Have you ever been disappointed with the way a DIY project turned out? Maybe your home flooring project just doesn’t look quite as neat and polished as you had hoped. Maybe you had hoped your kitchen cabinets would have been hung just a bit more level. Frequently, the reason that you don’t get the results you had hoped for is because you didn’t have the right tools to do the job right.
As an employer enrolled in LeadingAge’s group retrospective rating program using the right tools can also help you achieve the results you hope to achieve in terms of controlling your claim losses.
One of your main risk management tools is the transitional/light duty return to work job offer. This tool, if used properly, can maintain a claim in a “medical only” status. This is significant because every dollar spent on a medical only claim has a significantly smaller impact on retro than that same dollar paid on an indemnity/time loss claim. For example, for the 2017-18 plan year, coming up for first adjustment on March 31st of this year, time loss claims costs are multiplied by a factor of 4.5 vs. 1.67 for medical only claims. In other words, $1.00 spent on a time loss claim costs our retro program $4.50 vs. $1.67 for claims that remain in a medical only status.
The key to a successful retro program is to limit the number of indemnity claims filed against the program each year. To do that, each member must have a program in place that can make the appropriate offer within a three-day window, following the day of injury. In order to keep claims in a medical only status, from their inception, the claimant must return to work by the fourth day (inclusive of the day of injury) following the injury.
A transitional/light duty return to work job offer can also be great tool to limit time loss exposure on more difficult and expensive indemnity claims. A properly made transitional job offer can cut off time loss payments in cases where an employer has been struggling with a claim where a full release to work does not appear to be possible in the immediate future.
Just as with any other tool you might use, the transitional/light duty job offer tool has to be used properly, to achieve the desired outcome. The Comprehensive Risk Management manual and webinar training lay out the elements necessary to make this program work. Therefore, it is not the intent of this article to review all of the elements of a transitional return to work program but instead to focus in on several key elements to the program that seem to have been challenging our members recently.
Job offer: The offer has to be made by you to your employees. The offer is between you as an employer and your injured-worker employee. CRM cannot make a job offer for you since we are not the employer.
Job offer letter: The CRM Risk Management Manual has a job offer letter template that must be used to create a valid offer. This template contains the necessary elements for a valid job offer. If you use something else, you run the risk that your job offer will be invalid. Contact CRM if you cannot locate your electronic file copy of the risk management manual, that contains this template.
Job description: A valid job offer letter must have attached, to it, a copy of a job description, at minimum, or better yet, a more detailed job analysis. The job description or job analysis must have been approved by the attending physician, prior to the making of the job offer. The worker must receive a copy of the job analysis concurrently with the job offer letter. LeadingAge has a bank of job analyses for return-to-work purposes. These job analyses have been professionally prepared and meet the current standard required by the Department. If you have misplaced your job analysis bank file, please contact LeadingAge and they will provide you with the link to the file for download.
Transitional/light duty is probably the most important tool for maintaining control over your L&I losses. However, to make it work for you, you must follow the process exactly. As a member of LeadingAge group retro, the tools to make this program work, are in your copy of the Risk Management Manual and the Job Analysis Bank.
