Frequently Asked Questions

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  1. What are the financial benefits to an employee for early return to work after an injury?
     
    For many injured workers, workers’ compensation benefits alone are insufficient to replace lost wages. Returning to work in sustained employment, therefore, is probably the best way for injured workers to avoid significant financial losses. In addition, scientific evidence shows that returning to medically suitable modified-duty work aids healing and recovery. Many obstacles, however, hinder successful and sustained returning to work, including communication problems and financial disincentives of important stakeholders in the workers’ compensation system.
     
  2. What strategies are suggested for ensuring the high quality of modified-duty jobs?
     
    To ensure that jobs for injured workers are rewarding and fulfilling, the following recommendations are suggested:
     
    • Increase information and resources for employers and employees about these positions and how to design them.
       
    • Include the injured worker in the negotiations.
       
    • Develop written job descriptions that include worker input.
       
    • Allow enough time for discussion, interaction, and negotiation.
       
    • Develop methods for following up on individual plans and avenues of recourse if a plan is not followed.
       
    • Create a position for a “worker advocate” (possibly a nurse or nurse practitioner), who would have early involvement in the case.
       
  3. What efforts are recommended for employers to assist injured workers to return to sustained employment?
     
    Efforts to help injured workers return to sustained employment include the following steps:
     
    • Injured worker’s signs and symptoms: The injured worker describes his or her experience with the injury, including subjective symptoms such as pain, and sometimes shows objective signs of injury.
       
    • Treating provider’s diagnosis, treatment plan, and work restrictions: The treating provider interviews and examines the injured worker, makes a diagnosis, determines necessary treatment, and specifies work restrictions.
       
    • Employer’s efforts to correct hazards and accommodate injured workers: The employer encourages reporting of injuries, corrects safety problems, and provides accommodations to allow the injured worker to work safely while recovering and to work with accommodations permanently if necessary.
       
    • Claims administrator paying for necessary health care services: The claims administrator promptly authorizes and pays for necessary health and medical evaluation services
       
  4. There are many parties involved in what is often a complex workers’ compensation system. How can we better sort out the responsibilities of these various parties, eliminating some of the confusion and/or distrust that seem to exist?
     
    There are many perceptions, viewpoints, beliefs and disagreements that often contribute to some level of confusion and/or misinformation in the workers’ compensation system. A proven way to help dispel misunderstandings and to clarify roles and responsibilities is to develop and disseminate informational materials that define procedures, roles and expectations of the various persons involved. Parties most frequently involved in the workers’ compensation system include:
     
    Claims Administrators
    Self-Insured Employers
    Treating Physicians
    Qualified Medical Evaluators
    Case Managers
    Third-Party Administrators
    Self-Administered Employers
    Panel/non-panel Health Care Providers
    Rehabilitation Counselors
    Injured Workers
     
    Developing and distributing communications which describe the roles of these and other parties, and, where appropriate the contact information, can greatly help employees and injured workers understand what a particular individual or group’s duties and responsibilities are.
     
    For a Return-to-Work program to be successful, it is important that, prior to being injured, an employee know the process that will be initiated, the roles of those within the process, and his or her responsibilities within the process. This structured and planned process allows the injured worker to concentrate on his/her rehabilitation.
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