SUPERVISOR

1
BEST PRACTICES IN FEDERAL WORKERS COMPENSATION
SUPERVISORY COURSE

• SUPERVISORS ROLE IN RETURN TO WORK
• (LIMITED DUTY AND PERMANENT JOB OFFERS)

2
OBJECTIVES

• Identify supervisors role and responsibility in
  returning injured worker to suitable work
• Discuss components of an acceptable work
  statement and use in affording suitable
  assignment to injured worker
• Recognize the difference between a limited duty
  assignment and permanent job offer
• Identify necessary components of a limited duty
  offer and permanent job offer
• Explore methods and options to afford an injured
  worker suitable work

3
SUPERVISORS ROLE

• Advise employee of responsibility to
• Keep supervisor advised of work status-written
• Provide SPECIFIC written limitations, if any,
  and duration
• Return to work when work capacity exists
• Advise of next follow-up appointment
• Request permission to be absent due to
  injury/condition
• Supervisor is responsible for
• Instructing employee of above responsibilities
• Affording suitable work to the injured worker
  in writing
• Ensuring work status is obtained following EACH
  medical visit
• Acting on related leave/LWOP requests

4
LIMITATIONS

• Must be from the attending physician
• Must be in writing
• Must be specific
• Should not be open-ended
• Should have a to or end date
• indefinite as end date is not acceptable

5
WHAT IS A LIMITED DUTY ASSIGNMENT?

• Normally not a permanent, long-term assignment
• Does not always result as permanent job (but may)
• Not an assignment to a graded and classified
  position description or functional statement
• Must be in writing
• Verbal offers allowed but must be offered in
  writing within 2 business days of verbal offer
• Assigns duties commensurate with physicians
  recommended limitations
• May or may not be in same unit, same tour, same
  schedule, same position

6
What if

• Limited duty is not on same tour or schedule and
  employee loses pay?
• If eligible for COP, COP will cover loss of pay
  to the extent otherwise prohibited by law.
• If no COP, employee may claim loss of wages with
  OWCP by filing a CA-7 through the WC Office.
• Supervisor will need to provide tours and work
  schedule for employee to reflect what these would
  have been but for the injury

7
WHY OFFER LIMITED DUTY ?

• Employee is injured, not totally incapacitated
  for all work
• Regulation requires when work capacity exists,
  employee must seek work
• If employer fails to offer suitable work,
  employee may receive COP and eventually
  compensation until suitable work is offered.
• Decreases chargeback and COP costs to the
  employing agency
• Studies show improved recovery period
• Improves moral of employee(s)

8
WHEN TO OFFER LIMITED DUTY?

• Work status indicates existence of work capacity
• Employee indicates desire to return to work
• Nature and severity of injury is not consistent
  with recommendation of total disability
• Immediately (if any of the above exist)
• In absence of work status or release to work
  with limitations, coordinate list of tasks with
  WC Specialist to submit to attending MD for
  review and approval.

9
HOW DO I OFFER LIMITED DUTY?

• Determine specific limitations (work status)
• Offer in writing (or if verbal, follow in
  writing)
• Include beginning date, tour and work schedule
• Include tasks to be performed
• Re-state specific limitations recommended by MD
• Include contact for instruction and leave request
• Acceptance/Declination by employee and signatures
• Duration of assignment
• Indefinite
• vs.
• Specific ending date (temporary)

10
SAMPLE-LIMITED DUTY MEMO

• Date May 29, 2013
•  To Employee Name (118)
   
• From Supervisors Name, Nurse Manager (118)
• Subject Limited Duty Assignment
• In reference to your traumatic injury (or
  occupational
• condition if applicable) on April 3, 2013, the
  following
• limited duty assignment is offered to you in
  Nursing Service
• based on your physicians recommendations dated
  May 28,
• 2013. Your tour of duty will initially be
  730am-400pm,
• Monday through Friday. This assignment will be
  effective
• today, Wednesday, May 29, 2013. Your duties will
  consist
• of 
• -answering and referring phone calls
• -monitoring residents north and south end
• -documentation in CPRS
• -assisting in feeding all residents
• -vital signs using electronic devices
• -passing medications/treatments such as passing
  ointments, creams, etc. from med cart. (Note
  Push/pull force for med cart is 12 pounds on
  tile)

•  If you encounter any problems or difficulties in
  relation to
• your injury/condition, please advise your
  supervisor
• immediately and contact your physician as soon as
  
• possible if needed. Your assignment will be
  continuously
• re-evaluated following any medical visits and/or
  receipt of
• additional medical information. This is to
  assure
• compliance with your physicians recommendations
  and
• to meet the needs of the medical center.
•  
• This assignment does not affect your employment
  status.
• you remain employed as a Nurse, VN-0610, Level 3,
  
• Grade 1, currently step 21 with salary of 55,363
  per
• annum. Your assignment will continue until such
  time as
• additional restrictions are imposed or modified.
  If you
• have any questions, please contact your
  supervisor or
• the FWCP office (ext. 9991 or 9996.)
• ________________________ ___________
• Supv Name, title
  Date 
• --------------------------------------------------
  -----------------------

11
WHAT IF

• the employee accepts the offer?
• the employee declines the offer?
• the employee refuses to sign with acceptance or
  declination?
• the employee doesnt agree with all the tasks
  assigned?
• the employee doesnt want to change tour or work
  schedule?
• the offer is not appropriate not suitable?

12
BEST PRACTICE PROCESSES-Limited Duty

• WC Office receives copy of work status
• Sends email to supervisor and next level of need
  to offer limited duty
• Includes copy of work status and/or states
  limitations
• Includes template or sample to follow
• Indicates date required (immediate)
• Follow-up after deadline
• Next follow-up to next level supervisor and so on

13
No Limited Duty Available?

• Supervisor replies as such with reason(s) to all
  on email
• Service Chief or Service Line Manager certifies
  no limited duty exists in service.
• Notification is forwarded to HR staffing (et al)
  to coordinate limited duty across organizational
  lines with copy to facility leadership.
• Identified limited duty is provided to supervisor
  and limited duty offer is made in writing.
• Home service incurs cost of employee while
  assigned to another service

14
REASONABLE ACCOMMODATION AND WORK COMP

• Two (2) separate programs for permanent
  conditions
• Reasonable Accommodation
• Separate from workers compensation
• Does not retain the pay of injured worker
• Permanent Job Offer
• Separate from Reasonable Accommodation
• May protect the pay and benefits of the injured
  worker
• Cannot share information between 2 programs
  without specific written release from employee

15
Permanent Job Offers

• Employee has work capacity but cannot perform the
  full scope of DOI (Date of Injury) position
• Attending MD (or in some cases OWCP) has
  identified permanent limitations
• Compare permanent limitations with physical
  demands of DOI position
• Determine if adjustments can be made to tailor
  the duties and demands of the position to comply
  with recommended limitations.

16
CONTINUE IN DOI JOB?

• Revise position description or functional
  statement to comply with limitations
• Ensure physical demands re-state recommended
  limitations or are clearly compliant with
  recommended limitations.
• Ensure description of duties or functions are
  void of any possible interpretation of being
  noncompliant with limitations.
• Request review of revised description/statement
  by WC Specialist
• Request review and classification by
  Classification Specialist (include OF-8 if
  applicable)
• Do NOT identify position as limited duty or OWCP
  position.
• Identify position as incumbent only
• Following classification, WC Spec will prepare
  permanent job offer letter for presentation or
  mailing to employee

17
Needs a Different Job?

• Follow same process as with non-availability of
  limited duty.
• WC and HR staffing will coordinate identification
  of appropriate position
• Offer existing vacant position compliant with
  limitations
• Offer existing vacant position with adjustment of
  duties/demands to comply with limitations
• Create new position
• Following identification and classification of
  position, WC will prepare job offer letter for
  presentation or mailing to employee.

18
Permanent Job Offer-Loss of Pay or Grade

• Permanent job offer can be developed to afford
  pay retention
• Indefinite
• Protects employees salary-based benefits
• Pay is set at less of DOI pay or 150 of top step
  salary of grade of position offered
• Any remaining pay loss can be claimed by employee
  with OWCP known as an LWEC (Loss of Wage
  Earning Capacity)
• Paid to employee tax free
• May result from loss premium pays such as night
  differential, Saturday, Sunday, Holiday and/or
  on-call pay that cannot be included in pay
  retention calculation.

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REQUIREMENTS

• Must offer classified and graded position
• Must be same employment tenure as when injured
• Temporary job offer is not suitable for an
  injured permanent employee
• Temporary job offer may be suitable for an
  injured temporary employee (time limit must be
  appropriate)
• Location of job offered must be within 50 miles
  of employees geographic location
• Must consider other conditions/limitations that
  may have occurred or changed since DOI

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REQUIRED INFORMATION IN A JOB OFFER LETTER

• Description of duties of position (i.e., Position
  Description)
• Physical requirements of the duties
• Work schedule (include tour)
• Organizational and geographic location of the job
• Date on which job offer will first be available
• Date by which employee is to notify employer of
  decision to accept or refuse offer
• Provide pay/position information (Title, Pay
  Plan, Series, Grade, Step and Salary )

21
USEFUL INFORMATION TO INCLUDE

• Assigned Service of Position
• Person to report to, where and what time and day.
  
• Effective date of job change or re-employment

22
EMPLOYEE RESPONSE

• ACCEPTS

• REFUSES

• Notify WC and HR staffing of decision
  immediately.
• Prepare SF-52 to effect job change
• Advise WC on effective date of employees actual
  return or report for new position.

• No response is considered a declination
• Notify WC and HR staffing of decision
  immediately.
• If employee is working, make every effort to
  continue current work assignment pending
  suitability decision by OWCP.

23
Reasons for Declination

• Potentially Valid

• Potentially Not Valid

• Working elsewhere
• Condition has worsened
• Medical information was not current
• Physician submits position is not within physical
  capacity
• Agency withdraws offer
• Position no longer available

• Tour of duty/work schedule
• Does not wish to relocate
• No promotion potential
• Receiving constructed LWEC
• Is retired or elects to retire or separate
• Personal dislikes of offer

24
Continue Limited Duty Pending Suitability

• Upon notification to OWCP of employees
  declination
• OWCP must determine suitability of position
  offered
• If suitable, OWCP will afford the employee 30
  days to reconsider their decision or face
  possible termination of benefits for failure to
  accept suitable work.
• If NOT suitable, OWCP will advise employee and
  employer requiring the job offer to be revisited.
  
• During 30 day period, make every effort to
  continue to afford the employee suitable limited
  duty
• Following 30 day notice from OWCP, if employee
  provides no medical evidence or valid reason(s)
  to support declination of offer , final 15-day
  notice to employee will be issued by OWCP to
  allow employee to ACCEPT position offered.

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FAILURE TO ACCEPT SUITABLE WORK

• Loss of employment-Removal/Termination
• Management has the right to assign work
• Employer is not required to offer another
  position the employee would prefer
• Loss of compensation benefits
• Compensation for wage loss is terminated at the
  end of 15 day notice if employee fails to accept
  suitable permanent job offer
• Medical benefits may continue
• Employee may wish to pursue retirement or
  voluntary separation

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LETS LOOK CLOSER

• LIMITED DUTY AND PERMANENT JOB OFFERS

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EXERCISE 1

• Jane Smith, Food Service Worker in Nutrition
  Food Service slipped in hot syrup that had been
  spilled on the floor, fell and injured her right
  ankle. She has been off work, per doctors
  orders since the injury. Her claim was accepted
  for Right Ankle Fracture. She has had surgery
  and the physician has released her to return to
  work with the following limitations
• Sedentary work only
• Limited walking
• No prolonged standing
• Follow-up appointment indicated on work status as
  
• 4 weeks

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EXERCISE 2

• On 1/10/13, an LPN filed a traumatic injury claim
  for right rotator cuff tear and is placed off
  work at time of injury. Claim is accepted for
  same and surgically repaired in November 2010.
  Claimant is released to return to work 7/15/13
  with limitations of
• No pushing, pulling or lifting greater than 25
  pounds
• No reaching above the shoulder
• Follow-up appointment on work status states
  PRN

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EXERCISE 3

• Joe D. (RN) provides a return to work statement
  from MD indicating the following restrictions due
  to an accepted back injury
• No lifting greater than 2 pounds
• No pushing or pulling
• No overhead reaching
• The supervisor offers the following written
  limited duty
• Answering telephones
• Clerical duties
• Charge Nurse with no direct patient care

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EXERCISE 4

• Clarification was requested from attending MD and
  received regarding MDs recommended limitations
  for Jane Smith (Food Service Worker with right
  ankle fracture).
• No lifting greater than 20 pounds
• No pushing or pulling greater than 10 pounds
• No standing or walking more than 30 minutes at a
  time

31
EXERCISE 5

• Jane Smith (Food Service Worker with right ankle
  injury) was offered limited duty by her
  supervisor in a telephone conversation on Monday
  6/18/12, to return to work Tuesday 6/19/12. She
  agreed and accepted but did not return to work
  until Monday, 6/25/12. She has filed a CA-7
  requesting compensation for loss of pay for 6/19
  through 6/24. A Report of Contact from the
  supervisor dated 6/18/12 was provided to the
  workers compensation office to document the
  limited duty offered via telephone.

32
EXERCISE 6

• Peter Piper provides a work status from his MD
  indicating release to return to work with
  limitations
• Sitting up to 4 hours continuously
• Walking up to 2 hours/ standing up to 1 hour
• Reaching above shoulder 1 hour
• Climbing ½ hour
• Pushing, pulling, lifting up to 25 pounds
• No twisting, bending, stooping, squatting or
  kneeling
• The following duties were stipulated in the
  written limited duty offer
• Sedentary duty to include clerical work in
  support of service
• Receiving patients/visitors and referring to
  appropriate office
• Picking up mail twice daily
• Answering phone, messaging and referring callers

33
EXERCISE 7

• Tommy Tonka provides work status indicating
  restrictions of no climbing more than 4 feet no
  kneeling, squatting or crawling. May
  occasionally walk up to 50 feet at a time, may
  lift up to 30 pounds as tolerated. The
  supervisor lists the following tasks in the
  written limited duty offer
• Normal duties minus what your physician stated
• Light duty tasks
• Complete all installation work orders
• All other duties as tolerated

34
EXERCISE 8

• Xander, Nursing Assistant, was offered accepted
  a written limited duty assignment 2/7/13
  compliant with his physicians recommended
  limitations of
• No lifting, pushing or pulling over 30 pounds
• Standing and walking limited to1 hour alternating
  minimum 15 minutes sitting
• Bending limited no more than 15 minutes per hour
• He provides the supervisor with a work status
  dated 8/12/13 indicating same limitations as
  permanent.

35
QUESTIONS
36
CONTACT INFORMATION

• Jacqueline Jackie Wiser
• VISN 9 FWCP Product Line Manager
• MidSouth Healthcare Network
• 210 Glenis Drive
• Murfreesboro, TN 37129
• 615-225-6981 (o)
• 615-898-6594 (f)
• jacqueline.wiser_at_va.gov