Return to Work
April 12, 2011
Louise Caicco Tett, RN, BScN, CRSP
© 2011
Learning Objectives
• The participants will:
• Discuss WSIB’s New Service Delivery
Model
• Describe the theory and legal
requirements associated with Return to
Work (RTW).
© 2011
Some food for thought…..
• Rates of return to work
in Ontario have declined
over the past 10 years
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Some guiding principles
• If an injured worker is off for six
months, there is a 50% chance of
that worker returning to work
• Chances drop to 20% if worker is off
one year
• Time is of the essence!
WSIB 2008, based on NIDMAR research
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More guiding principles
• RTW is a process and must be
managed in a systematic way
• Injured workers want to get better
and be productive members of
society
• Workers need to be treated with
dignity and respect
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More guiding principles
• RTW is based on objective medical
information
• We need to treat all employees in the
same manner – i.e. consistency
• Focus on abilities, not disabilities i.e.
what can the worker do?
• Think outside the box
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New Service Delivery Model
Primary Adjudicator
(for straight forward decisions)
Eligibility Adjudicator (entitlement not obvious)
Short Term Case Manager (30 days)
Focus is on RTW and recovery - At 12 weeks, use
RTW specialist
Long Term Case Manager (6 months)
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Why RTW?
The law:
o the employer shall contact the worker ASAP
after injury and maintain communication
throughout recovery
o the employer shall provide suitable
employment that is available and consistent
with the worker’s functional abilities
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Why ESRTW?
The law:
o the worker shall contact the employer ASAP
after injury and maintain communication
throughout recovery
o the worker shall assist the employer to
identify suitable employment that is available
and consistent with the worker’s functional
abilities
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Physical Demands Analyses
o systematic procedure to quantify, and
evaluate all of the physical and environmental
demand components of all essential and nonessential tasks of a job.
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Independent Medicals
o Employer can request an independent
medical; pays for it
o Worker may appeal decision for IM
o Board hears appeal, and makes a final
decision
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Health Care Practitioners
o Required to promptly give the Board such
information relating to the worker as the
Board may require
o This includes Functional Abilities Forms
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WSIB Forms
Form 6
Form
7
Form
8
• Worker’s Report of Injury/Disease
• Employer’s Report of Injury/Disease
• Health Professional’s Report
•
Functional
Abilities
Form
FAF
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Worker and Employer
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The RTW Team
o Injured Worker
o Immediate Supervisor
o Union Representative
o Claims Manager
o WSIB
o Health Care Professional
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Injured
Worker
•
•
•
•
Seeks health care
Cooperates with medical and employer
Maintains contact with employer
Plans for RTW
Employer
•
•
•
•
Has PDAs done ahead of time
Maintains contact with IW
Plans for RTW
Pays for IM if necessary
WSIB
• Makes timely decisions
• Facilitates medical information
• Offers RTW specialist (12 weeks)
Health
Care
• Completes FAF
• Provides assessment, treatment
• Supports RTW
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RTW Plans
• Set Goals ex return to pre-injury
employment
• Actions – outline responsibilities of
worker, supervisor, manager, coworkers
• Time Frames – ex two hours first
week, 4 hours second week, etc
• Health Care Needs – ex.
appointments during work hours
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Communication is the key
• Fill in the Blanks
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Case Study-2004 to 2007
• Knee injury Sept 2004, no lost time
• Dec 2006 – employer informed that
worker needed knee surgery in Jan
2007
• Started working on RTW – worker
missed one week of work
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Case Study-2004 to 2007
• Received permission from WSIB to
include a “road trip” with supervisor
as part of RTW plan – was part of
normal job; WSIB put some
parameters in place to ensure safety;
spoke to worker who was in
agreement
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Case Study-2004 to 2007
• RTW included
•
•
•
•
•
working from home,
company driving worker to work (winter)
company paying for taxi to physio
physio as part of work day
wife driving worker to work
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Case Study-2004 to 2007
• RTW included
•
•
•
•
exercise bike at work
worker able to drive self to work
physio appointments at end of work day
back to full time hours, same job
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Why did it work?
• Planned in advance
• Supervisor had support from
corporate office
• Worker and his wife were supportive
of process
• WSIB was very involved
• Physio focused on improvements
• It was progressive – there was a goal
© 2011
© 2011
Learning Objectives
• The participants will:
• Discuss WSIB’s New Service Delivery
Model
• Describe the theory and legal
requirements associated with Return to
Work (RTW).
© 2011