Transcript Document
Accommodation Matters The Art and Science of Linking HR, Workers Comp and Productivity Margaret Spence, President/CEO Douglas Claims & Risk Consultants, Inc. 1 Why Do We Do What We Do? 2 Absence and Presence Management 54% of HR Professionals Surveyed says they didn’t know how much absenteeism cost their organization. What is the Organizational Cost to Replace Employees? Can you quantify the cost right now? 50% of all hourly employees leave their job within 120 days of hire. They may not feel valued 75% of Employee do not feel Valued by their Employer These Employees are your next nightmare! All of this occurs before the “Workers Comp Claim” 3 2,986,500 Number of Recordable Injuries in 2011 Bureau of Labor and Statistics – 41 States Actual Injuries 5,000,000 A Workplace Injury Occurs Every Six Seconds – 96,000 Each Week 4 5 The Cost of Injuries.. The National Safety Council Estimates that injuries cost US Employers – (National)…. $176.9 Billion Annually $86.6 Billion in lost wages & productivity $43.2 Billion in medical cost $32 Billion in administrative expenses $1300 – the Cost Per Worker (Each Worker in the USA Must Produce $1300 in Goods or Services to Offset National Cost of Injuries) 6 Our Why…. Injury Management Is Talent Management™ We see Value…. 7 We See the Employees Ability to Continue Working – Really We Do! We Do Not Limit the Employee by Focusing on What They Can’t Do – Right? We Understand that Labels Matter… 8 Day 1…Engagement Return to work is the primary focus of every discussion you have with injured employees starting on the 1st day of the injury. 9 Our Job/Role…….We: Keep the W in Work Find ways to Engage Injured Employees in their Own Medical Care and Outcome – we instill Value despite the injury. Create a “Best in Class” Medical Treatment Process that is focused on Immediate Care and Measured Outcome Get our organizations to understand they must prevent instead of manage Help Supervisors & Managers Understand Value Create a Tribe of People Who Believe in What We Do! Use Data to Enact Change - We must make the Business Case for Why this Process is Important! 10 We are Return to Work Coordinators…. We are here to facilitate the return of injured employees to work as soon as they are able to perform meaningful, productive work within their restrictions. The Key Words: As soon as possible Meaningful Productive Accommodation Matters Every member of your organization contributes to the employees successful reintegration to Work… 11 We Will Create a Business Model That articulates the Financial, Legal and Procedural Benefit we provide to our organization. What will your program achieve? What will success look like? and What will you accomplish? Vision Mission Goal Process Results Affect/Effect on Bottom-line Cost 12 Tribal SWOT – Analysis • Best Quality • Landmines • Best Timing Strength Opportunity Threats Weakness • Holes 13 The Negative Argument We don’t need to bring the employee back to work because… He or She was a bad employee He or She will only get injured again He or She will sue us We don’t want that employee here anymore We have little tolerance for injured employees Its too much energy to establish and maintain a RTW Program. 14 The Positive Argument… It’s all about cost… We will mandate return to work Because it saves us money. Because we have a written policy that says so. Because we will not allow our insurance carrier to pay any lost wage benefits if we can help it. We value our employees – after the injury! 15 We Do Not Exist in a Silo… We must be able to articulate the positive side of Return to Work Programs and We must be ready to deal with detractors who don’t feel these Programs are viable! We must learn to speak the CEO’s Language We must instill Value in every fiber of our program. We must be willing to Rinse and Repeat 16 Business Case… We Must Make a Business Case for the What! What impact does getting injured employees back to work have on our bottom-line cost and our non-Workers Comp Exposure? What did we accept, condone, overlook that lead to the employee injury and lack of compliance? We Must Articulate Our Value “Why should we keep you employed as the RTW Coordinator?” and “Why should we keep the injured employee working?” What do you add to your companies bottom-line? Justify Your Existence or You will be Extinct! 17 The ROI What is it? Defines the Cost of Leaving Employees at Home Evaluates the HR vs. Workers Compensation exposure Defines What Successful Return to Work Programs Should Look Like The Roadmap to building an Effective Team Approach to Getting Injured Employees Back to Work and Keeping Them There. 18 The Engagement Leading with Cost and Cost Drivers 19 Prove Me Wrong… How do you gather the data to prove the ROI? Premium Payment Loss Data – 1 Year OSHA Log Average Hourly Rate of Pay Companies Profit Margin – Assume 2% 20 Using the OSHA Data… Data Number of Lost Work Days Number of Restricted Days Add Lost Work Days and Restricted Days/ 365 = Year(s) of Lost Productivity Average number of Hours Worked Each Day Average Hourly Rate of Pay 21 Result… Cost Calculation Worksheet Policy Year - 2007 Data/Calculation Lost Productivity Number of Lost Workday (A) Number of Restricted Days (B) Lost Productivity Total - (C-) (A+B)/365 - Years of Lost Productivity Results 368 249 617 1.69 How many years did we loose? 22 Productivity Evaluation… Lost Productivity Calculation Add the Lost Work Days + Restricted Days Enter Total Here Multiply by Hours Worked Each Day Multiply by Hourly Rate of Pay Lost Productivity or Replacement Staffing Cost 23 Productivity Loss… Lost Productivity Totals (C) Average Hours Worked Each Day (D) Average Hourly Rate of Pay (E) Multiply (C*D*E) Replacement Staffing Cost (F) 617 8 $9.50 46,892 $46,892 Calculation = Number of Lost Work Days (Productivity)x Average hours worked each day x Average Hourly Rate of Pay 24 Claims Cost… Pull out the Loss Runs/Claims Statistics How much did the insurance carrier pay for claims cost? Enter – Reserves + Paid Amounts = Total Incurred What is the Annual Premium Payment Add Total Incurred + Annual Premiums Total Insurance Cost 25 Program Cost… Insurance Cost Annual Incurred Cost (G)*** (paid+incurred) Annual Premiums (H) *estimated Total Incurred + Premiums (I) Total Insurance Cost (J) $332,648 $482,835 $815,483 $815,483 Raw Data from Loss Runs – Statistical Data Used to Calculate the Experience Modification 26 The Reality…Kicks In! True Workers Compensation Cost Add Lost Productivity Cost + Insurance Cost = Total Cost of Risk What is your profit margin? It’s Your Money! Additional Sales Required to Cover My Company’s Cost of RISK? Total Cost of Risk Calculation: Multiply the Total Cost of Risk by 100 then divide it by the Profit Margin Multiply by 100 Example: Divide by Profit Margin 500 x 100/2.5 27 Cutting Into Profit… Profitability Total Cost of Risk (K) Profit Margin (Estimate 5%**) (L) Sales Required to Cover Loss (Kx100/5%) Additional Sales Required to Cover Cost $862,375 5% $8,623,750 $8,623,750 28 Simple Math… Linking Productivity with Accommodation (Any Company USA) – Lost 155 days 155 days x 8 hour work day = 1240 hours Median Hourly wage = $15.95 ($15.95 x Hours = Lost Productivity) Lost Productivity: 1240 x $15.95 = $19,778 The Salary of 1 full time employee for (X) year(s) Now add: Replacement Cost, Unemployment Insurance, delays in meeting deadlines…….. Do not allow the blame game to set in. 29 Along Comes Johnny… When you speak what does he hear? • • • • • You’re disabled You don’t count You’re not capable You’re not wanted here anymore We don’t need you…you were bad news….you are ineffective 30 Pre-Injury - The Cycle of Engagement Disengaged + Engaged Frustrated/Disheartened Inspired/Innovative Ineffective + Effective Resentful/Pessimistic Conscientious/Productive Disconnected Angry/Resentful Unaware/Self-absorbed 31 The Engaged – Disengaged 9% Benchwarmers 34% Star Employees Employee 7% Free Agents • • • • 9% Benchwarmers 50% Disengaged 7% Free Agents 34% Star Employees 50% Disengaged Now Add the Injury 32 Your Injured Worker…. Injured “Johnny” 49 Years old Simple but Complex Back Injury Surgical Possibility Strategically Educated Long-term employee Dislikes his Supervisor Really wants to continue working….maybe! Someone in your organization is plotting ways to get rid of Johnny – and he knows it. 33 What Does He Hear?…. I have a Simple but Complex Surgical Back I have to have Lumbar Surgery I will be Off work for 16 weeks I may be Released to Return to Work Modified Duty I will have Restriction: Limited Standing, Walking, Must sit, has difficulty managing daily chores, no lifting over 10lbs, no bending – The Restrictions may be permanent 34 Typical Workers Comp Restrictions: No lifting over 25lbs Limited sitting or standing No use of the right hand No walking No bending No pushing or pulling No driving No work No full time work…. 35 The Double “O” Challenge Obesity Cost Employers $73.1 billion each year 13 Times as many Lost Work Days Medical and Indemnity Cost: 7 – 11 times higher 30% Suffer from Two or More Co-morbidities Opioids Rx Accounts for 19% of Claims Cost Working While “High” Using heavy narcotics to treat chronic pain conditions Epidemic Can We Add Wellness as a Key Component of Injury Management? 36 Every Workers’ Comp Claim Starts With An HR Decision…. Old Exposure Lost Wages Indemnity or Lost Wage Payments Medical Cost Ancillary Providers Litigation Settlements Increased Premiums New Reality ADA – ADAAA FMLA Age Discrimination Wage and Hour GINA Obesity & Opioids Retaliatory Discharge Medicare Workers’ Compensation and the associated cost. 37 What are the ADA Qualifiers? Major life activities: In general – major life activities include but not limited to – caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating and working 38 Typical Workers Comp Restrictions: No lifting over 25lbs Limited sitting or standing No use of the right hand No walking No bending No pushing or pulling No driving No work No full time work…. 39 Well Defined Return to Work Procedures… What do you want me to do when I am released to return to work… Who do I notify that I am able to come back to work? What is your company or organizations requirement? What will accommodation look like for the employee? 40 Return to Work Policy… This policy should define your return to work program… By addressing how you will accommodate the injured employee. Outline your expectations for accepting light or modified duty positions. It should explain that the position is temporary and based on the restrictions imposed by the treating physician. You should explain how permanent restrictions are handled. 41 Along Comes the Injured Employee Your Next Step… Job Description Job Analysis Letters to the injured worker Effective Communication with Supervisors & Managers Effective Communication with other employees Proactive communication with the treating physicians 42 Case Study…. Nancy Brown is a Home Health Aide. She has a back injury and goes to the doctor. Her restriction is: Limited lifting – nothing over 5lbs. Treatment Plan Physical Therapy – 3x per week Able to return to work light duty… RTW Coordinator Toolkit: Employee’s Post Accident Guide Employee Pre-Injury Job Description Evaluate FMLA Exposure 43 Step 1: Pre-injury Job Check The employee is released to return to work light duty: Identify the light duty restrictions and decide where you will assign the employee. Evaluate the pre-injury job to determine if the employee is able to perform all or only specific parts of the position. Question: Can the employee return to the pre-injury job? Yes or No Evaluate and Reviwe the: Pre-injury Job Description 44 Step 2: Light Duty Assignment If the restriction prohibits or limits the employee’s ability to do their regular job: Evaluate the restrictions and determine the exact tasks that will be assigned to the injured worker. Complete a Job Demand Evaluation for the pre-injury position and the post accident position. Toolkit: Job Demand Evaluation Physicians Approval of Light Duty Job Assignment Form Supervisor Meeting 45 Step 3: Compliance Two areas Employee and Supervisor Compliance: Employee: Is the employee showing up for light duty work? Did the employee respond to your request to return to work light duty? How do you document that you relayed the job to the injured employee? Toolkit: Letters to the Employee Communication with the Adjuster 46 Step 4: Documentation Employee Non-Compliance I’m in too much pain to work? I’m taking medication that is making me sleepy – this is a real issue! Working while totally ill – “Working While Sick” or “Too Sick to Work” My supervisors is making me do things I shouldn’t My attorney told me I don’t have to do what you said! The answer: I really don’t care what your attorney said – We are the employer we set the rules. We are offering you a job within the stated restrictions – these are our rules. Toolkit: Document! Document! Document! No Intimidation Zone 47 Toolkit – Tricks of the Trade Immediate and Prompt Referrals for Specialty Care Functional Capacity Evaluation Physical Therapy Progress Reports Physicians approval of the light duty job Video tape of the job Physician visit to your facility Malingering – Non-Compliance! 48 Multiple Physicians…. Rinse and Repeat Enlist the help of the adjuster Send the job description to new doctor Ask if the employee can return to the pre-injury job Ask if the employee can continue in the light duty position Challenge off work status from “New” treating doctors 49 Follow-up You must create a plan or diary system to follow-up with all the players in the RTW process Employee: When is your next appointment? Did you go to the appointment? Are you feeling any better? Any problems accessing medical treatment Adjuster: What is the status of the claim? What information did you get from the last appointment? What is the anticipated full duty release date? Are there any issue I need to know about? Supervisor: How is the employee adjusting to work? Any issues, challenges, problems? 50 Step 5: Final Release – Now or Never Long-term light duty How long is too long? ADA Compliance – is the restriction permanent and does it qualify the employee for ADA protection? MMI with Permanent Restrictions Can you continue to offer employee a job if they have a permanent restriction? What are your options? Toolkit See Legal advise – from an Employment Attorney in your State 51 Advocate + Enforce + Liaison + Customer Service What would your program look like if you focused on being a Customer Service Advocate for the Injured Employee? How would we impact the outcome of the claim if we added Wellness as a component of our Talent Retention Strategy? Litigation triangle: People hire attorneys because they think someone is out to take something away that they are entitled to… or They saw your prior pattern and they anticipated the outcome and that outcome requires legal representation. 52 12 Steps to Re-introduce Your Employee to Work Contact the employee notify them that you have light duty job Contact the adjuster or case manager and let them know you are offering the employee a light duty job Send offer letter to the employee or schedule an appointment to meet with the employee Create your form that list the restrictions and light duty job Get the supervisor to understand the restrictions 53 12 Steps to Re-introduce Your Employee to Work Before the employee returns to work, sit down with him/her and review the job description, duties and restrictions Explain that his is temporary and will be evaluated weekly to determine if the job is fitting the employee Step back and recognize that you are not a babysitter The employee is either going to comply or not – do not over manage or micro-manage the injured employee. Become an advocate Track all medical appointments – You must have a method to track appointments and compliance with attending appointments 54 12 Steps to Re-introduce Your Employee to Work Contact the adjuster after the employee returns to work and provide them with the return to work date, work schedule and rate of pay Follow any State rules on Return to Work and workers comp payments Continue to send letters to the treating physician to determine if and when the employee can return to work full duty Monitor for FMLA and ADA compliance with HR Department oversight. 55 12 Steps to Re-introduce Your Employee to Work Monitor each appointment for signs of progress Is the employee getting better? Red Flag for permanency Make sure the employee returns for the final appointment and gets either a full duty release or final release with permanent restrictions Monitor for ADA exposures Determine if your insurance carrier intends to settle claim file – What’s allowed in your State? Transition the employee back to regular job gradually Determine the Accommodation (Temporary or Permanent) 56 What’s Next… Create and Add policies to your Employee Handbook… Add Return to Work Policy as a poster in your break- room. Get everyone on board…Education can change the heart and the mind. Coordinate, Advocate, Enforce Create checklist, forms and procedures that work in your organization 57 Change the Lingo… Re-Onboarding – How do we bring the employee back to work? Talent Management – How do we determine what they can do? Or How do we create pathways to work? How do we extract the talents the employee has if they can’t do their regular job? Retention – How do we keep the employee here after the injury? Value – Do we continue to value the employee after they have an injury? How do we Eliminate the “De-Valued” Employee Syndrome? How do we get others to understand that the employee has value? 58 Job Accommodation Network… www.AskJAN.org Most Accommodations Cost Less then $500 59 Contact Information… Blog – www.WorkersCompGazette.com LinkedIn – Margaret Spence Twitter – @MargaretSpence @WorkCompGazette Training…www.WorkCompSeminars.com Phone: 561-795-3036 Email: [email protected] Speaker: www.MargaretSpence.com 60 61