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Managing Expectations and Outlook Leads to Brighter Return-to-Work Programs

Jan. 21, 2016
The path from injury to resuming work duties is not always a smooth one. It can be difficult to balance the concerns of both your business and the injured worker.

No one wants to get hurt. We all prefer to go about our days without the pain, frustration or aggravation that an injury causes. It comes as no surprise then that often immediately following a workplace injury, the first question asked by the injured worker is, “When can I go back to work?” As an employer, you share these same sentiments. After all, healthy employees are good for business.

However, the path from injury to resuming work duties is not always a smooth one. It can be difficult to balance the concerns of both your business and the injured worker, but alignment is possible by managing expectations.

Setting Expectations

Several weeks after a strain/sprain injury, a physician recommends the injured worker return to modified duty. The injured worker looks forward to getting back into their work routine. However, when presented with the return-to-work plan, the employer is hesitant about the idea out of concern for a potential exacerbation of injury, re-injury or liability. With the plan rejected, the physician is frustrated and the injured worker feels defeated, remaining on temporary total disability (TTD) for several more weeks. In this situation, each party involved had a different expectation of how the claim should progress.

The outcome would have most likely changed if the process and expectations were managed differently. A total (100 percent) recovery may not be attainable in all cases, but this does not necessarily mean the injured worker is unable to work in some capacity. Light or modified duty may be an appropriate, safe and welcome option. Conversations between the employer and the injured worker’s physician can level-set expectations in this instance and open the door to constructing a return-to-work plan that makes everyone comfortable.

Understanding Duties

Physicians are experts in care – not construction or manufacturing operations. By thoroughly explaining a job’s requirements, work environment, and safety policies to the physician, he or she can better understand the situation and design a treatment plan that is more appropriate (and more effective) for the injured worker.

You might consider sharing with the physician training videos or other visual aids that demonstrate the required job functions. The knowledge gained could not only influence return-to-work considerations, but may also guide future treatment recommendations to assure optimal recovery for the injured worker. For example, appreciating the safety sensitivity of a position, a physician may choose not to prescribe an opioid medication and instead opt for a less sedating analgesic.

Another strategy to help manage and align expectations between you and your injured worker is to speak of abilities in specific, relatable terms. If an injured worker is allowed to lift 15 pounds, specify instead that they can lift a 15-pound 2x4 or piece of sheet metal. Speaking about capabilities in definitive terms directly related to the injured worker’s position successfully align expectations, as it eliminates subjectivity and provides a common point of understanding.

Knowing the Condition

It is also imperative that the treatment, and ultimately the return-to-work plan, fully address the injured worker’s physical and psychological impairments. Strains, sprains, fractures and dislocations can disrupt

coordination. Head injuries can affect concentration, memory and attention span. Amputations can disrupt gait. Injured workers may also suffer from post-traumatic stress, depression, fear of re-injury, worry and other emotions as a result of their injury. In those instances, a focus on the injured worker’s progress towards an improvement in function may be a more realistic goal.

Learning Limitations

Yet another important consideration when managing expectations associated with return-to-work is the break period. How many consecutive hours may the injured employee safely work before a break is required? When the break occurs, what does it consist of? Are there stretching exercises that will need to be done? Does the break require sitting or resting?  In addition, what is the medication therapy regimen? Are there certain things that you need to do or consider in order to promote compliance with the medication therapy?

For example, the injured worker might need to take medication with food or require a safe place to store them while he or she is working.

Based on their experiences, physicians, employers, claims professionals and injured workers each carry preconceptions and expectations when it comes to how a claim should progress. Managing these expectations with open communication around the what, when and how an injured worker may return to work benefits you as the employer and the injured worker, leading to a brighter return-to-work program.

As corporate medical director for Helios, Dr. Robert Hall advises customers and employees on evidence-based clinical and rehabilitation guidelines that optimize pharmacy, home health, and durable medical equipment programs to promote better outcomes and earlier return to work for injured workers. He also offers counsel on our processes and procedures to identify and reduce prescription drug misuse and abuse.

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