Workers Comp Question

Dgross

In November, 2004, an employee filed an incident report claiming a lower back injury. Since that time she has seen two physicians (one specialist) and has been on restricted duty since the incident (and we have offered modified duty to accomodate). However, the Specialist that has been treating her is now saying "She has essentially reached a platueu level in her improvement. Although I do not have any formal restrictions from any work-related injury, it would be advisable for her to minimize repetitive twisting and bending of her lower back and not lift more than 30 pounds, primarily secondary to a pre-existing condition." Basically, those are the same restrictions he had imposed during his treatment for the work-related injury.

Now our WC carrier & the Specialist are saying her condition is no longer work-related and they are done! We now have to decide whether she should be working. When I pressured the Specialist, through his nurse, he said he did not believe she could do the job.

What do we do now? Do we terminate? Any suggestions?

pork1

DGROSS: When I get a written determination by a physician that reaches MAXIMUM MEDICAL IMPROVEMENT ACHIEVED, we call it medical disqualification and terminate. I would not accept the specialist determination, we would send the person back to the physician that prescribed the "physical therapy, as a part of his medical treatment plan" and get his determination that there is nothing further for the medical field to do. Upon receiving the physician's determination that he/she is through we call it Medical disqualification and terminate.

We move forward with a new employee search and let the chips fall where they may.

PORK

Don D

I see no need to further accommodate by continuing to offer restricted duty, especially since the 'specialist' says she can't perform the job. Depending on your state laws, I'd find a way to cut her loose. Of course only you and the company can weigh the value of keeping her or cutting her loose, and remember that workers comp (in most states) does not include offering continued accommodation.

The conclusion of your carrier that 'We are done' is an odd one, if that's all they had to offer in the way of counsel. You are paying those people to do more than that!!

So, it's time to decide if you want the liability of carrying this employee, perhaps anticipating future WC events, or parting ways, and cutting your losses.

System

If the employee has reached MMI and still cannot perform the essential functions of the job, I would terminate. The longer you make those accommodations and keep the employee in a modified assignment, the more difficult it will be. Get a statement from the physician that the employee cannot return to work with no restrictions, then act on termination.