Slow return to FT work -- what should policy be?

[sorry, this is a bit of a longee.]

We have policies on short and long term disability, but have a situation unfolding which goes beyond current policy and may need creation of new policy. You tell me.

Cherie went out on short term and then long term disability for kidney failure. She returned to work a little on partial disability. Now she receives pay for actual hours worked, plus full LTD pay. Once she increases her hours beyond a certain amount her LTD pay gets reduced until she is at or near full time pay. She is historically a full-time employee but she was authorized by her doctor to return up to 20 hours/week to start.

Sherie began her return at 10 hours per week, and we expected (but did not outline) a gradual ramping up to 20 hours per week. Two months later she is still at 10 hours per week. My Benefits Manager tells me that she would like to go to 20 hours in August.

First question: when she returned, should we have outlined a schedule for increasing her hours over time up to the 20? We didn't because we were concerned about her stamina and wanted her to pace herself. It was also going to be as much trouble to have a constantly changing schedule (she's a front desk person whose hours need to be built around others, or vice vers) as to have her stay at one level for a while before stepping up.

Second question: assuming there is no reason she start her 20 hours per week now (remember, her doctor authorized "up to" 20), what should we put in place beginning in August?

Third question: what should her benefits level be while she is ramping up? Should she be treated as a part time employee based on actual hours, or a full time employee based on what was and what she's working back to (presumably). Medical and dental premiums aren't an issue (same rate for pt as for ft) but time off accruals depend on actual hours worked. In the past we have considered an employee working back to full time employment eligible for full time accruals. I am thinking we should now put a limit on it -- if after six months she is still working 20 hours/week, maybe she should be accruing at that level.

Other relevant information: we were hoping the LTD company would be monitoring the EE's progression back to work, but they are taking a very laissez-fare (sp?) approach. They've commented that with this particular illness they rarely see people return at all (they seem to remain on disability) and maybe they have already decided the claim and are happy if it gets reduced but not motivated to push it.

From the organization's point of view, we have been filling her position with a temp. We need the full time position and at some point we have to decide if we are comfortable with the temp + pt EE scenario, or want to go for requesting an increase in staffing to allow her to ramp up or not, etc.

Advice appreciated.

Carol


Comments

  • 14 Comments sorted by Votes Date Added
  • [font size="1" color="#FF0000"]LAST EDITED ON 07-17-05 AT 04:21AM (CST)[/font][br][br]TMI. No Comprendo.




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  • >
    >TMI. No Comprendo.
    >
    Hmm. Hard to know how to simplify except maybe to ask for a response to the first question first, which is before it gets too complicated.

    Or, let me try it another way.

    If your company has a policy, what is your policy on people returning from work on partial disability? That is, people phasing back from no work to part time to full time work slowly. Do you let them determine the schedule or do you set it? Do you have time limits by which they must be back full time before the job is in jeopardy?

    Thanks, Carol



  • We allow injured/ill employees to set their return to work schedule with their supervisor. Therefore, it is incumbent upon the supervisor to track the situation if they want a full staff. However, if I notice an injured employee is back at work and doing everything they did before but they're still on modified duty, I'll sure be asking for verification that they still need the modification. I think it would be difficult for us to be very specific about return to work requirements, in light of just a few of the absences and returns to work we've had in just the past year (heart attack, back surgery, broken toe, temporary paralysis, ankle reconstruction, cancer, broken collar bone, etc.).

    I created a modified duty progress tracking form for supervisors of employees who have been injured or become ill on the job, but we have no actual policy or procedure specifying dates and time-lined reassumption of duties. If you'd like, I can email you that template.

    -Abby
  • Abby, I sent you an e-mail off-forum, but i would indeed like a copy of your modified duty progress form. thanks.

    Carol
  • I haven't received an email from you that I can locate. Resend?
  • First, no employee (here) returns to work without the knowledge and approval of HR and then only following a review of their return to work form from their doctor. We often return employees to work on a restricted basis (some still call it light duty) if they were out due to industrial injury or accident (work comp) and then only because it is in our best interest to do that. Often we insist that a nurse, case-manager be assigned by the comp carrier to shepherd this process. That takes us entirely out of the 'medical forecasting' loop. Medical forecasting and attempting to determine MMI and return to full duty progress rates is not the responsibility of HR and certainly not of a supervisor.

    If the employee has a non-work related medical situation and is attemting to return to work with restricted duty or limitations, we would take it case by case, evaluating carefully. If we decided to pursue that, it would be guided solely by the physician's or physical therapist's recommendations, never those of a supervisor or the employee herself. Even in this case, we would expect that the ee would 'ramp up' within several weeks to total, unrestricted duty.




    Disclaimer: This message is not intended to offend or attack. It is posted as personal opinion. If you find yourself offended or uncomfortable, email me and let me know why.
  • Same at our company as described by Livindon.
  • >First, no employee (here) returns to work
    >without the knowledge and approval of HR and
    >then only following a review of their return to
    >work form from their doctor. [text snipped]
    >
    >If the employee has a non-work related medical
    >situation and is attemting to return to work
    >with restricted duty or limitations, we would
    >take it case by case, evaluating carefully. If
    >we decided to pursue that, it would be guided
    >solely by the physician's or physical
    >therapist's recommendations, never those of a
    >supervisor or the employee herself. Even in this
    >case, we would expect that the ee would 'ramp
    >up' within several weeks to total, unrestricted
    >duty.
    >
    Part of the pickle we got into was that we assumed the LTD company would perform this function, with the incentive that the sooner the EE returned to work, the sooner they could stop the salary supplement.
    They have been pretty lackadaisical about this, and we are perplexed as to why. they've made several comments about how fortunate we are that the EE even wants to return to work, their experience is that with this sort of diagnosis EEs never return from disability.
    It sounds like my next step is a progressive return-to-work-full-iime plan backed up with some documentation from the physician.
    Don, does your return-to-work form have a place where the EEs work duties are specificed?

    Carol

  • I've never known a STD or LTD carrier to do anything other than require paperwork and pay the weekly benefit. We don't have a specific "Return to duty form". We may or may not return workers to restricted duty based on what the physician's return to work (his form) states. If unclear, we have the employee/patient return to him for specific restrictions and we provide a complete job description for the physician's use. If it's work comp, we reserve the option to employ a nurse case manager to negotiate this cakewalk as we are not clinicians. If it's comp and a relatively simple process of temporary, very time-limited restricted return, we handle that in HR. Please, never, ever get into the business of having a supervisor or HR specialist involved in this process. Can you see yourself on the stand testifying that your supervisor, with no medical training, arrived at a step-up return to full duty plan based on his/her assumptions about the employee's medical condition and the employee's statements about how she felt, etc? I think not.




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  • Then are we to take the physician's word which is based solely on observation of and feedback from the employee? Must we allow our employment procedures to be dictated by a manipulative employee?

    Who gets hurt worse in the long run when an employee either manipulates a good doctor, or finds a bad doctor to provide "certification" that the employee can't (yet!) return to full employment? Employer or employee? (retorical question)

    I value information provided by someone that can actually see the employee perform (or not perform) the job; the supervisor *should* know what it takes to do the job. It is my understanding that it's very difficult to maintain the illusion of a "disabling" condition for a number of hours every day, and if the supervisor catches an employee "faking it," then HR knows it needs more information (we'd send the EE to OUR doc at this point). I certainly don't have time to follow a light duty employee around all day to make sure they're following restrictions. However, most of our supervisors have at least periodic if not continual contact with their employees throughout the day. (Please keep in mind that we're relatively small - 65 FTE; I've got 11 supervisors, and I'm a one-person HR department.)
  • [font size="1" color="#FF0000"]LAST EDITED ON 07-20-05 AT 03:03PM (CST)[/font][br][br]"I certainly don't have time to follow a light duty employee around all day to make sure they're following restrictions."

    Well then you probably don't have time to attend depositions, answer interrogatories or sit on a stand explaining how your supervisor came up with medical restrictions, a return to duty schedule and a diagnosis of when someone is faking medical issues.

    It is never an HR staff member's responsibility to follow someone around policing their restrictions. The employee should be terminated for violating medical restrictions. A supervisor should be violated (edit: Whoops, terminated) for encouraging an employee to do that or for ignoring the restrictions. But, it is the employee/patient's ultimate responsibility to follow their restrictions. If you allow an employee to return, restricted, it is your (our) responsibility to make sure the restrictions are accommodated.

    I'm just trying to offer advice based on experience, not complicate your life.




    Disclaimer: This message is not intended to offend or attack. It is posted as personal opinion. If you find yourself offended or uncomfortable, email me and let me know why.
  • >Well then you probably don't have time to attend depositions, answer interrogatories or sit on a
    >stand explaining how your supervisor came up with medical restrictions, a return to duty
    >schedule and a diagnosis of when someone is faking medical issues.

    True! I still think we have to have some sort of mechanism to prevent abuse of an employer's generosity, though, and having the supervisor simply track an employee's progress wouldn't necessarily be practising medicine, would it?

    >If you allow an employee to return, restricted, it is your (our)
    >responsibility to make sure the restrictions are accommodated.

    I guess I was trying to confuse accommodation with a greater sense of responsibility that could have been costly had I never read Don's advice. I love finding ways to uncomplicate my life!



  • Your approach also makes sense, Abby, in that there ought to be a step between "here are the restrictions for your return to your job, welcome back" and "Hey! I saw you lifting that 10-lb box when you have a 5-lb restriction, you're fired."

    So some manner of general "observation and feedback" as opposed to "constant monitoring and policing" needs to be in play, and unfortunately probably depends on the case, going back to one of Don's original points.
  • >Please, never, ever get into the
    >business of having a supervisor or HR specialist
    >involved in this process. Can you see yourself
    >on the stand testifying that your supervisor,
    >with no medical training, arrived at a step-up
    >return to full duty plan based on his/her
    >assumptions about the employee's medical
    >condition and the employee's statements about
    >how she felt, etc? I think not.
    >
    I would generate a gradual return schedule with the supervisor, ask the employee to review with her physician and have him/her authorize the ramping up schedule in writing, at the specified job description which I would attach.

    This is not a worker's comp situation, so we are on our own. I'm not so much worried about the person being able to accomplish the duties within the job description, it's pretty much a deskbound job, but I do need the physician to approve the number of hours per week.

    I am hopeful that she returns to full time smoothly, but does anyone have an opinion on how much time we should wrestle with a slower-than-hoped-for return to work? One Month? Three? Six?

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