The same thing needs to happen in your hiring practices. Unfortunately, when you decide to hire someone you don't know their past medical history and physical condition. When you make the choice to hire someone, you should have them complete a conditional offer of employment form. This form lets them know that they have the job, but only so long as a doctor says they are physically and mentally able to perform substantially all of the essential functions of the job.Once they have completed the form, off they go to the doctor (more on choosing a doctor in a moment), who will examine them and determine if they have any restrictions that are relevant to what they are being hired to do.

If they don't have any restrictions, then they are good to start the job. If the doctor places restrictions on them, it is then up to you to determine if your business can reasonably accommodate those restrictions. I have no way to accommodate the fact that the dog can knock over my six year old, but maybe you can accommodate an employee who is restricted to not being able to lift their arms above their shoulders.

Once you know you have an employee who can perform their job safely, you are off to the races. They'll go through training on how to do their job and they are unlikely to get injured.But when one of your employees does get injured, then it's time to jump back into “parent mode.”

Selecting A Provider

In most states you can direct employees to the doctor of your choosing. It's important that you speak with your insurance agent about the rules in your state. Choosing the doctor may be the single mostimportant thing you can do to effectively manage the costs of employee injuries. If you choose the wrong doctor, all of the best practices you have set up for later in the process can become useless.

How can you find a great doctor? I'd start by looking for a physician that is board certified in occupational medicine. You can find them by searching at acoem.org. No board certified doctor in your area? Then start looking at the urgent care clinics in your area. Many urgent cares market workers' comp services and they are looking for businesses like yours to partner with.

Once you find a physician, visit with them. Are they comfortable sending employees back to work with restrictions or are they inclined to send folks home for several days? Will they come visit your business so they can understand the work you do and how you would accommodate injured employees that have restrictions? Will they agree to see your employees quickly after they arrive at the clinic? Will they give you a comprehensive list of restrictions when an employee is injured so you can find suitable transitional work until they are ready to go back full duty? All important questions.

It's important that both you and the doctor understand that there are only three reasons an employee can't be at work doing something:

1. Hospitalization
2. On medication that makes it unsafe for them to get to and/or be at work
3. They are contagious.

Otherwise, both you and the doctor should be committed to returning any injured employees back to work immediately.

Why is it important that they get back to work immediately? First, when an employee is at home rather than at work, the clock is ticking for them to start receiving lost wage benefits from the insurance company. There are 36 states that when you keep the claim “medical only,” meaning that there are no lost wages paid by the insurance company, you receive a 70-percent discount for that employee injury on your experience mod.

Also, studies show that the longer an employee is out, the less likely it is that they will ever return back to their job. By the time an employee is out 12 weeks, there is only a 50-percent chance they will everreturn to work. When employees are home on a workers' comp claim, it's likely that they are lying around the house, watching TV. Have you watched any daytime TV lately? Every commercial break has at least one ad for an attorney that cares about them and will get them what they are owed (operators are standing by).

If the doctor is committed to getting your employees returnedfor transitional duty, then you have to commit to finding work for them to do. It is common for employers to feel like they don't have any light duty work. Start by brainstorming the work that isn't getting done. Some employees would be great candidates to call your current clients and do a survey. There is likely clerical work that they could help with. Talk with your employees about how they could modify their jobs if they had a physical restriction.

What could they still do if they couldn't lift more than 20 pounds? What if they couldn't use one of their arms? You'll likely be surprised by the feedback you get.

Even in states where you can't force an employee to the doctor of your choosing, it is likely that you can recommend a doctor. “Doctor Joe treats most of our injured workers and he does a great job,” can go a long way toward getting employees to do what you want them to.

Once they go to your doctor and come back to you with restrictions, get them into their transitional job right away. Make sure that you know when all of their follow up appointments are scheduled and accept no excuses about missing appointments. They don't have a car? Drive them or find them transportation.

If an employee has to be out of work, make sure that you are consistent in communicating with them. Almost every time an employee retains an attorney to help with a workers' compensation claim it is because they felt uncertain, scared or ignored. You can prevent all of these emotions by being very transparent about what is going to happen. Most employees who get injured on the job have never been hurt at work before. They don't know if there are co-pays or deductibles. They don't understand that the insurance company will pay all of their medical bills and even pay for their lost wages if they have to be out of work.

While an employee is in a transitional duty position, be sure to get updates from the doctor. Many light duty positions are less strenuous than the work the employee was doing prior to injury. You want to make sure they get back to full duty as soon as possible because you don't want them to get comfortable in their “new” job and wind up malingering on the claim.

One last critical step in this process is getting the supervisors on board. Many times an employee sees their supervisor as their boss, even if that supervisor has no direct hiring and firing authority. If a supervisor has a bad attitude toward an employee that is working with restrictions, it can sink your effort. When that employee is made to feel bad about the fact that they can't do 100% of the job, they are very likely to crawl into the arms of that attorney that cares for them.

Just like a parent with a child, dealing with injured employees requires compassion, but also firmness. As a skilled claims manager, you know what the best path through an employee injury is and it is critical that you communicate your expectations to that injured employee. If you have all the pieces in place, you will find that your injured employees will follow your lead and get back to work happy, healthy and productive more quickly and less expensively that you thought possible.

Kevin Ring is the Lead Workers' Compensation Analyst for the Institute of WorkComp Professionals, which trains insurance agents to help employers reduce Workers' Compensation expenses. A licensed property and casualty insurance agent, he is the co-developer of a new Workers' Comp software suite that will help insurance professionals in working with employers. He can be contacted at 828-274-0959 or [email protected].