The Return to Work Hierarchy – A Strategy to Identify Temporary Transitional Work Opportunities written by Michelle Gauder, MBA, CPDM Sr. Absence, Health & Productivity Consultant Zurich Services Corporation Risk Engineering In this day and age it is common knowledge that the early return to work of injured or ill workers (in both occupational and non-occupational settings) reduces the overall cost of claims. Returning injured/ill employees with a physician’s approval in a temporary transitional capacity has been proven to expedite the employee’s recovery process and as a result reduces medical expenses. Bringing an employee back to the workplace can also reduce the amount of indemnity benefits paid to the employee which aids in reducing overall injury costs. Return to work has also been proven to reduce chances of litigation, reduces indirect costs associated with the injury management process as well as countless other benefits. While many companies understand the benefits associated with return to work and may have good intentions of practicing return to work, it is not uncommon to hear of companies struggling to identify temporary transitional duties when the opportunity to accommodate presents itself. I often hear customers state, “we don’t have any light duty” or “due to the nature of our business it’s impossible for us to accommodate”. While there are admittedly some industries that present more accommodation challenges than others, I am a firm believer that temporary transitional work opportunities always exist - you just have to approach the situation of making an accommodation from the right perspective. Taking into consideration a concept often referred to as the return to work hierarchy can help employers use a logical thought process to aid in identifying meaningful and tangible temporary transitional work opportunities. The return to work hierarchy consists of four layers – 1) current/modified job – same location; 2) different job – same location; 3) different job – different location; 4) alternative work.

Current/modified job – same location Different job – same location Different job – different location Alternative work When presented with an injured/ill worker with restrictions, the employer should first consider the top layer of the hierarchy, ‘current/modified job – same location’. Sit down with a copy of the employee’s full duty job description and a copy of the employee’s restrictions and do some comparisons. Ask yourself these questions: 

Are there any parts of the employee’s pre-injury position that are within the scope of the employee’s restrictions? It is important to focus in the employee’s abilities and not get hung up on their disabilities. Maybe an employee can still perform 50% of the essential functions of their job – the employee can be brought back on a part-time basis until restrictions lessen or 50% of the employee’s time can be spent in their pre-injury position while the other 50% is supplemented by activities determined in another level of the hierarchy.

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Are there any parts of the employee’s pre-injury position that are outside the scope of the employee’s restrictions, but can be modified slightly to align with the restrictions? If a restriction of no prolonged standing is in place, can a chair or stool be provided to the employee? If a restriction of no lifting/carrying is in place can a wheeled cart be provided to help eliminate the need to manually handle the product or material? Can a co-worker temporarily assist with various tasks during the temporary transitional work period?

If the answer to these questions is ‘no’, or if additional work is needed to provide more hours for the injured/ill employee then the next level of the hierarchy, ‘different job – same location’ should be considered. When considering this level of the hierarchy, ask yourself these questions:

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Is there another department within the organization that could benefit from the assistance of the injured/ill worker? Think about jobs that need to be completed that the company typically has difficulty keeping up with due to workloads and capacity. Is there any filing, shredding or other miscellaneous clerical work that could be done in the main office? Are there any tasks that are not done on a regular basis that would be nice to have – for example, dusting/wiping down tools or equipment, taking inventory, repainting railings/lines on the floor or stairs, light organizing or rearranging?

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Is there anything that could be done to help the injured worker learn new skills that would aid them in their professional development? Can the injured/ill worker participate in any on-line or in-person training in their temporary transitional capacity? Could the injured worker shadow a colleague in another area to increase his/her knowledge or skills in other areas of the organization? Can the injured/ill worker act as an assistant to the safety manager/director and assist in performing inspections that may help the employee be more safety conscious once they return to their pre-injury position?

Once again, if the answer is ‘no’ to the questions above or if additional tasks need to be identified we move down the hierarchy to ‘different job – different location’. For organizations that only have one location or if there are hundreds of miles between locations, this level of the hierarchy may not be an option. However, for example, in the retail industry, consider another location that is in the near vicinity of where the employee is located or in the construction industry maybe another job site that is nearby. When considering these other locations, ask the same questions that were asked in the previous level of the hierarchy. Finally, as a last resort – we come to the final level of the hierarchy, ‘alternative work’. Alternative work involves having an injured/ill worker volunteer at a local non-profit organization as a form of temporary transitional work. While the employer does not directly benefit from the productivity of the injured work, they still benefit by getting the injured/ill worker up and out of the house and out of the disability mindset. By keeping them active in society it allows them to experience the benefits associated with traditional return to work efforts. The employer can also benefit from these arrangements by demonstrating community outreach through providing volunteer time to local non-profits. There are organizations that exist to facilitate alternative work arrangements between injured/ill workers and employers for both occupational and nonoccupational illnesses and injuries. Utilizing a third party to facilitate these arrangements can ease the burden on the employer who likely does not have experience or expertise in this particular area.

When utilizing the return to work hierarchy to determine appropriate temporary transitional work opportunities it is important to keep in mind these opportunities are just as the name says, temporary and transitional. With that said, it is a return to work recommended practice to provide a time limit (e.g. 30/60/90 days) within an organizations return to work policy to confirm these temporary transitional opportunities are not misinterpreted or misrepresented as permanent accommodations. While a company may be quick to say they do not have temporary transitional work available, we would challenge them to consider each level of the return to work hierarchy and to think outside the box for creative ways to accommodate employees. Often times at a quick glance it may not look like work is available, but upon closer consideration and investigation tasks can be found that can be mutually beneficial to both the employer and the injured/ill worker. After an organization has had the opportunity to go through the process of utilizing the return to work hierarchy to identify temporary transitional opportunities I would encourage them to start a task bank of ideas. Having a predetermined list of opportunities can help ease the burden put on managers and supervisors when it comes to making accommodations and can help to instill more buy-in for the return to work culture. Return to work is most impactful when it is a positive experience for all involved. By taking the time to identify meaningful and tangible work, and understand the restrictions, the return to work process can truly be a mutually beneficial experience for employees and employers. It is important to keep in mind that employees are an employer’s most valuable asset – we need to do everything we can to expedite their recovery in order to return them to their pre-injury capacity as soon as possible.