Building a Better Return-to-Work Program
This past summer I had the pleasure of working as co-lead of the Transition Back to Work Policy Work Group. Under the U.S. Department of Labor’s Office of Disability Employment Policy’s (ODEP’s) Stay-at-Work/Return-to-Work Policy Collaborative, the work group was charged with developing recommendations to State policy makers that would help workers who have lost work time due to injury, illness, or disability make the transition back to work as early as possible. In this blog I would like to highlight information from one of the group’s work products regarding the development of a model return-to-work program.
The business case for Stay at Work/Return to Work (SAW/RTW)
The high cost to business of workers leaving the job due to injury, illness, or disability is well documented. Improving the worker’s ability to transition back to work as soon as possible helps lower the cost to business for expenses such as absenteeism, lost productivity, and, in some cases, the need to replace employees. In some instances, employees are ready to RTW, but not full-time or able to perform all of the usual responsibilities of the job.
One of the most effective ways to support positive employment outcomes for the worker is to implement RTW strategies early in the recovery process, as soon after the employee takes leave from the job as possible, with a focus on maintaining the employer-employee relationship.
What does a model SAW/RTW program look like?
Listed below are recommendations for the components of a comprehensive, collaborative and proactive SAW/ RTW program. These components can be utilized by both large and small employers, as well as public and private-sector entities. Employers should include as many aspects as practicable, tailoring the specific details to their own organization. For an SAW/RTW program to be successful, it is imperative that the employer make a fundamental commitment to retaining/returning employees with an injury, illness, or disability to work in a timely and safe manner, and to communicating within the organization that SAW/RTW is part of their business strategy to retain valued employees and to enhance the productivity of the workforce overall.
The following program components provide the guidance and support employers need to make this commitment.
Develop and maintain communication tools and instructional materials to introduce SAW/RTW to the stakeholders and set expectations regarding RTW
These tools and instructional materials may be customized to particular audiences within the employer organization, including (as applicable):
- Upper Management – Explain the financial benefits and return-on-investment (ROI) associated with RTW to gain buy-in and program support.
- Line Supervisors – Outline the supervisors’ role in the RTW process, set the expectation for support of RTW, and explain benefits and program parameters.
- Labor/union – Promote buy-in and support from labor organizations and highlight the benefit of RTW for their employee members.
- Healthcare Providers – Solicit providers’ support for RTW as a goal, educating them on the RTW options available to employees, and encourage the timely provision of detailed information on employee limitations and capabilities for RTW.
- Insurance Carriers – Define the insurers’ role in the employer RTW program and set expectations for program support and timely communication of information regarding employee restrictions and RTW capacity.
- Other departments in the employer organization, such as Workers’ Compensation or Leave Management departments – Foster collaboration across stakeholders to minimize duplication of effort, support positive outcomes, and ensure compliance with a range of applicable laws.
Establish an RTW Coordinator role and functions within the organization
Depending on the size of the employer and their resources available, this may include creating an RTW Coordinator position or the assignment of RTW coordination tasks to an already existing position. These functions include assisting the employee in navigating through the process, providing education to supervisors on appropriate RTW strategies, identifying transitional work tasks available within the organization, and facilitating/ documenting communication among all parties related to RTW efforts and outcomes.
Identifying and communicate roles and responsibilities for all entities involved in RTW
Assigning specific roles and responsibilities establishes the accountability required for positive outcomes and overall program success, and helps promote collaboration across the various entities within the employer organization. Descriptions of roles and responsibilities should be developed for:
- RTW Coordinator (and/or Human Resources)
- Health care providers
- Unions (if applicable)
Develop, implement, and communicate the organization’s policy on RTW
The Return-to-Work policy statement is a joint labor/management directive offering an introduction to the workforce of the organization’s RTW program. The policy statement will be a point of reference throughout the entire development and operation of the RTW program as it sets the general scope of, and guidelines for, the program. Once developed, it is important to communicate the commitment to RTW throughout the organization.
Develop and deliver training for all entities involved in RTW
Given that the RTW program is designed to work as a partnership between employee, employer and healthcare provider, it is important to educate the entities involved in RTW efforts to make them aware of the practices of the program and the benefits of making a commitment to the program. Training those involved in the organization’s RTW efforts will set clear expectations, support consistency in practices as well as encourage the use of appropriate strategies throughout the RTW process. Training should be developed and delivered to:
- RTW and related coordinators
Develop a method to document essential job functions and associated job demands
RTW strategies are based on a comparison of the employee’s limitations and the demands associated with performing the essential functions of the job. This comparison allows the employer and employee to identify what accommodations or assistance may be needed to support productive work, either in full or partial performance of the essential functions, or in other productive work tasks as needed. It is best for employers to identify essential functions and job demands proactively and in collaboration with employees and (as applicable) unions. As jobs may change over time, the essential functions and job demands should also be reevaluated when working with individual employees and supervisors to identify RTW strategies. The Job Accommodation Network provides guidance on the development of job descriptions with essential job functions.
Identify and implement the process by which temporary, transitional work tasks are identified
As part of the individualized RTW plan, an employee may temporarily be unable to perform all essential functions of his or her job. In those situations, assigning other productive work tasks to employees will support early and sustained RTW. When opportunities for transitional work tasks exist in an organization, employees are twice as likely to successfully resume work. Employers should implement a means to solicit from various managers, supervisors, and leaders what productive work tasks they have available, especially those tasks better suited for individuals with restrictions or limitations as a result of illness or injury. Once the tasks are identified, the RTW Coordinator can also determine and document the physical and mental demands associated with performing the tasks, so that appropriate matches can be made between an employee’s limitations and a medically appropriate task.
Provide guidance on methods and resources that can be used to assess assistive technologies and other technical expertise in RTW
Research shows that most job accommodations provided are low cost or no cost, and are effective at supporting RTW. Assistive technology can be an important component to RTW for some employees. One potential barrier to employers considering RTW strategies such as assistive technology, is the concern that they do not have the expertise to identify accommodations that will be effective in supporting the individual’s ongoing productive employment. The fear that the money invested into these efforts may simply not result in the desired outcome can prevent the employer from moving forward. When employers receive technical resources and access to experts, they can be more confident that the costs incurred will result in RTW. Employers should be made aware of resources such as the Job Accommodation Network (www.askJAN.org) and other resources potentially provided by their State which employers can utilize to both offset costs incurred with RTW and support successful employment outcomes.
Establish standardized communication and documentation tools
Developing and utilizing formal, written policies and procedures that apply across the organization creates a consistent and cohesive RTW framework and supports successful and sustained RTW. Included in the procedures should be samples of standardized forms used to communicate about the program, guide the various entities involved through the steps of the program consistently, relay information needed to develop RTW plans, and document the outcomes of the process. Included in this collection of templates would be:
- RTW Program FAQs
- RTW Coordinator checklist
- Supervisor checklists
- Healthcare provider forms to provide limitations/restrictions
- RTW Task assignment agreement form
- Letters to employee to communicate RTW status and actions
- Job description format
- Transitional task description format
Identify information to be collected and analyzed in support of RTW program effectiveness, cost/benefit, and ROI calculations
Evaluation is critical to identifying the strengths and weaknesses in employer RTW programs, both in terms of positive employment outcomes and positive financial gains. Employers should have methods established to collect data pertaining to time frames for RTW, RTW plan durations, cost of accommodations or modifications, changes in trends for lost-time work days, rate of employee retention, and cost savings associated with RTW such as avoiding the cost of hiring new employees if current employees had not returned back to work.
For more information on or assistance with designing and implementing a successful SAW/RTW program feel free to contact me at [email protected].
- Ceniceros, Roberto. (2012). Tracking True Cost of Lost Productivity Remains a Challenge. Workforce Magazine. Available at: http://www.workforce.com/2012/09/17/tracking-true-cost-of-lost-productivity-remains-a-challenge/
- U.S. Department of Labor, Occupational Safety and Health Administration. Available at: https://www.osha.gov/Publications/safety-health-addvalue.html
- Bardos, M., Burak, H., & Ben-Shalom, Y. (2015). Assessing the Costs and Benefits of Return-to-Work Programs. Final report submitted to the U.S. Department of Labor, Office of Disability Employment Policy. Mathematica Policy Research. https://www.dol.gov/odep/topics/pdf/RTW_Costs-Benefits_2015-03.pdf
- Loy, B. Accommodation and Compliance Series: Workplace Accommodations – Low Cost, High Impact. Job Accommodation Network (JAN). https://askjan.org/media/lowcosthighimpact.html
- Franche, R. L., Cullen, K., Clarke, J., MacEachen, E., Frank, J., Sinclair, S., & Reardon, R. (2004). Workplace-based Return-to-Work Interventions: A Systematic Review of the Quantitative and Qualitative Literature. Institute for Work & Health. Available at: https://www.iwh.on.ca/system/files/sbe/summary_rtw_interventions_2004.pdf
- Waddell, B., & Kendall, N. A. S. (2008). Vocational Rehabilitation: What works, for whom, and when? Industrial Injuries Advisory Council. Available at:
- Mitchell, K. (2012). The Return to Work Dividend: Protecting Productivity. Testimony to the US Senate Committee on Health, Education, Labor and Pensions. Available at: https://www.help.senate.gov/imo/media/doc/Mitchell6.pdf
- New York State Workers’ Compensation Board. Return to Work Program. Available at: http://www.wcb.ny.gov/content/main/ReturnToWork/RTW_Handbook.pdf
- Orslene, L. Accommodation and Compliance Series: Return to Work Programs. Job Accommodation Network (JAN). Available at: www.Askjan.org/media/rtwprograms.html
- State of Pennsylvania, Department of Labor and Industry, Return-to-Work: A Model for Pennsylvania Business and Industry. Available at: http://www.dli.pa.gov/Businesses/Compensation/workplace-comm-safety/ReturnToWork/Pages/Table-of-Contents.aspx
- State of California, Department of Industrial Relations, Commission on Health, Safety & Workers’ Compensation. Report on the Return-To-Work Program Established in Labor Code Section 139.48. Available at: https://www.dir.ca.gov/Chswc/Reports/2010/CHSWC_RTWReport.pdf