Avoid these 3 common problems with RTW

'Serve as an educator to the supervisor.'

Three things commonly stand in the way of getting an injured employee back to productive work as soon as possible.

These are a treating physician's lack of buy-in, the employee's lack of confidence in his or her ability to return to work, and the immediate supervisor's reluctance to offer restrictions, according to Deborah L. Dicken, RN, BSN, MSHSA, CCM, COHN-S, CLNC, principle of Legal Nurse Services in Pace, FL. She offers these strategies:

Contact the treating physician. Many physicians are reluctant to release an employee back to work, because they're concerned about further injury or exacerbation of the problem. "This will keep a program from being as effective as anticipated," she says. "In my experience, this has been an issue with employees that have had burns or other skin problems where there is a potential for infection."

Although you wouldn't want to allow the employee to return too soon, the physicians treating these cases are typically reluctant to release the employee to return to work. In this case, you should contact the provider to be sure he or she understands the essential functions of the position.

"Explain what options are available for alternative duty positions, and how willing the company is to accommodate the employee's safe return to work," says Dicken.

Give the injured employee the confidence to return to work. "Determine the cause of the problem, and address the identified issues," she says. Before an employee can return to work in any type of industrial or safety-sensitive position, for instance, he or she must not be under the influence of narcotic pain medication. "This increases the potential for the employee to injure themselves or others," says Dicken.

On the other hand, employees may think they have recovered more fully from their illness or injury than they actually have. "These employees tend to come back to work and do too much, too soon," she says. "This can result in having to be taken off work, or restrictions increased."

Do your part to ensure employees are returning to the work environment safely. "Determine what restrictions are indicated, monitor the employee's progress, adjust restrictions as necessary, and provide information to the direct supervisor," she says.

Address resistance from supervisors to accepting the employee back at less than 100% capacity. Since it is the supervisor's responsibility to make production quotas, they often have difficulty understanding how bringing a person back to work with restrictions can be beneficial. Depending on the situation, this could result in a perception that some employees are given favorable treatment.

"Serve as an educator to the supervisor," she says. "Explain the prescribed restrictions, and how they can be applied to the employee's normal position."