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CAMBRIDGE, Mass.-New research about return to work for workers compensation claimants helps identify injured workers who are at high risk for a late return.

The Workers Compensation Research Institute study says high-risk workers are those who: were out more than six months with the injury; worked for a small employer; worked intermittently prior to injury; and were experienced workers who took a post-injury job with a new employer.

The study by the Cambridge, Mass.-based WCRI drew its conclusions from an analysis of workers comp and unemployment insurance claims for 120,000 lost-time cases from 1989 to 1990 in Wisconsin, which has a "good" workers comp system, said Monica Galizzi, a WCRI labor economist.

She said the study took care to isolate key individual factors, including medical care, worker and employer attributes, working environment and the features of the state's workers comp system. However, outcomes could differ in other systems.

The major findings are that:

Workers out more than six months have double the unemployment rate one year after returning to work.

14% fewer workers in the smallest companies-those with one to 50 employees-return to the pre-injury employer.

Intermittent pre-injury employment slows return to work by 34%. Those workers who had at least one quarter of unemployment before the injury were likely to be younger and in the construction or service trades.

Return to work at a new employer slows the return for workers who had spent at least six months with the previous employer. Those previously employed six to 12 months take 85% longer to return to work when moving to a new employer, while those previously employed one to five years take up to 258% longer to return to work when moving to a new employer.

The research has significant implications for managed care, Ms. Galizzi said. The findings emphasize the long-term importance of return to work during the first six months, she said.

In addition, the findings should help improve health care providers' awareness of the importance of return to work to the former employer, rather than to a new one. The findings also could be used to help price risk-sharing contracts, she said.

While most good employers will take the time to support and learn about new research outcomes, many already are establishing effective return-to-work programs.

Cincinnati-based Procter & Gamble Co. requires supervisors to do extensive pre-injury training with health care providers on how to get medical care for each worker, but "we focus on "training employees (about the worker comp system) at the time they are injured," said James M. Palmer, associate director of human resources and employee benefits.

Those efforts must be coupled with prompt payment of benefits and answers to workers' questions, he said. It also requires follow up.

"A lot of people in claims think that once they get an employee back to work that their job is done," he said. It's not. Claims handlers need to continue communicating and must remember that returning employees may need time to catch up, emotionally as well as physically, he added.

Company structure sometimes inhibits return to work, adds Paula Rinta Stewart, corporate director of safety and health risk management at Weyerhaeuser Co. in Tacoma, Wash.

The paper manufacturing and processing giant could improve its return-to-work program more if it could assign recuperating workers to different divisions that cross union lines, she said. However, union leaders generally oppose that.