Light duty for workers hurt off-duty: Cost of leave vs. cost to bring back
Companies look at workers hurt off the job differently
Accommodating employees returning to the job after a work-related injury is a fairly well-accepted practice at most workplaces, with light-duty or alternate duty placements made available as the job and the employee’s abilities permit.
But what if the employee is off the job with a nonwork-related injury? Companies appear to look at them differently, and in many cases, it boils down to money.
Workers injured on the job often are paid by their employers’ workers’ compensation insurance, perhaps while the employer also has to pay a temporary employee to fill in for the injured worker. Someone injured off the job, however, often is off work on his or her own sick leave, vacation, or without pay, unless disability insurance is provided; so even if the employer is paying someone to fill in, it’s sometimes not seen as quite as great a financial burden. In those cases, there is not as great a motivation to bring the worker back before he or she is at 100% capacity.
Follow the money
"If things are structured in a way that the employer has incentives to bring somebody back, then they’ll strive to bring them back," says Karl Auerbach, MD, MS, MBA, FACOEM, assistant professor of environmental medicine and staff physician in occupational medicine at the University of Rochester (NY). "If the incentives are not there for bringing back both workers comp and nonworkers’ comp [employees], managers tend to say, We don’t want you back until you’re 100%,’ and that’s unfortunate, because limited-duty programs can be valuable to employers."
To understand why some employers strive to find light duty for any employee who needs it, regardless of what caused the disability, and others don’t, Auerbach says, "Just follow the money."
Many employers, he says, believe it costs more money to bring employees back on light duty than it does to let them stay home until they’re 100% recovered, particularly if the employer is not having to pay out workers’ compensation benefits.
Julie Miehe, RN, BSN, COHN-S, CM, an employee health nurse at St. Mary’s Hospital Medical Center in Madison, WI, says decisions on bringing employees back on light duty at St. Mary’s are based on the costs involved in work-related and off-duty injury leaves.
"We’re paying workers’ comp and the costs of replacing them when they are hurt on the job, so there are two costs," she reports. "If they’re off on nonwork-related causes, they are using their own vacation or sick leave, so the costs are less.
"With work-related injuries, it’s better to get them back to work," Miehle adds.
Some employers, such as The Lancair Co., a Bend, OR, manufacturer of airplane kits, give employees returning from workers’ compensation injuries preference in light-duty assignments, but try to accommodate everyone.
"There are always jobs to do that people can’t find time to get done, so I’ll send out an e-mail [to managers] with a description of the employee [who wants to return on limited duty], and then I’ll just stand back and watch the replies pour in," says Leilani Monson, RN, occupational safety coordinator for The Lancair Co.
Getting workers back saves money
Auerbach says companies that think they are only losing money when employees are being paid workers’ compensation are forgetting the costs associated with nonwork injuries.
"Traditionally, companies treat them differently, and it’s only the more enlightened companies that have more comprehensive programs" that don’t differentiate between work-related and nonwork-related disabilities, Auerbach says.
"If a person’s not there, they’re not there, regardless of the reason," he explains. "Either they’ll be replaced at a cost to the employer, or their work will be spread out to create more work for the people left, or the work won’t get done."
Added to that is the ultimate cost to employers who offer disability insurance that kicks in for nonwork-related disabilities.
"Companies ultimately pay for disability insurance, just like they do workers’ comp," Auerbach says. "There are variety of scenarios, depending on how the benefits are structured, but in the end, if a person’s not there, it’s costing someone money."
Auerbach says if a worker is receiving insurance benefits through a personal policy, and pays increased premiums as a result, he or she will make financial and work decisions based on the economic impact. If a company is paying benefits through workers’ compensation, then the impact is on the employer.
"So the costs are ultimately the same with work-related injuries and nonwork-related injuries," he says. "Sometimes it comes out in dollars, sometimes in human resources interactions, and sometimes in insurance premiums."
Risks no different in return to work?
Auerbach insists that concerns that employees returning from nonoccupational injury are more prone to reinjury are not based in evidence.
"And is the staff any less short due to a nonwork-related disability absence than for a work-related one? Is morale any different as a result?" he asks.
Auerbach says he would like to see all the companies cared for by University of Rochester providers treat all disabilities the same, regardless of where they occur.
"Some employers have trouble finding limited-duty placements, but if they have a universal policy of it, they will try to find something," he says. "Hopefully, we’re moving toward comprehensive universal disability for all employers."
Work-related injuries get priority
Miehe says employees off work from job-related injuries always take priority when it comes to return-to-work placements, and sometimes even they are difficult to place in the hospital units, depending on their ability to perform when they come back.
"Some units lend themselves to light duty more readily than others," she points out. "Nurses or nursing assistants can do things like watch monitors, monitor patients, that sort of light duty. Units can use some people to serve on committees, prepare educational pieces, set up competency testing, and act as mentors if they have earned that status."
Secretarial and administrative personnel are also easy to accommodate for light duty and are often able to do a large portion of their regular duties even before they are cleared to return to full workload, she says.
Miehe says she is more likely to reassign employees with work-related injuries to different units, but not as likely to do so for employees whose absences are not related to work.
Some employees are harder to place, regardless of the nature of their disabilities.
"I probably have the most problems with our plant maintenance workers because they can have some pretty serious injuries and finding light duty for them is next to impossible, whether they are off for on-duty or off-duty injuries," she says.
Auerbach says companies that adopt policies of consistently finding appropriate limited duty for employees returning from any disability are those that focus on longer-term benefits vs. the short-term issue of whether costs are paid in workers’ compensation or disability insurance.
"It benefits everyone, including the company, to place anyone who’s out in a job that’s safe and appropriate, with input from knowledgeable physicians who can assess the job and determine if it is safe and appropriate," he says.
Miehe says each unit at St. Mary’s decides how to accommodate nonwork-related employees as they are able, but the hospital does not obligate units to find light-duty work for employees returning from nonjob-related disability.
Monson says her employer does what it can for any employee returning from disability, but gives priority to workers with job-related injuries.
"We offer it when we can, as long as they’re not on probation and as long as they can do the things we need done," she says.
If an employee is on probation or has absenteeism issues, Monson says, that employee is likely to be suspended from returning to work until he or she is at 100% ability. Because preference is given to employees injured on the job, those who are injured off the job who return to limited duty might find they are in less preferential jobs.
"People want to be productive, and they don’t like letting their co-workers down," Monson says. "We make beautiful airplanes here, and they’re jazzed about what they do. Studies show people recover and heal faster with less depression when they are active in their usual routine, within their restrictions."
Providing a way for employees to return to work breeds loyalty to the company, as well, she adds.
[For more information, contact:
- Karl Auerbach, MD, MS, MBA, FACOEM, Assistant Professor of Environmental Medicine; Staff Physician, Occupational Medicine, University of Rochester, NY. Phone: (585) 275-7795. E-mail: karl_ [email protected].
- Julie Miehe, RN, BSN, COHN-S, CM, Employee Health Nurse, St. Mary’s Hospital Medical Center, 707 S. Mills St., Madison, WI 53715. Phone: (608) 258-6974.
- Leilani Monson, RN, Occupational Safety Coordinator, The Lancair Co., 22550 Nelson Road, Bend, OR 97701. Phone: (541) 330-4117.]
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