Monday, May 16, 2011

Church of Latter-day Saints: Giving Praise to Transitional Duty

The workers' comp team at the Church of Jesus Christ of Latter-day Saints gets a nod for transforming its return-to-work and transitional-duty program.

By MATTHEW BRODSKY, senior editor/Web editor of Risk & Insurance?

Great return-to-work programs are a tricky balancing act between compassion and good business sense, between promoting healing and exercising personal responsibility. Perhaps out of the many candidates for the 2010 Theodore Roosevelt Workers' Comp and Disability Management Award, the Church of Jesus Christ of Latter-day Saints feels the difficulty of this tight-rope walk.

The church didn't win top honors in the 2010 Teddy competition, but we thought they deserved recognition in the not-for-profit category in particular because of the success of their return-to-work program.

It was back in 2003 that the church's workers' compensation department, managed by Bruce Hock, designed a return-to-work program to apply across the entire organization. And it's a bigger organization than you might think. As of last year, it employed thousands of full-time employees across 26 nearly autonomous departments, everything from media generation to agricultural production, security to global humanitarian relief, thrift retail operations to construction.

In each of these entities were "deeply embedded traditions of operational independence" and a "silo mentality" the church explained in its application for our annual workers' comp and disability management award. Organizationwide changes had always been difficult.

"Local managers had for years varied widely in their support for return-to-work and other best practices," Hock wrote in the application.

One division might offer transitional work to its employees, for instance, while another might offer none at all.

So that was one huge hurdle in the way of taking that written return-to-work plan and making it a universal truth across the organization.

Another hurdle was, as Hock put it in the application, the "difficulty of balancing the church's culture of taking care of its members with its equally strong ethic of personal responsibility for healing, independence, hard work and self reliance."

Put simply, managers often kept their workers' comp checkbooks open too long. Not to say employees took advantage of it, but they "misinterpreted" this "tradition of care" and expected this "lax" treatment.

"Workers were also sheltered from the financial impact of a workplace injury by the organizationally sanctioned practice of supplementing temporary total disability benefits with sick leave," the team wrote in its application.

"Some injured workers made more money being off work than they would have made working" they said.

Needless to say, these practices tended to produce prolonged absenteeism and increased claims costs.

What do you do when you have to effect a change in culture across an entire entity? Talk to the people at the top.

And that is exactly what Hock and his team--including claims coordinators Cheryl Burt and Jan Powers--did. In getting the approval of senior leaders for the new return-to-work plan, Hock made sure to stress another aspect of the church's culture: the values of personal effort and self-sufficiency and how a successful return-to-work program aligns with them.

With senior management's blessing, the workers' comp team at the Church of Jesus Christ of Latter-day Saints added staff to work on loss prevention and safety, while assigning claims coordinators with cross-departmental authority to ensure that the program got implemented.

The church also brought in Memphis, Tenn.-based Sedgwick Claims Management Services Inc., one of the largest national third-party administrators, to assist with management of the program.

THE NUTS AND BOLTS

At the core of the church's return-to-work program is the belief that the "best return-to-work results are achieved when the employee returns to familiar tasks and workmates." To turn that strategy into action, the risk management department aims to return injured workers to some form of transition duty whenever possible until the maximum medical improvement has been achieved. The official policy is 90 days of transitional duty, but the team confided in its application that extensions are granted "customarily" when medically necessary.

To make the process a success from day one, the transitional work is located in the following manner: first attempt to place injured employees within their current work group; if not there, then within the current department; and finally, only if necessary, place them within the greater organization.

The value of trying first and foremost to get injured workers back with their friends in their current group is illustrated by how the process works at the church's thrift-store division. When injured workers at the 50 thrift stores come back for transitional duty with new work restrictions, sometimes the claims coordinators cannot, despite their best efforts, broker a return-to-work assignment in their current work unit.

"Interestingly, when faced with the prospect of relocation, many transitional-duty candidates return to their treating physician and request 'less restrictive' restrictions that will allow them to return to their own work group," the team wrote in its application.

It works out for the organization too, because happier employees, working with friends in familiar settings, tend to recover faster and return to their previous level of working ability.

The overall program has seen a success, too, because risk management department's claims coordinators are in close contact with the staff of 21 Sedgwick offices across the country. They also meet regularly with department mangers about injured workers. For them, the use of sick leave to supplement income when out injured was ended.

And let's not forget about that balancing act. With new policies and enforcement also comes the compassion.

Take the case of an audiovisual technician who was involved in a motor vehicle accident in November 2008 while traveling for work. He had his left leg amputated and lost the use of his right leg. An independent medical exam ruled that he was permanently and totally disabled, but with the help of the central claims coordinator and his department, the worker was able to return to work on an extended transitional assignment. The department relocated the employee's workspace and made physical modifications to the office for his wheelchair. The church even funded his move to an apartment near his jobsite, which helped him get to work but also got him out of the assisted living center, reducing claims costs. Transitional duty has now become permanent work accommodation, upon the worker's request.

Successful return-to-work programs generate feel-great stories like that. They also create solid financial results. The Church of Jesus Christ of Latter-day Saints has seen reduced total incurred costs per go down on average by 5 percent (excluding outliers). The duration of lost-time claims of greater than three days was reduced by an average of 13 percent, from 65.8 days in 2005 to 57.5 in 2009. Overall, the heightened sense of safety, personal responsibility and accountability has produced average savings of $140,000 in incurred comp costs for the years 2007 to 2009 compared with 2005 to 2006.

"In a way this is an old-fashioned story about trying hard to do the right thing, but the results demonstrate the value of modern risk management programs and the power of enlightened, compassionate employee relations practices," Hock and team wrote.


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