1997
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Workers' Compensation
TRANSITIONAL DUTY PROGRAM
a Return - To - fVork Strategy
PER M A
A service program of the Public Employer Risk :\lanagement Association, Inc.
Albany, Ne,'" York
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May 2,1997
This publication is intendedfor 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.
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Transitional Duty Program
Table of Contents
Overview - W11at's it all about'?........................................................................ 11
I. Introduction - What is Transitional Duty?............................................
II. Value of a Return-to-Work Strategy....................................................... 1
II1. Historical Perspective - What's happened before!................................... 3
IV. Communication Tools - \\'110 is involved?............................................ 4
V. Position Descriptions - What skills does the job require? ........................ 6
VI. Implementation - Fining the pieces together~......................................... 7
VII. Training - How do we knO\V what to do?.............................................. 9
VIII C l. W' . . !
. onc USIon - rappmg It up................................................................. 10
Appendix A Sample Policy Statement A-I
Appendix B Sample Transitional Duty Assignments B-1
Appendix C Sample Transitional Duty Procedure C-l
Appendix D Transitional Duty Quick-Reference D-l
Appendix E Resource Information E-l
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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 dtsability 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 tinancial
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 towards your PER..vIA safety discount during the annual Loss Control
Program Evaluation process.
The Transitional Duty strategy described in this booklet uses a team of in-house
personnel and outside consultants. The consultants include PER"IACARE 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. PER..vIA 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.
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I. INTRODUCTION - What is Transitional Duty?
A Transitional Duty program is a retum-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 RETUR1~-TO-'VORK
STRA TEGY
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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 Duty is employment, so its wages are not charged as
workers' compensation indemnity. Thus, Experience lvlodification 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.
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· 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 red1.iction in medical costs can be achieved by implementing a Transitional Duty
program in concert with a Safety and Health Comminee.
· \Vbile the Americans "vith Disabilities Act (ADA) "vas enacted to prevent disability-
based discrimination, it has had 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 ne"v 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.
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
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every day, even if only on a light-duty assignment. It also will provide co-workers with a
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. \Vnen an injury occurs, the employee is sent by management to the
designated initial medical care provider (or, the employee's O\\'TI provider choice).
The doctor determines the extent of injuries, treats the problem, and writes a rekase.
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. \Vithout 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
super/ISOr.
. 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, hO\'iever, 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 payro n, 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
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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 PERlvIA 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 next scheduled shift, fax a completed copy of the Quick-
Fa..'C Report to PERlU at (518) 458-7811. Section "c" will provide basic information
for Transitional Work assignment review by the PER..vIA Patient Advocate/Nurse.
Prompt reponing allo\vs PER..vI.-\. to properly document mes. make required reports and
conduct any necessary investigations and follow-up. PER-vIA statistics have proven that
early immediate reporting has decreased the costs of claims by as much as 40% due to
earl v intervention bv our Nursing staff.
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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 superv'isor for work site accommodations consistent with the
medical prognosis to facilitate a return-to-work.
· Monitoring the employee's condition by PERi\JACARE 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 PERi\lACARE staff of both the employee and the
employer in the event of controversy.
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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 r.estrictions to be observed. Physicians are
required to provide the employer and PER...i\'lACARE with a written post-injury report
stating the employee's work restrictions. This report allows the employer and PERLvlA 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'VL-\CARE representatives. and PER...\[A 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 Transiti<(nal 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 PERi\-lA
PER..'VIACARE representatives must be fully informed of the injured employee'sjob
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 PERvlACARE representatives.
Injuries that involve home or hospital confinement, referrals to specialists, or other
complications, require closer communications between PERL'v1A 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 dury 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.
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In all cases and all phases of the program, PER..c\1A 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 \vith transitional or modified \vork
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.
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· Transitional duty will be limited to the time for which it is medically necessary.
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 bet\veen the employee and the employer, all
parties \vill know \vhat 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 dO\,;TI 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.
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Listed for each position, are tasks-that are done in ~lace under normal
circumstances. Many 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 employee's 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
Classification of Jobs Jlanual Dictionary of Occupational Tirle)s. 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).
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VI. IMPLEMENTATION - Fitting the pieces
together
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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
betvleen the employee, management, PER.V1A and medical care providers.
The follo\ving 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 assigrunent. 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).
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The policy should emphasi:;e-the program is administered on a case-by-case basis,
isfor temporary assignment, and must establish specific ma..'Cimum time frames
(Usually, twelve weeks is suggested).
· Appoint a coordinator to explain the program to management and to get a
commitment to change policy, if ne<:essary. This coordinator should interact with
PEFJvIA 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 c~uld 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 duty 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 identify all
requirements of a position. including specific skills. education, experience and
physical 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.
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· Conduct a task assessment. Evaluate all specific elements of a given job, including
workstation design and job functions. Problem jobs can be identified, along \\"ith
opportunities for job redesign and alternate or transitional work responsibilities. The
task assessment allon's job requirements to be matched with physical
capabilities. A v,Titten 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 \vith the environment.
· Develop a communication plan. Transitional work requires a communications
strategy. 'Nhen the employee is out of work the PERJ.'v{A Nurse Patient Advocate will
contact the injured employee within 24 hours of the injury to check on the employee's
condition, the extent of injury. and \vhen he or she can return. This is time to express
genuine concern. In on-going cases, the PERMA Nurse Patient Advocate and/or the
manager! supervisor can make periodic calls. A caller should be sensitive to each
employee's situation.
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. 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
'Hith the medical caregiver to determine the earliest possible date the employee can return
to transitional duty - - and will work 'Hith 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 inj ures his
or her back, for example, may be able to return to the job if he or she learns ne\v 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:Tl?loyee's c3.pabilities to pre-injury levels. On-go;:'cg com~,u!l.ic2..tion with
the transitional duty team members is essenr;-::l until the em()ye~ reaches the best
possible outcome for his or her case.
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VII. TRAINING - Hovv do vve knovv \vhat 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 fo llo\ving 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 \vho have
successfully used the program.
d. Review of the process, and the team involved.
e. Question and answ'er 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.
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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 PE&.V1A 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 l\'lanagers
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 imp.lement 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 employer. The savings can be identified
easily. and directed back to other areas of municipal needs.
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APPENDIX A
SAMPLE POLICY STATEMENT
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Transitional Duty Program
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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 tempora~ 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 OtIty 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:
I. 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.
2. The employee's regular work division shall attempt to locate or design a work
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
ex ists.
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 hislher
permanent work unit and his/her regular position.
APPENDIX B
SAMPLE TRANSITIONAL DUTY
ASSIGNMENTS
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Transitional Duty Program
SAMPLE TRANSITIONAL DUTY
ASSIGNMENTS
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PUBLIC WORKS E,.1//PL0 YEES:
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
CC;STODIALl7YfAINTEiVANCE WORKERS:
S\'.ieep. wash floors
Vacuum rugs
Install shades
Empty wastebaskets
Dust and clean furniture
Clean bathrooms. offices
Outside housekeeping
Wash. clean windows
Painting
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OFFICE/AD1HINISTRA TIVE WORKERS:
Ans\vering phones
Selling, issuing permits
Collect tax bills
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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 crossing guard
Safety Inspections
Minor electrical work
Minor plumbing work
Cut grass
Substitute crossing guard
Inventory tools, equipment, parts
Anend safety programs
Present safety programs, talks
Conduct safety inspections
Safety training. inspections
Cleaning
Filing
PARKS and RECREATION 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 DEPARTJ.Y/ENT 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
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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
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APPENDIX C
SAMPLE TRANSITIONAL DUTY PROGRAM
PROCEDURES
"
Transitional Duty Program
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Sample TRANSITIONAL DUTY PROGRAM
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 \'1111 be included with the letter. The doctor will
indicate which jobs mayor may not be ~thin 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 any 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 ..vill
. meet with the Chief Administrator who will arrange the Transitional DuN schedule and
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activities consistent with the medical release and capacities. Adjustments to the work
schedule and type of modified dutres 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:ber
normal job.
WORKING \VITH MEDICAL LIMITATIONS
It is essential that transitional work be assigned only upon proper medical authorization.
This presumes good rapport bet\veen the municipality and the physician. The physician
needs to know the policy regarding Transitional Duty and the degree of accommodation
that the Municipality will make. This can best be accomplished by discussing the matter
with the doctor before asking him/her to put it dov.n on the Transitional Duty Evaluation.
The Municipality needs to knov,r, 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 modi tied duty is not common but is quite possible if limitations are
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ignored. Unless limitations are cl~arly understood by the employee and the administrator
and are adhered to, there is great potential for creating ill will.
FORCED TO RETUR'i TO TR-\NSITIONAL DUTY
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 clairri 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 duty
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.
3. 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 will 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.
(Copv this letter on vour Municipal letterhead)
RE: Transitional Duty Program
Dear Doctor:
(Municipalitvl has a program of Transitional Duty Assignm~nt for qualified p~rsons
who have sustained a work related injury as provided for under the State of 0."ew York
Workers' Compensation la'N.
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 mayor may not be. attempted, and list any work limitations you feel
appropriate.
As the treating physician. your judgments are paramount. You may alter the Transitional
Duty assignments 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 CMunicipalitvl
Sincerely,
24
DOCTOR'S FORl\'1
TRAJ.'lSITIONAL 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 hislher accident on
The employee's job description is attached for you to reviev.; in order to determine if:
A. The employee can return to work with no restrictions to the performance of
hislher 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 n6t return to work until released from doctor's care.
If there are any questions at all, please call the Chief Administrator of (Municipalitv)
at (phone #)
25
DOCTOR'S CERTIFICATE FOR WORK AUTHORIZA nON
Employee's Name:
Department Employed by:
Employee's Occupation/Job Title:
Physician's Name:
Date of Exarn/Treatment:
Date of Accident:
Nature of InjurylDiagnosis:
Treatment Administered:
Medication Prescribed:
How Long Have You Been Treating Employee?
Could Any Other Prior Injuries in Your Records Have Contributed to This Problem?
a Yes 0 No
Restrictions on Employee's Activity:
Date Disability Begins:
No Disability or Time Lost.
Disability Begins: --1--1-
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,?Jld "Transitional Duty" tasks employee can:
A. Rerum to normal duties with no restrictions. 0 Yes a No
B. Can rerum to duties of job with restrictions noted. 0 Yes 0 No
C. Can rerum to work and perform tasks checked on the form entitled "Transitional
Dut;/' tasks. 0 Yes a No
D. Cannot return to work performing any task until released from Doctor's Care.
a Yes 0 ~ 0
Date Employee can return to work.
Follow-up visits - scheduled.
NaTE: 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 hislber normal duties. if
possible, in the most timely method possible.
I, , 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
4~~
26
TR-\.i'fSITIONAL 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 moviniZ machinerY for the duration of transitional duty
- . .
· No tvvisting motion
· Weight lifting restrictions:
· 0 - 15 pounds ,I
15 - 35 pounds
· 35 - 50 pounds
Doctor's conunent:
Doctor's Name:
Address/Phone:
- -- -- .
27
-.
...
APPENDIX D
TRANSITIONAL DUTY
QLTICK PJ:FERENCE
:s
Transitional Duty Program
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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 emp loyee' s sense of confidence and '.veU be:ng.
. Reduce medical. disability and lost time costs
. Reduce indirect accident costs.
. Minimize the chance of re-injury.
. Encourage cooperation and communication between the employee and management.
f
Identify the Transitional Work Team and their responsibilities:
. Employee
. Injury Coordinator/Super"'iisor/Safety Officer
. Patient A.dvocate
. Medical Care Provider
Employee Responsibilities:
. Immediate reporting of an injury to hislher supervisor.
. Completes all necessary paperwork, including the PER.\L-\ Quick-Fax.
. Complies with employer's procedures.
. Maintains contact with the employer and provides information regarding the injury/
illness and treatment plan on a weekly basis.
. Returns to work in a temporary modified capacity within restrictions that are outlined
by a physician.
0-1
Responsibilities of the Injury Coordinator I Supervisor I Safety Officer:
. Initiates medical treatment.
. Conducts investigation and corrects hazards.
. Completes and distributes required paperwork and the PER..'vf.A. Quick-Fax.
. Reinforces the municipality's disability process and the employee' s responsibility.
. Maintains and encourages communication Vlith the employee.
. Identifies and develops productive Transitional Work assignments, and ensures that
the employee is working within the prescribed physician guidelines.
. ~{onitors employees to ensure adherence to the Transitional Work assignments and
monitors progress.
~ i/ I Oil ::;
Res.ponsibilities of the PERy[A Patient Advocate (~urse):
. Communicate ""ith the treating medical providers to coordinate the most appropriate
and cost effective care for th~ employee until ma'<.imum mecic:ll improvement is
achieved.
. Continually evaluate the treatment plan and expec:ations to coordinate the best
possible outcome for the employee.
. Actively communicate with the employee, employer and medical providers.
. Be instrumental in working with the employer in de',ising early rerum to work
programs, job descriptions and transitional duty assignments.
~
Responsibilities of PERyL-\ Claims Personnel:
. Provides prompt investigation and decision reg3.rding compensability
. Provide for filing and processing of necessar:" forms as :-equired by I a'.'",'
. Informs the employee of rightS and benefits.
. Pro'tides for prompt deliver)' of benefits. to include cost containment measures.
. Ad"ises employer on rightS and procedures under the v..orkers' compensation la\.\fs.
Responsibilities of the L\ledical Provider:
. Provides prompt and appropriate medical treatment for the injured employee.
. Supports a safe and timely return to work for the employee
. A5 contacted, maintains necessary communication with the rest of the Transitional
DUlY Team.
D-2
Considerations when identitying Transitional Work assignments:
. Transitional Duty assignments are TE.MPORUY.
. 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' 5 review.
. The assignments should be meaningful and provide value to the employer and
employee.
. The Transitional Duty Program should be approached in a consistent fashion to assure
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 3.\vare that the Transitional Dury assignments are temporary and
part of the rehabilitative process
. Employees must be aware that they are expected to participate in the Transitional
DrilY program if injured or ill. when medically approved.
. Tnev should know that thev will be reauired to return to full dutv as soon as medic31lv
~ _. 4 ~
able.
. They should be ad,,;sed of the municipality's return to work program prior to
becoming ill or injured. !
D-3
- ..---.....
28
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APPENDIX E
TRANSITIONAL DUTY
RESOURCE I1VFORL\;L4 TIO~'l
*-
Transitional Duty Program
T~~:NSITIONAL DUTY
RESOURCE Il'lFORi\;fA TIOiV
PER..\-l-\ members have access to various resources to assist in development and
irntJlementation of Transitional Duty programs. For more information, or assistance in
program development or training of management and supervisory staff: call the PER.\1..-\
loss Control Department.
PER.\-L-\. Video Library
The foHowing video tapes and training materials are available to membi!r5 by calling the
PER.\L-\ Video librarian at (513) ~53-7796, or (300) 334-3697 C:--;e'N York only):
TAKLVG CO~VTROL, The %rkers' Compensation Return to W'ork
Connection, 1993, ~1ilt \Vright & Associates. PER..\l-\ Reference # 6003.-\. 27 minutes.
The goal of the video is to pro'"ide practical. reasonable approaches for employers to:
. Reduce Workers' Compensation costs
. Reduce Workers' Compensation-related litigation
. Improve rerum-to-work rates
. Reduce time loss
. Improve company morale
. Address the requirements of the American with Disabilities .A.ct
. limit potential ADA litigation '
This is the initial program of a three-part series, designed for use with upper management,
administrators, front line supef"isors, managers, human resource professionals, risk
managers, safety professionals and coordinators, occupational health nurses, physicians
and claims administrators.
E-l
. .
Return To Work for Superv.isors, 1996, ~li1t \Vright & Associates, PER,\1A
Reference # 6001 A., 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:" '41 have no job for
the injured employee.", "1 don't return an employee to work until they are 100%,'"
. Chan~e anirudes and commit to earlv 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 Workfor Employees, 1996. ~tilt ""'right & Associates, PER.'vL\
Reference # 6002A.. 16 minutes.
Designed for presentation to employees. the goal of ~his video is to overcome employee
objections: "1 have the right to recover at home ". Once my injury is tJerrnanent. the
employer doesn't want me.", "'1 do as I am told."
. The Rerum to Work process can be a positive experience
. To take control, rather than fee! a ....ic:im of circumstances
. To communicate one's needs to the super;isor and treating physician
. To apply skills and abilities productively through transitional employment
. ""'ark can be therapy to accelerate the recover;.' process.
Other Resources:
There are a large number of organizations, medical providers and specia/i:ed health
centers and hospitals which offer sef'tices which may directly or indirectly supplement
your Transitional Duty program acti....ities and employee retum-to-work. These may be of
consideration especially for potentially severe injuries, such as lower back injuries.
Local contacts should be evaluated for these sef'tices. As alwavs your PER.vLA. Claims
. '.
Analyst or Nurse-Patient Advocate can be consulted. Some of these sef'tices include:
. Industrial Rehabilitation Sef'tices
. \Vork Hardening I ",,'ork Conditioning Programs
. \Vork Capacity Evaluations
. Pre-placement Screenings
. Ergonomic job analysis
E-2