When I first joined the workers’ compensation industry more than two decades ago, the concept of “return to work” was already in the process of waning. It might be better described as a full-on retreat. Retraining programs and vocational services were being cut. Second Injury Funds were rapidly becoming nothing but a memory. The shift in the industry was focusing on the easier road of “process and close,” and what happened to injured workers after the fact was really none of our concern. Thankfully, that trend is showing signs of reversal.
There has been a notable shift in discussions over recent years focusing on the need to treat the “whole person” after a workplace accident. The concept is called numerous things, including bio-psychosocial care and Claims Advocacy; but all discussions recognize the importance of understanding and responding to the mental condition and status of the injured worker. With this trend has been an acknowledgment that focusing on the bigger picture improves outcomes and even lowers costs. And the more tacit admission is that simply dumping injured workers with a settlement and disability label does no one any good. Society suffers as much as the injured workers do in that scenario.
Another recognition is that dignity is an essential part of gaining a positive mental attitude, and that purpose from meaningful work can provide dignity. Returning injured workers to the workplace is again gaining recognition as an essential part of the recovery process (and as you know, we are all about Workers’ Recovery in this neck of the woods). There are definite signs that RTW is coming back in vogue.
The State of Washington has been a leader in this area, and Tennessee is also showing terrific innovation designed to gain more effective RTW results. Washington L&I successfully shepherded legislation in the state that greatly enhances their ability to employ early interventional vocational services. The concept of pairing vocational counselors with claims adjustors early in the life of a claim appears to be generating very positive results. Care is improving, outcomes are better, and the state-run insurer is showing evidence that the savings will be in the billions. That is Billions with a B, folks.
In Tennessee, they just announced this week new employer training programs that are part of the “BWC’s newly developed Returning Employees to Work And Reducing Disabilities (REWARD) program.” According to the agency, “The initiative helps interested employers develop and customize a return-to-work program for their businesses. A REWARD program can be beneficial for both large and small employers.” The initial training offered six online courses for employers: Workers’ Compensation 101, The Role of a Return-to-Work Coordinator, Working with Physicians, Job Demand Analysis, Legal Issues Outside Workers’ Compensation, and Effective Communication.
In a statement, BWC Administrator Abbie Hudgens said, “Helping injured employees find their way back to meaningful work is a goal that benefits everyone. Return-to-Work Coordinator Training provides employers with valuable skills and tools to make REWARD a reality for employers and their employees.” The release also said, “The BWC training program utilizes expertise from vocational rehabilitation, case management, physical therapy, employers, medical providers, legal professionals, and state government to provide a comprehensive training experience.”
There are numerous private vendors that have been focused on these new strategies designed to improve outcomes for the industry. Some employers have also of their own accord initiated very effective RTW programs. An article on this site last month highlighted an RTW program at aviation company Sikorsky that produced a 48 percent reduction in lost workdays within 9 months of implementation. True change, however, will not occur until the state regulatory bodies embrace the concept and recognize the importance of effective return to work principles (in a greater sense I would make the argument for calling it “Return to Function,” but I will leave that for another day). Moves by states like Washington and Tennessee are critical to making effective Return to Work part of the everyday routine, rather than the exception to the rule.
In the end, it comes down to leadership, and the willingness to go against the flow of conventional thought.
This blog has long advocated that the workers’ compensation industry needs to be rebranded as “Workers’ Recovery.” No other phrase better sets the expectations for both the people entering the system and the professionals tasked with helping them. An essential cog in the Workers’ Recovery concept is the restoration of dignity through purpose, and avoiding workplace disability by restoring function to injured workers is the key to that process. It is refreshing to see that one of the most important elements for that process is beginning to once again see the light of day.
We will all be better off for the effort.