"Early Return To Work" And Its Effect On Workers Compensation Cost

One of the primary functions of a claims department of an Insurance carrier or Service company handling workman compensation claims is the control of claims dollars. One effective way of controlling claims dollars is by establishing a goal of an early return to work for an injured employee.

This program can reduce claim cost in three areas:

1. It will eliminate weekly temporary total disability payments. Currently under the State of Illinois Workers' Compensation Act, the maximum temporary total disability rate is $502.36 per week.

2. It will reduce the overall medical cost of the claim.

3. It will reduce the permanent partial disability settlement.

Permanent partial disability settlements are directly related to the length of time an employee is off work. Once a claim goes to the Illinois Industrial Commission the arbitrator always inquires about the length of time the claimant was off work.

As an example, a minor back strain with one week lost time would warrant a zero percent permanent partial award. The same injury with 6-8 weeks off could potentially be awarded 7 1/2 percent permanent partial disability of a leg. This is 15 weeks times the maximum rate of $293.61 which equals an award of $4,404.15.

A serious back injury involving a herniated disc requiring surgery has a permanent partial disability value of 75 to 125 weeks and possibly more depending on the claimant's recovery and length of time off work. The same injury with an early return to work could save up to 50 weeks at $293.61 or a total of $14,680.50. Accomplishing the goal of an early return to work can be done by referral of the employee to a treating doctor, hospital or rehab center that provides prompt care and treatment. Employees should also be referred to doctors with experience in treating worker's compensation injuries. Their reports will be timely and their diagnosis will be clear and well defined.

Finally, the employer should be receptive to accepting the employees for light duty in order to facilitate an early return to work date for the employee.

Implementation of a good early return to work program will ultimately result in an overall reduction of worker's compensation claims cost. •

Page 20 / Illinois Municipal Review / May 1986