 26 TRk NSITIONAL DUTY TASKS To the attending Physician: (Municipality) provides short-term restricted duty for employees who are temporarily disabled by occupational injuries. Our purposes are to facilitate recovery, prevent deterioration of work skills, demonstrate concern, minimize loss of human resources, and reduce costs. Because of the varied work activities, some type of work can usually be found to meet the injured employee's capabilities. Please consider the availability of this Transitional Duty program before making a decision on our employee's estimated period of disability. RESTRICTED WORK AS INDICATED BELOW: • No prolonged standing or walking • No climbing. bending or stooping • Limited use of right/left hand • Right/left handed work only • No work near moving machinery for the duration of transitional dutv • No twisting motion • Weight lifting restrictions: • 0- 15 pounds I • 15 -315 pounds • 35 - 50 pounds Doctor's comment: Doctor's Name: Address/Phone: 27 APPENDIX D TRANSITIONAL DUTY QUICK rl-EFERENCE Transitional Duty Program TRANSITIONAL DUTY QUICK REFERENCE for designing a Transitional Duty Program Goals: • Foster and enhance the physical and psychological recovery process of the injured worker. • Enhance the injured employee's sense of confidence and well being. • Reduce medical. disabilir: and lost time costs. l Reduce indirect accident costs. • Minimize the chance of re-injury. �- • Encourage cooperation and communication between the employee and management. } Identify the Transitional Work Team and their responsibilities: • Employee • Injury Coordinator,'Super:isor.'Safety Officer �, • Patient :advocate • Medical Care Provider Employee Responsibilities: • Immediate reporting of an injury to his/her supervisor. • Completes all necessary paperwork, including the PER.%L-� Or,ick-Fax. • Complies with employer's procedures. • Maintains contact with the emplover and provides information reaardina the injury/ illness and treatment plan on a weekly basis. V • Returns to work in a temporary modified capacity within restrictions that are outlined by a physician. D-1 Responsibilities of the Injury Coordinator / Supervisor / Safety Officer: • Initiates medical treatment. • Conducts investigation and corrects hazards. �`y►� • Completes and distributes required paperwork and the PERMA Quick -Fan. 1 •Reinforces the municipality's disability process and the employer's responsibility. • Maintains and encourages communication with the employee. • Identifies and develops productive Transitional Work assignments, and ensures that the employee is working within the prescribed physician guidelines. • Monitors employees to ensure adherence to the Transitional Work assignments and monitors progress. 0/13 Responsibilities of the PERMA Patient Advocate (Nurse): • Communicate with the treating medical providers to coordinate the most appropriate and cost effective care for the employe-- until maximum medical improvement is achieved. • atment plan and expectarons to coordinate the best Continually evaluate the tre possibie outcome for the employee. • Actively communicate with the employee, employer and medical providers. • Be instrumental in working with the employer in de,,ising early return to work programs, job descriptions and transitional duty assignments. Responsibilities of PERtiI A Claims Personnel: • Provides prompt investigation and decision re�ardinv compensability. • Provide for filing and processing of necessar. forms as required by la%v. ?, • Informs the emplovee of rights and benefits. a • Provides for prompt delivery of benefits. to include cost containment measures. ~ yer on rights and procedures under the workers' compensation laws. • Advises e;npio Responsibilities of the ?Medical Provider: • Provides prompt and appropriate medical treatment for the injured employee. • Supports a safe and timely return to work for the employee. • As contacted, maintains necessary communication with the rest of the Transitional Dun, Team. D Considerations when identifying Transitional Work assignments: • Transitional Duty assignments are TEAPORARY. • Transitional assignments should have a duration of 2-8 weeks, and not exceed 12 weeks. For example, an employee who is expected to recover from an injury within a 12 week period should never have to lose time unless medically contraindicated. • Job descriptions and transitional duty assignments should be available in writing for the medical provider's review. • The assignments should be meaningful and provide value to the employer and employee. vo r • The Transitional Duty Program should be approached in a consistent fashion to assure lk uniformity. • The Transitional Duty assignments must be evaluated on a case-by-case basis, but should not be limited to within one department if possible. Pre -injury Education of the employees: • Employees must be aware that the Transitional Dun• assignments are temporary and part of the rehabilitative process. • Employees must be aware that they are expected to participate in the Transitional 1?u. program if injured or ill, when medically approved. • Thev should know that they will be required to return to full duty as soon as medically able. Thev should be advised of the municipality's return to work program prior to becoming ill or injured. D-3 ` 28 APPENDIX E TRANSITIONAL DUTY RESOURCE I.-VFORtiI4 TION 4 Transitional Duty Program TRANSITIONAL DUTY RESOURCE INFOR L4 TION PERNLk members have access to various resources to assist in development and im*lementation of Transitional Bury programs. For more information, or assistance in program development or training of management and supervisory staff, call the PER..NfA Loss Control Department. PERSIA Video Library The following video tapes and training materials are available to members by calling the PERVL\ Video Librarian at (518) 4f3-7796, or (800) 834-3697 (Ne%v York only): T.4KT G CONTROL, The Workers' Compensation Return to Work Connection, 1993, Milt `Fright & Associates. PERNLA Reference T 6003 k 27 minutes. The coal of the video is to �rovide practical. reasonable approaches for employers to: • Reduce Workers' Compensation costs • Reduce Workers' Compensation -related litigation • Improve return -to -work rates • Reduce time loss • Improve company morale • Address the requirements of the American with Disabilities Act • Limit potential ADA litigation This is the initial program of a three-part series, designed for use with upper management, administrators, front line supervisors, managers, human resource professionals, risk managers, safety professionals and coordinators, occupational health nurses, physicians and claims administrators. E-1 Return To Work for Supervisors, 1996. Milt Wright &Associates, PEILMA Reference T 6001 k, 16 minutes. Designed for presentation to supervisors, the goal of this video is to overcome the supervisor's objections: "Once an injury occurs, it's out of my hands.", "I have no job for the injured employee.", "I don't return an employee to work until they are 10001'o." • Change attitudes and commit to early Return to Work • Improve communication and work relationships • Understand benefits of Return to Work for both employee and supervisors • Explore options for Reasonable Accommodation • Implement Transitional Employment during the recovery process. Return To Work for Employees, 1996, Milt Wright & Associates, PERNLA. Reference T 6002A- 16 minutes. Designed for presentation to employees. the goal of :his video is to overcome employee objections: "I have the right to recover at home. Once my injury is permanent, the employer doesn't want me. "I do as I am told." • The Return to Work process can be a positive experience • To take control, rather than feel a victim of circumstances • To communicate one's needs to the supe•icor and treating physic -tan • To apply skills and abilities productively through transitional employment • Work can be therapy to accelerate the recovery process. Other Resources: There are a large number of organizations, medical providers and specialized health centers and hospitals which offer services which may directly or indirectly supplement activities and employee return -to -work. These may be of your Transitional Duty program act consideration especially for potentially severe injuries, such as lower back injuries. Local contacts should be evaluated for these services. As always, your PERNLk Claims Analyst or Nurse -Patient Advocate can be consulted. Some of these services include: • Industrial Rehabilitation Services • Work Hardening / Work Conditioning Programs • Work Capacity Evaluations • Pre -placement Screenings • Ergonomic job analysis E-?