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Return-to-work programs expand beyond workers compensation

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Return-to-work programs are getting greater consideration among employers for workers who are on leave because of disabilities that are not related to their job.

Experts say workers compensation and nonoccupational disability return-to-work programs should have consistent approaches, and that corporate leaders' buy-in is necessary to ensure such programs effectively help employees get back to work.

Some 49% of employers with more than 10,000 employees already have a return-to-work program for their disability programs, according to a Prudential Insurance Co. of America survey released in October. Another 22% of employers plan to add such programs in the near future.

Jake Biscoglio, vice president of absence and disability products at Prudential in Roseland, New Jersey, said the survey focused mainly on nonoccupational disability leave, although respondents with integrated occupational and nonoccupational programs may have included workers comp-related leave.

Employers' preoccupation in recent years with implementing health care reforms under the Patient Protection and Affordable Care Act may have allowed return-to-work efforts to fall by the wayside while managing group health concerns, Mr. Biscoglio said.

“There's a lot of competing priorities that everyone's dealing with, so we know it's easy at times to set this aside and put it in the category of something to come back to,” Mr. Biscoglio said.

Prudential's results contrast with workers comp experts at broker Willis North America Inc. and third-party administrator Broadspire Services Inc., who say about 90% of large employers with whom they work already have workers comp return-to-work programs.

Return-to-work “started being popular around 25 years ago and it's nothing new to most companies,” said Joe Picone, Glen Allen, Virginia-based claim consulting practice leader at Willis' risk control and claim advocacy practice.

Randi Urkov, managing director at Marsh Risk Consulting's claims consulting practice in Chicago, said it's not surprising that fewer employers have nonoccupational disability return-to-work programs since such disabilities not related to the job are more common and can be more difficult to track than work-related injuries.

“There are just so many (nonoccupational) disabilities that you really need a very formalized program to be able to sustain that over time,” Ms. Urkov said.

Kimberly George, Chicago-based senior vice president and senior health care adviser at Sedgwick Claims Management Services Inc., said some employers lack nonoccupational return-to-work programs because they leave it up to their disability insurers or TPAs to handle the process.

“Historically, if you were to ask an employer whether or not they're aggressively managing return-to-work around disability, the historical answer would probably be 'no' in an insured market,” Ms. George said.

Ms. Urkov said many companies reduced their risk management and human resources staff during the Great Recession, making it difficult for some to focus on return-to-work outside of workers comp.

But even large companies that do help disabled employees ease back into the workforce are somewhat ambivalent about their success, giving return-to-work programs an average grade of C+, according to the Prudential survey.

“They feel ill-equipped to address disability and return-to-work issues,” Mr. Biscoglio said of the mediocre grades. “They're nervous about confidentiality, and they need that assistance around having a structured program that offers consistent opportunities for employees.”

Willis' Mr. Picone said the grade may also reflect many employers' frustration with monitoring the effectiveness of return-to-work programs and implementing changes that can improve results.

“The programs become outdated or stale and lose momentum,” Mr. Picone said of companies that fail to measure success metrics or periodically update their metrics.

Despite the challenges, Sedgwick's Ms. George said nonoccupational return-to-work programs can ultimately reduce employers' costs.

“Having people back in the workplace has historically led to faster healing,” Ms. George said. “People that tend to be out longer end up having more medical costs.”

Companies that want to implement nonoccupational return-to-work programs or improve the ones they already have should make sure senior leaders and stakeholder groups, such as the human resources or risk management departments, support the effort, said Mike Farrand, vice president and director of workers compensation cost containment at Willis in Radnor, Pennsylvania.

“You need upper management to support from the top down to really effect change,” Mr. Farrand said.

Erica Fichter, senior vice president of medical management at Broadspire in Sunrise, Florida, said employers can outsource their return-to-work programs if they feel they need additional resources or assistance in making such policies successful.

“Don't think that you have to do everything yourself in-house,” Ms. Fichter said. “There are great programs out there that are very cost-efficient (and) can help facilitate return-to-work strategies.”

Willis' Mr. Picone also recommends that companies regularly track metrics for their return-to-work programs, such as days employees are off the job due to disability, to determine whether a program is working or should be tweaked to improve its performance.