SAFETY POLICY

Return to Work SP# A-5


Quick Reference

1.0 Purpose
2.0 Scope and Applicability
3.0 References
4.0 Policy
5.0 General Responsibilities
6.0 Procedure
6.1 Definitions
6.2 General Provisions
6.2.1 Training
6.2.2 Return to Work Process
6.2.3 Return to Work Rules
6.2.4 Preferred Provider Network
6.2.5 Transitional Work Assignments
6.2.6 Permanent Job Modifications and New Position Assignments
6.2.7 Post Return to Work Notification
6.2.8 Program Communication
6.2.9 Tracking Results of the Return to Work Program
6.3 Specific Responsibilities
6.3.1 Managers
6.3.2 Supervisors
6.3.3 Employees
6.3.4 Human Resource Manager and Workers' Compensation Coordinator
6.3.5 Division Safety Officer/Consultant
6.3.6 Safety Risk Management
6.3.7 Workers' Compensation Administrator
6.3.8 Human Resource Division

APPENDIX A: Guidelines in Matching Employees to Alternate Duty
APPENDIX B: Common Restrictions Based on Body Part
APPENDIX C: Form to Match Modified Duty to Injury


1.0 Purpose

The purpose of this safety policy is to establish guidelines and procedures, consistent with NCGS 97-32.1, and the Office of State Personnel policies and procedures for returning injured North Carolina Department of Environment and Natural Resources (NCDENR) employees back to work with minimal lost time and as part of their recovery process.


2.0 Scope and Applicability

Returning employees to work who have been injured in the performance of their job is an important component of NCDENR's loss control strategies. Benefits of a return to work program include:


Without a return to work program, the healing process may be prolonged, employees have little incentive to return to work, and are less likely to return to work the longer they are out of work.

This safety policy includes provisions for supervisor training, a discussion of the return to work process, details on NCDENR's preferred provider network and information on transitional work assignments, permanent job modifications and new position assignment requirements. This document also outlines priorities for post-injury placemen
t of employees, notes post return to work notification, how the program should be communicated and highlights how results of the program are tracked.

This policy denotes the areas of responsibility for managers, supervisors, employees, the Workers' Compensation Administrator, the Division Safety Officer, Safety Consultants and Safety Risk Management and Division/Office/Program Human Resource Managers and Workers' Compensation Coordinators and the DENR Human Resources Division.


3.0 Reference

This safety policy is established in accordance with the North Carolina General Statute Chapter 97 (Workers' Compensation Act, 1994), the North Carolina Industrial Commission Rules and Regulations (1995), North Carolina Office of State Personnel, Workers' Compensation Employee Handbook (1999), North Carolina Office of State Personnel's, Workplace Requirements for Safety, and the Americans with Disabilities Act (ADA).
In the event of a conflict between the provisions of this safety policy and applicable state or federal laws, the latter shall contr
ol.


4.0 Policy

It is the policy of NCDENR to provide a place of employment that is free from recognized hazards that cause or are likely to cause death or injury to employees or the public.
However, when serious physical harm does occur to employees,
NCDENR is committed to the effective return to work of injured employees as part of their recovery process.  NCDENR is also committed to providing quality medical care and managing the costs associated with that medical care. 


5.0 General Responsibilities

It is the responsibility of each manager, supervisor, and employee to ensure implementation of NCDENR's safety policy regarding Return to Work. Specific responsibilities are found in Section 6.3


6.0 Procedure

This section provides applicable definitions, establishes general provisions, and identifies specific responsibilities required by NCDENR's safety policy on Return to Work. 


6.1 Definitions

Alternate Duty- Duties assigned to an injured employee on either a short term or permanent basis, and medically approved by the authorized treating health care provider.

Permanent Job Modification- Jobs that are permanently modified for employees that have permanent restrictions upon return to work following an injury.

Preferred Provider- A health care provider that has entered into an agreement with NCDENR, or its Third Party (TPA) Workers' Compensation program administrator, or the State of NC's WC Third Party Administrator to provide prompt health care services to an NCDENR employee injured during the performance of their job.

Transitional Work Assignment- Work assignments (duties) that are short term and that employees with temporary medical restrictions are assigned upon return to work following an injury. Also referred to as modified duties.

Workers' Compensation Leave- Period of time that employees are recuperating from job-related injuries and during which the employee receives 66.667 % of their average weeky wages.


6.2 General Provisions

This section details the provisions of this safety policy and procedure with each provision discussed in a separate subsection. The provisions adopted by NCDENR are:


6.2.1 Training

The critical link in NCDENR'S Return to Work Program is supervisors accurately understanding and applying their role in this process. Therefore, supervisors should receive training that includes specific details on the Return to Work process and their responsibilities under this program. This training will be conducted as a one-time training with re-training every three years, or as determined through safety audits or as case by case Return to Work issues require.


6.2.2 Return to Work Process

The following chart illustrates the major components of the return to work process.

RTW Basic Flowchart

 
 

When an employee, who has been injured on the job and placed on workers' compensation leave, has been released to return to work by the treating physician, there are three possible return to work scenarios.

Scenario 1-An employee has reached maximum medical improvement (MMI) and has been released to return to work by the treating physician/ health care professional.

Scenario 2-An employee has not reached maximum medical improvement and is ready to return to a transitional work assignment (limited or modified work duty) with approval of the treating physician/ health care professional, but retains some disability which prevents successful performance in the original position.

Scenario 3-An employee has reached maximum medical improvement and has been released to return to work by the treating physician/ health care professional, but has received a disability which prohibits employment in his/her previous position.

For scenario 1, when an employee has reached maximum medical improvement and has been released to return to work by the treating physician/health care professional, NCDENR shall return the employee to the original position he/she held prior to workers' compensation leave.

For scenario 2, when an employee has not reached maximum medical improvement and is ready to return to a transitional work assignment, NCDENR shall (re)assign and provide work duty suitable to the employee's capacity which is both meaningful, productive and advantageous to the employee and NCDENR. This work reassignment shall be a temporary assignment and shall not exceed 90 days without approval from NCDENR Human Resources. When the employee reaches maximum medical improvement, NCDENR shall return the employee to the original position held prior to workers' compensation leave.

For scenario 3, when an employee has reached maximum medical improvement and has been released to return to work but has received a disability that prohibits employment in the previously held position, NCDENR shall attempt to place the employee in a permanently modified job or another position suitable to the employee's capacity which is both meaningful, productive and advantageous to the employee and NCDENR. This work placement may be a permanent assignment or either a part-time or temporary assignment until a permanent assignment is found. For scenario 3, work placements shall abide by the following:

Additional Workers' Compensation processes to follow are located here.

6.2.3 Return to Work Rules

The general rules of NCDENR's Return to Work Program include:


6.2.4 Preferred Provider Network

NCDENR's preferred provider network is a list of physicians and health care professionals that have agreed to treat injured NCDENR employees when such injuries arise within the scope, or performance of their job duties.

This preferred provider list (network) should include orthopedic, neurosurgeon, neurologist, urgent care and/or emergency room physicians. This list shall be maintained by the division/office/program Workers' compensation coordinator, safety officer, or Human Resource Manager. Upon receipt from the Third Party Administrator (TPA), the DENR  Workers' Compensation Administrator shall make the list available to the Division/Office/Program WC coordinator.  Each division/office/program shall share its list with their supervisors.  Supervisor's shall ensure that employees that report to them are aware of the preferred provider location for the employee's assigned duty station, including field activities.

At a minimum, the preferred provider list (network) shall be updated annually.
The network is typically compiled and provided by the State's Third Party Administrator (TPA), but it can be amended through input from the Division/Office/Program's to the Departments Workers' Compensation Administrator.


6.2.5 Transitional Work Assignments

In order to assist in their recovery efforts, while maintaining a desirable productivity level, employees may be provided with transitional work assignments, or modified duties, during their recuperation, as applicable. These assignments (sometimes called limited or modified duty) should be short term in nature (no longer than 90 days) until the employee is able to return to his/her original job assignment. Ideally, these transitional work assignments should already be defined prior to an injury. Ideas for defining transitional work assignments include:

Appendix B lists some common restrictions associated with different body part injuries that could be used to develop transitional work assignments.
6.2.6 Permanent Job Modifications and New Position Assignments

Permanent job modifications and new position assignments are used for employees who receive a permanent disability as a result of an injury, and who are medically documented as unable to perform the original job duties. In many instances, permanent job modifications may be the same as transitional work assignments, except transitional work assignments are temporary in nature. If an employee cannot be placed in a permanently modified job, then that employee may be assigned to another position that meets the restrictions imposed upon the employee by the treating physician. 


6.2.7 Post Return to Work Notification

When an injured employee has missed work days due to the injury and returns to work, the supervisor shall contact the Division/Office/Program's Payroll Coordinator and WC coordinator to alert them of the employee's return.  The DENR Workers' Compensation Administrator shall be notified and the Third Party Administrator. This process minimizes the possibility of unauthorized payment and overpayment.


6.2.8 Program Communication

NCDENR's Return to Work Program must be effectively communicated to injured employees, affected supervisors, preferred providers and Third Party Administrator. Program communication for all DENR employees will be achieved by training supervisors, discussed at safety orientation training for employees and the distribution of available program literature.

Upon receipt of a Form 19
indicating lost time, the Workers' Compensation Coordinator will either provide a hard copy of, or direct the employee to the NC Employee Handbook on Workers' Compensation.  A DENR Return to Work brochure will be provided to the injured employee and their affected supervisor as budget and resources allow. These items provide information and specific details on the responsibilities and required actions for injured employees and affected supervisors. The injured employee shall also receive a Workers' Compensation (WC) packet from their supervisor. 

Preferred providers will receive information directly from the TPA or DENR WC Administrator. This information includes an annual mailing of the Employee Handbook on Workers' Compensation, a WC packet, a return to work brochure and a copy of this safety policy  from the Workers' Compensation Administrator's staff. Additionally, they will receive, as needed, verbal communication from the Workers' Compensation Administrator's personnel and from Safety Risk Management personnel. 


6.2.9 Tracking Results of the Return to Work Program

Results of NCDENR's return to work program shall be tracked by annually compiling trends and statistical reports from internal or TPA databases, as derived from reports submitted from the division/office/program,  OSH 300A summary, and/or information available from the TPA.

In February of each year, each division/office/program shall provide an annual report to the Workers' Compensation Administrator summarizing its involvement in the DENR Return to Work program.  This report shall include a comparison of lost work days for the previous and current calendar year, as well as efforts undertaken to identify and provide transitional duties and assignments for injured workers.


6.3 Specific Responsibilities


6.3.1 Managers

Managers will be responsible for:


6.3.2 Supervisors

Supervisors will be responsible for :


6.3.3 Employees

Employees shall be responsible for promptly reporting any injuries to their immediate supervisor and going to the preferred provider as directed by their supervisor. They will also cooperate with the Workers' Compensation Administrator's staff, preferred providers, Workers' Compensation Coordinator, Human Resource Managers, and DENR Safety  personnel in the treatment, recovery and return to work phases of the process.  (To ensure prompt medical attention, life threatening and severe injuries requiring emergency treatment are to be done so at the emergency medical facility nearest to the injured employees location.) 


6.3.4 Human Resource Managers and Workers' Compensation Coordinators

The division/office/program Human Resource Manager and Workers' Compensation Coordinator will be responsible to:



6.3.5 Division Safety Consultant/Officer

The division/office/program Safety Consultant/Officer will be responsible for:


6.3.6 Safety Risk Management

As staffing allows, Safety Risk Management will provide prompt assistance to managers, supervisors, and others as necessary on any matter concerning this safety policy and its procedures. Safety Risk Management will develop and assist in the appropriate training associated with this document. Additionally, Safety Risk Management will:


6.3.7 Workers' Compensation Administrator

The Workers' Compensation Administrator will be responsible for:


6.3.8 Human Resources Division



APPENDIX A : Guidelines for Matching Employees to Alternate/Modified Duty
 
Alternate/Modified duty includes transitional work assignments (limited and modified duty), permanently modified jobs and new position assignments.
  1. The supervisor should list all restrictions provided by the physician.
  2. The supervisor then lists all alternate duty jobs and their wages, including regular jobs with modifications available.
  3. The doctor's restrictions should then be matched to the best possible alternate duty. In the case where there may be a unique restriction from the physician, check the alternate duty job chosen to make sure it meets with the restrictions or can be modified to meet the restriction.
  4. Take the identified and available job description(s) that meets restrictions. Examine the wage section to ensure that none of the alternate duty jobs pays more than the original job.
  5. Forward or take the job description(s) to the physician's office. The physician will sign off on all jobs that are appropriate and make comments as necessary for this particular case. The physician will forward them back to the supervisor and Human Resource Manager.
  6. If the physician has identified more than one job as appropriate, the best alternate duty position should be chosen to best meet NCDENR needs.
  7. The Supervisor and Human Resource Manager will meet with the injured employee and physicians as needed to explain the alternate duty position.



APPENDIX B : Common Restrictions Based on Body Part
 
Injury Location
Common Restriction
Lower Back No lifting over ___ lbs.
No repetitive bending
No prolonged bending
No prolonged sitting
No prolonged standing
Wrist and Hand No forceful gripping
One arm work only 
Break every hour to stretch hands for 1-2 minutes 
No lifting with hand over five pounds 
Work at own pace - no production
Elbow No forceful gripping
No reaching with elbow extended 
No repetitive twisting of forearm
Shoulder No reaching over head 
No reaching with extended elbows
No reaching across body
No lifting over ___ lbs.
Knee No kneeling
No crawling 
No squatting 
Limited walking
No climbing stairs or ladders 
No lifting over ___ lbs.



APPENDIX C: Form to Match Modified Duty to Injury
Use this form and the information in Appendix B to pre-identify job tasks that an injured employee could do within the medical restrictions provided by the Preferred Provider.

Complete the form for various job positions and retain for use.

 
Click here (MS Word Document.)




Effective: January 2005

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