It takes a village for optimal RTW

Key personnel must get involved

At the Imperial (CA) Irrigation District (IID), any of the 1,200 employees who become injured or ill has access to an interactive return-to-work (RTW) program that has exceeded the expectations of the team who put it in place. (The IID is the largest irrigation district in the world, handling irrigation water and power.)

The program, which is outlined in five distinct phases, was instituted in 1993. Marcy Feuerstein, employee benefits services section supervisor, calls it interactive. "What I mean is that we have a team put together that involves some very key players," she explains. "By being interactive, you get input not only from the employee, but from the treating doctor, from our disability specialist, and from the employee’s supervisors — who are key."

If the injury or illness is work-related, a workers’ comp claims management and disability consultant is also brought into the mix. "As supervisor of employee benefits, I provide input, as well as the manager of human resources, and the department manager of the employee," Feuerstein adds. "We also keep the general manager up to date on all cases involved, and if there was an accident, we also share information with the supervisor of safety and the case’s legal counsel."

Why a village is needed

She uses the phrase "It takes a village" to explain why input from so many different players is needed. "Our focus here is on what abilities the employee has that we can use to bring them back to work as soon as possible and when deemed medically appropriate by the treating doctor," Feuerstein notes. "We need everyone’s input to do this."

When a disability exists for three or four months, Phase I is instituted, with an "initial interactive reasonable accommodation meeting." "We sit around a big table and review the guidelines," says Feuerstein. "Whatever updated information we have been allowed to obtain is assembled prior to the meeting; whenever we don’t have it, we ask the employee to share with us what happened medically with them."

Depending on the severity of the case, meetings, and communications continue along the five phases. "We work directly with the employer, the supervisor, and the provider," notes Shauna Callens, CPDM, human resources assistant disability management. "If at some point it looks like these absences are no longer temporary and we need to look at the larger picture of things, then we will initiate larger RTW meetings that involve the whole RTW team. If it is a temporary absence, it just involves the three main parties."

The larger roundtable discussions address reasonable accommodations, or reasonable job alternatives. "If needed, the consultant gets a release from the employer and sends a letter to the doctor to address the job description," says Feuerstein. "If the employee is returned to work with restrictions and limitations, we meet with the supervisor and maintain communications about any tasks the employee might be asked to do."

The members of the IID staff are very proactive, notes Callens. "Sometimes it will come out in a meet that the employee is not getting the appropriate care, such as seeing a specialist," she says. "We see that they do. It also helps that the managers are all on the same plane. If an employee is being treated very conservatively, they may make some suggestions about changes. As employers, we have even sent out for second opinions. "This is a totally integrated process," continues Callens. "We look at all of their benefits, the philosophy of the program and the culture of the organization."

New ideas generated

Because of this open communication process, says Feuerstein, a number of creative ideas have emerged that have helped employees optimize their productivity. "The more people who are aware of and involved in this process, the more ideas come out of it," she says. "We’ve had employees come up with very creative ideas about tools and equipment, redesigning things, and even body mechanics. When we sit down together, there is sort of a feeding frenzy of ideas."

For example, the IID has a canal system of running water that requires a lot of pressure. "We have what we call a lifting dog, a sort of lever that requires you to use your back, shoulders, knees, and so on," says Feuerstein. "One employee created a wheel to do the same thing — and it doesn’t blow out your back."

"It definitely improves the employee/employer relationship, creating a team effort," adds Callens. "The employee feels there’s partnership in this, that they are part of the solutions and process. From an injured worker’s standpoint, you know you are dealing with a progressive super and employer who are not looking to put you out to pasture. It’s a win-win situation for all parties."

"It has also changed how supers and department managers look at the function of a job," Feuerstein observes. "They will stand back and look at not just one person, but at all the workers. For example, we use a lot of pickup trucks, and [this approach] led to replacing bench seats with bucket seats for all those who work out in the field, because they provide more back and leg support."

The program has helped put a lot of people back to work, she continues. "It probably has exceeded what we ever expected in the beginning in regards to reducing lost work days," she says.

Again, says Callens, this comes back to communications. "We let the employee know up front that our goal and basic intent is to get them well and back to work," she says.

[For more information, contact:

• Marcy Feuerstein, Employee Benefits Services Section Supervisor, Imperial Irrigation District, Imperial, CA. Telephone: (760) 339-9777. E-mail:]