Lowering Workers Compensation Costs & Improving Return to Work Rates Marilyn Neuhausel MS, OTR/L,...
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Transcript of Lowering Workers Compensation Costs & Improving Return to Work Rates Marilyn Neuhausel MS, OTR/L,...
TRANSITIONAL WORK PROGRAMS
Lowering Workers Compensation Costs
&Improving Return to Work Rates
Marilyn Neuhausel MS, OTR/L, TWDOccupational Therapy Solutions, LLCMay 15, 2012
The Presentation Objective For you to leave with 2-3 concrete ideas that will improve your return to work rates after an injury has occurred.
Carpel Tunnel Syndrome
Lost Time Average Costs
$7,675.03 $17,544.48
$19,060.09
Indemnity AverageCosts
$4,091.22 $15,797.47
$17,509.73
Total Cost $11,766.25
$33,341.95
$36,569.82
1st Year 3rd Year 5th Year
Based on Private & Public Employer Claims in Open MIRA II Status
Rotator Cuff Tear
Lost Time Average Costs
$ 15,097.70 $26,005.02 $34,381.31
Indemnity AverageCosts
$4,711.81 $19,394.63 $26,548.88
Total Cost $19,809.57 $45,399.65
$60,930.19
1st Year 3rd Year 5th Year
Based on Private & Public Employer Claims in Open MIRA II Status
Degenerative Thoracic or Lumbar Intervertebral Disc Disorder
Lost Time Average Costs
$ 12,467.20
$ 30,395.69
$44,332.25
Indemnity AverageCosts
$ 8,658.43
$24,035.89
$37,062.93
Total Cost $21,125.63
$54,431.58
$ 81,395.18
1st Year 3rd Year 5th Year
Based on Private & Public Employer Claims in Open MIRA II Status
The Old School Approach to
Managing Lost Time Claims The injured worker must
be 100% recovered before returning to work
The Old School Approach: Role of the Physician
The POR controls the length of time off work and the duration & the types of treatment
The Old School Approach : Impact on the Injured Worker
Their isolation from work affects the injured worker’s attitude, their physical condition, and their motivation for return to work
Physicians of Record SurgeonsRehab Specialists
Your MCO The BWCThe Ohio Legislature
Company CultureThe Supervisors The Union
Corporate PhilosophyGeneral Manager
Return to Work
Coordinator
Influences on Return to Work Rates
Destination Excellence: What Employers Will See From
BWC
oLess red tapeoMore consultative assistanceoThe injured worker is back to
work sooneroIncreased accountability
BWC’s Destination Excellence
Focus on Injured WorkersoDecrease in lost workdays
oDecrease in average claim costs
o Shorten the claim tails
oReduce Permanent Total Disability frequency
Transitional Work Bonus ProgramRewards companies that use their TWP (developed between 2001 and 2006) or plan to implement one in 2012. Previous grant recipients must show proof of the transitional work program use/updates
Back end bonus up to 10% off premiums
Must be current on premiums and no lapse >45 days
Private employers must have submitted the bonus application by May 25 , 2012
Public employers must submit the bonus application by October 31, 2012
Transitional Work Program Definition
A workplace program that provides an individualized interim step in the recovery of an injured worker with job restrictions.
Advantages of a
Transitional Work Program
The employer: Direct involvement in work return
The injured worker: At work while performing real job tasks
What if your Current Transitional Work Program is not Effective?
•Submit the application and have the BWC representative determine what needs to change to improve the program
•Confer with your MCO to ensure that all cases are managed well
The Written Policy Entry, Exit and Extension Guidelines
The Timeframe: 45, 60, 90 days
Roles and ResponsibilitiesThe Essential Forms Methods of evaluation
The Job Analyses
Material handlingNon-material handlingPositional requirementsFrequenciesEnvironmental Exposures
List of Modified Duty Tasks
◦Involve the Supervisors◦Refer to the job analyses◦Sort the tasks according to physical demands
◦Get the union’s buy-in
Build your RTW Team
Initial Treating Provider Field Case Manager
Managed Care Case Specialist
Physician of Record
The Union Rep
Onsite TW Therapist
Clinic Based Therapist
Surgeons & Physiatrists
The Supervisors
Modified Duty Off-Site Program
Have your MCO arrange to use a non-profit organization for an injured worker who is medically stable, but has restrictions that cannot be accommodated
Usually lasts 90 days or less.
The injured worker is productive, maintains their “worker mentality”, and they heal more quickly.
Combining Modified Duty Off-Site & Transitional
WorkProgress from MDOS to TW as restrictions
are lifted
Divide the shift between TW & MDOS when you don’t have enough work for a full day or when POR has set a GRTW program
Move the IW from TW to MDOS if there is a set back or there is not enough work
Onsite Transitional Work Therapy
Address the Barriers
Use the job tasks to improve function
Must Show Progress
6-8 weeks in Duration
Teach body mechanics and safe work methods
Fitness for Duty Functional Capacity Evaluations
Onsite at the Company or Offsite
Assesses the injured worker’s ability to perform the job tasks
Internet ResourcesJob Accommodation Network www.jan.wvu.edu
BWC Safety and Hygiene Department
www.ohiobwc.com
What if Return to the Same Job at the Same Company is Not Feasible?
Vocational Rehabilitation Options
Same Company/Different Job
Different Company/Same Type of Work
Different Company/Different Type of Work
In ConclusionBy using your transitional work program and RTW rehab services, you will decrease costs and significantly improve return to work rates
Thank YouMarilyn Neuhausel, MS, OTR/L,
TWDOccupational Therapy Solutions,
LLCCell Phone : 419-366-6391E-mail: [email protected]