Try a 'light duty' program for injured workers

Minimizes lost work days for employees

At Saint Joseph Health Center in Kansas City, MO, the risk manager created an innovative light-duty program for injured hospital workers that has resulted in a steady decline in the number of lost work days.

By transferring injured workers to light-duty responsibilities, lost work days at Saint Joseph will fall to 40 in 1995, from 142 in 1994, estimates Cynthia Wickstrom, JD, manager of risk and safety services. Furthermore, the intangible benefit of keeping an able employee on the job has boosted hospital morale, Wickstrom says.

For many risk managers, handling workers' compensation is an unfulfilling challenge. Statutes in most states prescribe the handling of claims and the amount of compensation, making any attempt to rein in the costs of workers' compensation a virtual impossibility. Saint Joseph's light-duty program is one measure that can make a difference.

Injured workers at Saint Joseph used to be labeled as disabled and generally would stay at home until they were able to return to their position at the hospital, Wickstrom says. Under her light-duty program, the hospital looks at what injured employees can do and places them temporarily in other positions that can accommodate their medical restrictions or limitations while they recuperate.

When possible, worker stays in same area

Wickstrom tries to keep workers in the same department as their permanent job, so they don't have to be trained about new regulations and procedures. If injured workers cannot be placed on light duty in their same department, she then looks at other departments in the hospital where they can be used.

"As people become more attuned to the idea that a nurse can work without having to be able to lift a 300-pound patient, more people are taking the light-duty option," she says.

The light-duty program has a three-part mission:

* to improve the management of the medical component of the workers' compensation claim;

* to reduce the number of lost work days;

* to ensure that injured employees are treated as valuable members of the hospital team.

Following are six key steps in creating a light-duty program like Saint Joseph's:

1. Build a strong relationship with health care providers.

Injured employees at Saint Joseph are sent to a physician of the hospital's choice to be treated and assessed for light-duty eligibility and restrictions. The participating doctors understand the objectives of the light-duty program.

"Have a good relationship with whatever medical care providers you are using, because they are the ones writing the restrictions," Wickstrom says. "If they understand the objectives, they can make the determination of whether a person can be used in light duty."

Make it financially desirable

2. Build in financial incentives for the employees.

As in most states, Missouri law allows injured workers to recuperate at home and collect a portion of their salary. Employees on light duty at Saint Joseph are paid their full salary, Wickstrom says. They also benefit by not running up the limits of their benefits while recuperating.

3. Include supervisors as part of the light-duty program.

At Saint Joseph, supervisors serve as liaisons in the light-duty program. Once an injured employee returns to work, supervisors are included in conferences with the worker and risk management staff when the employee's medical restrictions are reviewed.

Workers are encouraged to communicate directly with their supervisors about any concerns they have while on light duty.

Wickstrom has found that including supervisors in the process alleviates concerns from both sides. "Since we've always been so liability-minded, by giving supervisors information, they know that as long as [the employees] stay within the restrictions, they are OK," she explains.

4. Make sure light duty is temporary.

Wickstrom advises hospitals to set a time limit on the number of days an employee can be on light-duty status. Injured employees should be returned to their original job as soon as they meet maximum medical improvement. At Saint Joseph, employees undergo a full medical review after 90 days on light duty.

If an employee's work restrictions are permanent, Wickstrom brings the human resources staff into the process to determine the long-term implications on the injured worker's employment.

Don't apply double standard

5. Apply the same personnel standards as for conventional employment.

Apply the same personnel policies to employees on light duty as for other employees, Wickstrom cautions. Otherwise, workers' compensation programs can be seen as a haven where the employee is exempt from rules and regulations.

For example, the employee on light duty must call in if he or she is going to miss a scheduled shift, like everyone else. Light-duty employees with excessive absences are subject to counseling, like everyone else, Wickstrom says.

6. Focus on the program's human resources philosophy.

"You can't just boiler-plate this program," Wickstrom advises. "You have to understand your organization's philosophy on human resources. It takes a lot of support and encouragement to get [injured] people to return to work. If this program is viewed just as a dollar-and-cents proposition, you won't get that kind of interaction."