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ATLANTA-Modified work works.

Not only does it save money and reduce work days lost to injury, but employees feel appreciated, says Patricia Morey Walker, workers' compensation agent for the City of Boston.

Her conclusion is based on the city's modified work program she initiated in 1994. The workers compensation department is responsible for a self-insured, self-administered program covering 17,000 city employees.

Ms. Walker discussed Boston's modified work program and its success to risk managers at a session last week at the annual Risk & Insurance Managers Society Inc. conference.

A preferred provider arrangement is among changes that are helping improve Boston's program, too (see story, page 36).

When Ms. Walker took over the city's workers comp program, she received a telephone call from a manager asking what to do with an employee who had been on light duty for four years. That doesn't happen today, she said.

"But it certainly was not easy to get there," Ms. Walker said.

One obstacle to overcome was receiving the cooperation from the city workers' unions. "Don't forget to involve the unions," she repeated numerous times. "When we were involved with the unions early on we were very successful."

Two features of the program contribute to its success, Ms. Walker said. First, the program is not light duty, but modified work. The injured worker returns to his or her job modified to accommodate physical restrictions.

Also, involving the injured worker's supervisor in the process eases the transition back to work and reduces chances for confrontation.

"It's a total package of people that come together to make it successful," she said.

Perhaps the key to the city's program, however, is a meeting between the employee, the supervisor, a union official and a claims representative from her office. From this meeting emerges a form that spells out specifically what the employee can and cannot perform after returning to work. "It's something that protects both sides, employee and supervisor," if a conflict arises over what duties the returning employee can perform, she said.

Not only has the city benefited by reduced workers comp costs due to the program, but employees also benefit by getting back to work sooner, thus aiding the healing process.

"Employees want this," Ms. Walker said. "They really don't want to sit at home."

Ms. Walker said employees benefit both physically and psychologically. By getting back to work sooner through modifying their job, they will heal faster than sitting at home. Psychologically, people also benefit by getting back on the job in a productive role.

By staying away, she said, workers mentally magnify their injury so they begin to believe they cannot get back to doing their job.

"We see a lot of people get overwhelmed by psychological issues," she said.

The efforts have paid off. Since beginning the program more than three years ago, Boston's expenditures for workers comp claims have dropped 30%. Also, the number of employees out on workers comp disability has dropped 32%. And with city custodians, the first group of employees subject to the new modified work program, the number out on workers comp has been cut in half-an improvement she attributes solely to the modified work program.

John Walsh, a workers' compensation attorney for the City of Boston, said that every state's laws may not permit the type of modified work program Boston adopted. Some states, he said, might prohibit collective bargaining with unions to allow such a program. On the other hand, some states might require such a program to be collectively bargained, he added.

The program also helps the city in the courtroom. Because of the program, judges have looked toward the city more favorably during litigation with employees over their workers comp benefits, Mr. Walsh said.

Prior to the program, when litigation centered around the city taking an employee off workers comp, claiming the employee was capable of returning to work, the city could only offer a medical report saying the person was fit to work. But under the program, the employee no longer receiving comp benefits has been offered a job that is modified to accommodate any physical restrictions. If this job is rejected, "the onus is on the employee to convince the judge why that job is unsuitable or why they are still taking workers comp benefits rather than taking the job," he said.

"If employers can show the judge that they are working with the employee to bring that person back to work, they have more credibility with the judge than just taking a medical report saying the person can return to work," he said.

Ms. Walker was coordinator and moderator of the session.

Stephanie E. Hart, vocational consultant with Occupational Resource Network in Boston, who consults with Ms. Walker's department, also was a speaker.