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(c) 2016 Jon L Gelman, All Rights Reserved.

Monday, January 27, 2014

Return To Work is a Program; Return To Function is a Philosophy

Today's post comes from guest author Kit Case, from Causey Law Firm. I am taking Bob's advice and sharing his article with our network. His concepts are spot-on.

I wish I had thought of the two concepts reflected in the title of this article. Alas, I did not. I did, however, once again take two dynamite ideas, combine them into one cohesive concept, thereby saving the universe while still managing to create an enticing, killer headline in the process.

I swear, sometimes it's exhausting being me.

I now serve on the Disability Management & Return to Work Committee of the International Association of Industrial Accident Boards and Commissions (IAIABC). We met Tuesday during the associations 99th Annual Convention in San Diego, CA. Committee Chair Peter Federko tasked the group with defining a working strategy that would encourage and promote successful disability management and return to work programs for both the industry and injured workers. This prompted what I can best describe as a passionate discussion among the members, each with their own take and view on where barriers exist, and what segments should be targeted in any RTW effort.

Federko, who by day is CEO of the Saskatchewan Workers' Compensation Board, did a masterful job of keeping the conversation focused as we rambled about with our various opinions. Personally I believe that there are many "moving parts" within workers' compensation that all must be aligned and engaged to effectively deploy any respectable RTW program. It requires a team effort from all players. Unfortunately, our current trend in claims management is taking us towards a dehumanization of the process, and this is not conducive for the development of such initiatives.

Two members of this group gave what I believe to be stunning insight, and not just because they dovetail nicely with my beliefs (ok, mostly because they dovetail nicely with my beliefs). Joachim (pronounced Yoke-em) Breuer, with the German workers' comp system and Chair of the ISSA Technical Commission on Accident Insurance, provided tremendous insight when he stated that Return to Work was not a program, but rather a philosophy; a philosophy that needed to be ingrained throughout the workers' compensation system. He was followed in short order by Ken Eichler, Director of Government & Insurance Services, Guidelines Division, for Reed Group. Eichler, who is also Committee Vice Chair, talked of suspicion and resistance on the side of the injured worker. He suggested that, to allay fears that RTW was merely a cleverly disguised cost control scheme, the committee instead develop criteria for a "Return to Function" program. He correctly pointed out that "function" is at the core of all life necessities, and that if we can focus on improving that for injured workers, return to work would be a natural extension of any successful effort.

Brilliant observations from both of them. Federko immediately instructed each to take an extra thousand out of petty cash for their input (not really - I made that up. Ever the cost control maven, Federko wouldn't even open the committee liquor cabinet). Still, this theory was not quite complete. We haven't quite finished mixing all ingredients for our RTW stew. We still have one more to add.

As you may notice, both suggestions by Eichler and Breuer fit quite nicely with my (as yet unsuccessful) effort to reposition and rebrand the workers' compensation industry into the Workers' Recovery industry. We will therefore include that as a third element in the recipe. This concoction produces the following final scrumptious result:

Successful Return to Function must be driven as an overriding philosophy ingrained throughout the Workers' Recovery system.

There. Not too shabby if I do say so myself.

The philosophy maintains that we must return as many people as possible to functional capacity for as normal a life as possible. Severely injured workers almost without exception wish to have some normalcy in their life. They have children or grandchildren they hope to hold. They want to dress, walk or go to the bathroom without assistance. They want to be able to do their own shopping, and they literally would like to be able to take a moment, bend over, and smell the roses. An entire system that embraces that knowledge, from employers, TPA's, brokers, carriers, doctors, regulators and the workers themselves, can improve both outcomes and individual lives. With that return to function we offer a return to normalcy, a return to life, and indeed, a return to work.

I cannot speak for the committee nor do I even wish to reveal the path we ultimately chose. Suffice it to say we're on the right track, and have an amazing amount of work ahead of us. But it will be worth it, as it needs to happen. The current trends are not sustainable. Disability rates are on a dramatic rise, being completely dependent on others is becoming socially normalized, and as workers we are getting older by the day. Our knees are wearing out. Our backs are starting to fail. Many of us have no appreciable skills beyond our current jobs. It is a recipe for disaster if we don't act, and act quickly.

Restoring life and viability by returning to function via the process of workers' recovery must be the wave of the future. The choice is simple. Embrace the philosophy today or pay for the reality tomorrow.

What choice will we make?