CITY OF PORTLAND
EARLY
RETURN TO WORK PROGRAM
POLICY AND PROCEDURES
Revised January 2001
City of Portland
Early Return-to-Work Program Policies and Procedures
TABLE OF CONTENTS
TITLE PAGE
City of Portland
Early Return-to-Work Program…………............................................................................3
Early Return-to-Work Defined……….................................................................................4
Injured Worker Packet………..............................................................................................5
Supervisor’s Role – Emergency Situation (Life Threatening/
Serious Injury)...................................................……...........................................................6
Supervisor’s Role- Non Emergency Situation.................................…........................7
Early Return-to-Work Procedures………….......................................................................8
Sixty Day Review…...........................................................................................................10
If the worker is not released to work…………….............................................................10
Notice of Available Employment (example)…...............................................................11
Temporary Modified Duty Task Description (example)................................................12
Risk Management’s Role………………………………………………………………………..13
Important Terms…………………………………………………………………..……………...15
THE CITY OF PORTLAND
EARLY RETURN TO
WORK PROGRAM
The City of Portland has developed a program designed to assist workers who are temporarily disabled due to a work-related injury or occupational disease. This program is called the "Early Return to Work Program".
When an employee reports an on-the-job injury or occupational disease, he/she will be given certain forms to take to a doctor for examination and/or treatment. If the doctor determines that the employee is not able to return to their regular work, but is capable of some level of work activity, the doctor will complete the appropriate forms indicating the restrictions and conditions for transitional work. The City of Portland will then attempt to provide a modified work position until the employee is able to resume regular duties.
Employees performing modified/transitional work will receive their regular rate of pay for hours worked. If they work their regular full shift, there will be no loss of wages. If they work less than their regular full shift, a temporary partial disability benefit will be payable in accordance with Oregon's Workers' Compensation Law.
The City of Portland may modify, change or discontinue the Early Return to Work Program or conditions of the program at any time.
Studies show that an early return to work program is therapeutic and helps speed the recovery process. In addition, injured employees stay "in touch" with the work environment and with fellow employees, which helps to facilitate a smooth and speedy transition back to their normal job.
Everybody "wins" with this type of program. The City of Portland wins by retaining the use of valuable trained employees while at the same time minimizing workers' compensation costs. Employees win by returning to their regular job and income sooner, and by avoiding the negative effects of a long-term absence.
If you have any questions concerning this program, please contact Risk Management (503-823-5101).
EARLY RETURN TO WORK
Injured workers should not be forgotten. Contact with the worker is vital. The supervisor and the Early Return to Work Coordinator will play an important role staying in touch with the injured worker.
ORS 656.268 (1) states, "One purpose of this chapter is to restore the injured worker as soon as possible and as near as possible to a condition of self support and maintenance as an able bodied worker."
It is our hope that the information on the following pages will provide you with the tools needed to better understand your role in the workers' compensation process, and to successfully return your employee to gainful employment.
Workers' Compensation Team
Risk Management
INJURED WORKER PACKET
Risk Management has assembled an Injured Worker Packet to assist the worker in filing a claim for workers' compensation benefits. The worker’s supervisor should become familiar with its contents in order to assist the worker in obtaining necessary treatment, and to help facilitate an early return to work. The Injured Worker Packet should
be given to the worker when they request a claim form for workers' compensation benefits. A supply of packets should be available in your bureau at all times. The packet consists of the following items:
▪ A claim form “801” for filing for workers’ compensation benefits, with a pink slip attachment “Please Return to Risk Management with completed form 801”.
▪ A MCO (Managed Care Organization) Election Form. The worker completes the election form and the "WORKER" section of the form 801. Both forms should be given to the supervisor or other designated bureau personnel.
▪ A document entitled "IMPORTANT NOTICE" that provides information about the City's managed care organizations and how to access the services of each health care provider.
▪ An envelope marked “GIVE TO ATTENDING PHYSICIAN”. This envelope should be given to the physician by the injured worker or by the supervisor or person designated to accompany the injured worker to a health care provider. The envelope contains information about the City of Portland's Early Return to Work Program and a Return to Work Recommendations physical capacities questionnaire that should be completed by the physician.
▪ A form (consisting of an original and copy) entitled "EMPLOYEE RESPONSIBILITIES REGARDING ON-THE-JOB INJURIES/ILLNESSES". The supervisor should go over the form to the worker. After reviewing, the worker should sign and date this form accordingly. The supervisor keeps the yellow copy and gives the original to the worker. In the event of an emergency or serious injury, complete the form as soon as practical.
• A letter addressed to the worker, “Dear Employee”.
• A sheet entitled, "The City of Portland Early Return to Work Program".
• A sheet entitled, "FREQUENT QUESTIONS ASKED REGARDING WORKERS' COMPENSATION".
• A "RED FLAG" is stapled inside the packet as a reminder to the worker to contact Risk Management immediately should they begin to lose time from work.
SUPERVISOR'S ROLE
EMERGENCY SITUATION (LIFE THREATENING/SERIOUS INJURY)
Injury Occurs:
1. Transport the injured worker to the nearest urgent care center or hospital. If injury/condition is life threatening or if worker cannot be safely transported without possible further injury, call 911 for emergency assistance.
2. After the injured worker has been transported to emergency medical care, call your bureau Return to Work Coordinator and/or Risk Management to report the incident and for any further instructions. Risk Management will follow up on the injured worker's medical treatment at this point.
3. As soon as medically feasible, provide the worker with the "Injured Worker Packet" and go over the packet as mentioned previously. Ask the worker to complete the MCO election form and the 801 claim form right away. If worker is not physically capable of completing the 801 form, contact Risk Management for further instructions.
4. As soon as appropriate, the supervisor will provide to the physician the bureau's temporary modified task descriptions so that the doctor can assess the capability of the worker to perform the tasks.
5. The supervisor's responsibilities from this point on are:
3 To stay in contact with the injured worker during their recovery.
3 To work with your bureau’s Early Return to Work Coordinator or other designated bureau representative to return the worker back to temporary modified duty upon release by the doctor.
Risk Management will work closely with the doctor to obtain a release to temporary modified duty, if requested. The supervisor or Early Return to Work Coordinator will provide the doctor with the task descriptions for the modified duty.
6. The supervisor should now refer to the Early Return to Work procedures and follow those instructions.
Once medical treatment has been provided, Risk Management will follow up on the medical treatment and will be in touch with the supervisor or the bureau's Early Return to Work Coordinator to coordinate the doctor's release to temporary modified duty.
NON EMERGENCY SITUATION (NON LIFE THREATENING OR SERIOUS)
Injury occurs or is reported:
1. Provide worker with the "Injured Worker Packet" and go over packet with worker as previously mentioned.
NOTE: In situations where you are not personally knowledgeable of a specific incident, and worker informs you that they think their symptoms may be work related, ask if it is their intention to file a claim for workers' compensation benefits. If the answer is yes, provide worker with an Injured Worker Packet.
Explain to the worker that an early return to work program is available to them within the bureau. If your bureau has prepared temporary modified duty task descriptions, insert them in the envelope that goes to the physician.
If your bureau has not previously prepared temporary modified duty task descriptions, this should be done immediately to provide the worker the opportunity to return to work as soon as the worker's physician releases them to temporary modified duty.
2. Offer to transport or accompany worker to their physician or to an urgent care facility.
If your bureau has an Early Return to Work Coordinator, they must be contacted immediately to assist with facilitation of the injured worker's return to work activities.
3. Call Risk Management to report the incident and filing of a claim, and for further instructions. Risk Management will follow up on the injured worker's medical treatment at this point.
4. The supervisor's responsibilities from this point on are:
3 To stay in contact with the injured worker during their recovery.
3 To work with your bureau’s Early Return to Work Coordinator or other designated bureau representative to return the worker back to temporary modified duty upon release by the doctor.
Risk Management will work closely with the doctor to obtain a release to temporary modified duty, but the supervisor or Early Return to Work Coordinator will provide the doctor with the task descriptions for the temporary modified duty.
6. The supervisor should now refer to the Early Return to Work procedures and follow those instructions.
EARLY RETURN TO WORK PROCEDURES
TEMPORARY MODIFIED WORK: Available tasks that provide accommodation for temporary limitations and restrictions, and consisting of progressive/transitional stages of activity as physical/mental capabilities permit. This includes return to job at injury, but at less than full shift or less than all regularly assigned duties.
The following steps will be handled by the Supervisor or the bureau's Early Return to Work Coordinator:
1. If you accompany the injured worker to the doctor, check in at the desk, identify yourself, and introduce the injured worker. Give the "ATTENDING PHYSICIAN" envelope to the injured worker to give to the doctor.
2. When the physician appointment is over, obtain and review the physician's release and if it is a release to regular work, you may return worker to their regular duties.
3. If the release is for temporary modified duty, you may offer the worker a temporary modified position at that time. If the worker refuses the offer, CONTACT RISK MANAGEMENT IMMEDIATELY FOR ASSISTANCE.
Failure to accept temporary modified work when offered may result in the worker forfeiting certain benefits under Oregon Workers' Compensation Law.
4. If the worker is not accompanied to the doctor, give him/her an Injured Worker Packet before he/she leave for the doctor visit. Advise the worker to give the "ATTENDING PHYSICIAN" envelope to the doctor. Remind him/her that once they have been released by his/her physician to return to work (regular or temporary modified full/part-time), the worker must report back to work immediately. If the worker leaves the doctor’s office near the end of his/her shift for that day, the worker must then report to work no later than his/her next scheduled shift, or notify you no later than the beginning of their next scheduled shift.
5. Obtain and review the physician's release and if it is a release to regular work, you may return worker to his/her regular duties.
6. Risk Management will assist you in obtaining a signed release for the temporary modified duty assignment from the worker’s physician. Once you have possession of the physician’s signed release, you will need to complete the “NOTICE OF AVAILABLE EMPLOYMENT”, and attach a description of the temporary modified duties being offered and the physician’s signed release for those duties. The originals should be given to the worker and the first copy sent to Risk Management. Keep the second copy for your bureau’s files. Please refer to examples on pages 11 and 12.
7. Once the worker returns to temporary modified work, make certain that the worker adheres to the physician's release. The worker must work within those parameters outlined in his/her physician’s release.
8. Meet with the worker within 24 hours of release to review the physician's release, the assigned temporary modified task(s), and to answer any questions concerning the worker's assignment.
9. Instruct the worker to contact his/her supervisor immediately if he/she has any physical problems related to the assigned tasks.
10. Advise the worker that he/she must not exceed the physician’s written recommended physical capabilities.
11. Coordinate the worker's medical and/or therapy appointments with his/her work schedule and take whatever action is required to authorize the worker to be away from work for these appointments. The worker should be encouraged to arrange his/her appointments near the beginning or end of their shift, whenever possible.
12. Advise the worker that you or the Early Return to Work Coordinator will be contacting him/her during the week to be sure everything is going well.
13. Conduct follow up meetings with the worker on a weekly basis, or as needed to assess the worker’s progress. Review the previous week's temporary modified task list to determine what the worker actually did, and how he/she feels about the physical appropriateness of the tasks. The goal is to gradually increase the level of physical activity until the worker is ready to resume full-time regular tasks. However, it is critical that the temporary work assignments are consistent with the worker’s physician’s release. Risk Management will assist you in obtaining updated information.
14. Resolve any difficulties the worker experiences with the temporary modified tasks performed during the past week. Also, find out if the worker is experiencing any other problems, and take necessary steps to ensure that the worker's return to work following his/her injury is as pleasant and rewarding as possible for you, the injured worker, and for your employees.
REMINDER: IF WORKER REFUSES MODIFIED/TRANSITIONAL DUTY AT ANYTIME, CONTACT RISK MANAGEMENT IMMEDIATELY (503-823-5101).
SIXTY DAY REVIEW
If the worker continues on temporary modified duty for 60 days, the bureau and Risk Management should meet to review what would be the best course of action for the worker and the employing bureau.
IF THE WORKER IS NOT RELEASED TO WORK
If the physician declines to release the worker to any work, the supervisor or the Early Return to Work Coordinator should:
1. Stay in contact with the injured worker to monitor progress and to promote the worker's return to work.
Risk Management will work closely with the doctor to obtain a release to temporary modified duty, but the supervisor or Early Return to Work Coordinator will provide the temporary modified task descriptions.
2. Review with the worker the physician's estimate of time before the worker may return to work.
3. Remind the worker that once he/she has been released to return to work by their physician, they must notify you no later than the beginning of their next scheduled shift.
4. Ask the worker when his/her next physician appointment will be.
5. Advise the worker that the Bureau will be in contact with Risk Management to facilitate release to return to work.
6. Upon the receipt of the worker's release to temporary modified work, refer to the number 3 on page 8 of this manual.
The entire program is worker centered. The goal is to provide the worker proper medical care and assist the worker in his/her eventual return to full employment.
EXAMPLE
NOTICE OF AVAILABLE EMPLOYMENT
DATE: _________________________________________________
TO: _________________________________________________ (WORKER)
FROM: _________________________________________________ (BUREAU REPRESENTATIVE)
_________________________________________________, City of Portland
(BUREAU)
RE: DATE OF INJURY:____________________
Your physician has released you to perform duties that are within your capabilities and we are happy to advise you that a temporary modified work position has been identified for you. Please see attached description of job duties.
Your _____ hour temporary modified work position starts ______ ________________________
(#) (date)
Time: _______________ to _________________ Location:________________________________
Report to: ____________________________
This position pays your regular hourly wage and will be available until _____________________ , or
(end date)
* you are released for regular work; or
* until it is determined you are medically stationary and you have permanent restrictions which would prevent you from doing your regular job.
NOTE: Pursuant to the City of Portland's Early-Return-To-Work Policy and Procedures, your bureau representative and Risk Management will consult with your physician to determine the appropriateness of continuing your early-return-to-work assignment should your modified work release go beyond 60 days.
Finally, you must immediately contact your supervisor and Risk Management should you decide not to accept an offer of temporary modified work, or if you experience any problems once your temporary modified work assignment has begun.
c: Risk Management
Bureau
EXAMPLE
TEMPORARY MODIFIED DUTY
TASK DESCRIPTION
DATE: _____________________________________________
TO: _____________________________________________ (Worker)
FROM: _____________________________________________(Bureau Representative)
Work on transit mall with long-handled tongs. The tongs are specifically made for litter pickup. The tongs are designed to preclude the need to stoop or bend and weigh less than one pound.
Work on the transit mall to pick up the papers in the bus shelters.
Work on the light rail doing the same, e.g., picking up papers.
Not much walking for there will be a pickup truck provided.
Picking up the paper materials and placing them into a plastic bag, not to get the plastic bag over 1/2 full because of weight restriction.
RISK MANAGEMENT’S
ROLES AND RESPONSIBILITIES
Your workers’ compensation team conducts the following as standard operating procedures dealing with early return to work of workers.
1. Upon receipt of claim, the team’s Assistant Claim Technician (ACT) contacts physician to ask first contact questions. Questions include those concerning time loss and modified duty release. The ACT also contacts the bureau supervisor to inform them of claim and ask questions, as appropriate. Questions include those dealing with early return-to-work (ERTW) modified duty information. The supervisor is asked if they wish to have the adjuster contact them for any further questions or concerns. The ACT also contacts the worker and asks them about time loss and ERTW.
2. If the worker is off work, the claim is referred to the team’s Claims Technician (CT) for time loss work up. The CT contacts the worker’s physician for any missing information and for needed time loss authorization. Also contact is made with the bureau timekeeper for information on wages, lost time and/or to confirm ERTW to temporary modified duty.
3. The team’s Adjusters receive the claim and does a new file review. If there are questions about time loss or modified duty release the adjuster may contact the physician for clarification or refer the claim back to the CT for follow-up. In cases where there is a modified duty release but the bureau has not found or provided modified duty to the worker the adjuster will contact the supervisor to discuss the ERTW issues.
Adjuster advises and facilitates to overcome problems between the work release and the available tasks that the supervisor is able to provide, i.e., how to understand the work release or how to apply the physician’s instructions of restrictions for the worker. If necessary, the adjuster contacts the physician to get clarification of the work tasks or will provide the physician with information regarding the City’s ERTW program if the physician does not have that information or is reluctant to give a temporary modified duty release.
In some cases adjuster will contract with a nurse case manager to work with the physician and the injured worker to facilitate the physician’s release to temporary modified or regular work. In unique situations, the adjuster will contract with a vocational expert to develop a job analysis of the proposed temporary modified work or the worker’s regular work, for the physician to review.
Adjuster stays in contact with the worker’s supervisor or other appropriate bureau representative, to keep them informed of the worker’s RTW status and when they may expect the worker to be released to any kind of work. In unusual circumstances, the adjuster may arrange for an insurer medical examination (IME) and/or physical capacity evaluation (PCE) or work capacity evaluation (WCE) to facilitate RTW at whatever the worker’s abilities allow.
When the work restrictions are permanent, adjuster will arrange for vocational expert to work with the bureau to attempt to return worker to permanent modified duty, if possible. Vocational expert also assists the bureau with procedures for Preferred Worker reimbursement money and any work site modifications that may be reimbursable from the State worker’s benefit fund.
IMPORTANT TERMS
Attending Physician: A doctor or physician who is primarily responsible for the
treatment of a worker's compensable injury or illness.
IME: Insurer Medical Examination – Any medical examination including a physical
capacity or work capacity evaluation or consultation that includes an examination that is requested by Risk Management and completed by any medical service provider, other than the worker's attending physician.
MCO: Managed Care Organization – An organization formed to provide medical services and certified pursuant to ORS 656.005 (12) (b) (A) and general practitioner, family practitioner or internal medicine practitioner. An MCO may contract with an insurer to provide certain managed care services. However, such insurer provided services must be in accordance with protocols and standards established by the certified MCO program and approved by the director review. The City of Portland is contracted with two MCO’s, CareMark Comp and Kaiser On-The-Job.
Medically Stationary: No further material improvement would reasonably be expected from medical treatment, or the passage of time.
PCE: Physical Capacity Evaluation - An objective, directly observed, measurement of a worker's ability to perform a variety of physical tasks combined with subjective analyses of abilities by worker and evaluator.
Temporary Modified Duty: Available tasks that provide accommodation for temporary limitations and restrictions, and consisting of progressive/transitional stages of activity as physical/mental capabilities permit. This includes return to job at injury, but at less than full shift or less than all regularly assigned duties.
Transitional work: Temporary duty tasks that may progressively change during the temporary modified work assignment, as the worker’s physical/mental capabilities permit.
WCE: Work Capacity Evaluation – A physical capacity evaluation with special
emphasis on the ability to perform a variety of vocationally oriented tasks based on specific job demands. Work Tolerance Screening shall be considered to have the same
meaning as Work Capacity Evaluation.