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Effects of an Early Return-To-Work Program

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Effects of an Early Return-To-Work Program EFFECTS OF AN EARLY RETURN-TO-WORK PROGRAM ON THE COSTS OF WORKERS’ COMPENSATION DISSERTATION Presented in Partial Fulfillment of the Requirements for The Degree of Philosophy in the Graduate School of The Ohio State University By Robert A. Mosley, M.A. ***** The Ohio State University 2003 Dissertation Committee: Professor Bruce Growick, Advisor Approved by Professor Michael Klein ____________________ Advisor Professor Bruce Walsh College of Education Copyright by Robert A. Mosley 2003 ABSTRACT One of the major issues confronting employers in the United States today is the high cost associated with workers’ compensation insurance. Although many factors contribute to the total overall cost of workers’ compensation, the major cost driver besides medical is lost time from work. As time off work due to a disabling injury increases, so do injury-related costs such as indemnity payments, medical and legal expenses, and employee costs. This study will investigate the relationship between the implementation of an Early Return to Work program as a component of an Employers’ Disability Management program and its effects on one of the cost drivers affecting their compensation cost (lost time). The purpose of this study is to determine to what extent there is a relationship between early return to work and the length of time off work (TOW) and successful return to work (outcome). This study compares two Early Return to Work (ERTW) programs, one with labor/management support (Toledo), and one without (Cleveland), and it evaluates each program’s effect on time off work (TOW) and rehabilitation outcome. This study will seek to find which of the following characteristics were predictors of desired outcome: Program type (labor/management support and non-labor/management support); Occupational group; and Nature of disability. ii The employer’s ability to impact workers’ compensation costs has wide- reaching implications in the workforce. Determining the impact of early return to work on time off work and outcome will guide rehabilitation professionals, employers, Disability Management companies, Managed Care Organizations, insurance firms, and other professionals providing assistance in the worker’s compensation arena to develop effective Early Return to Work programs whose goal is to manage lost time—that is, return injured workers safely and effectively back to work, and reduce workers’ compensation costs for the employers. Rehabilitation professionals, insurance companies, employers, and public and private rehabilitation companies and agencies need to have knowledge of what characteristics predict return to work in a workers’ compensation setting in order to increase programmatic emphasis on those program characteristics that affect time off work (TOW). iii This dissertation is dedicated to those who believed in, and supported me: Zelma Mosley, Rachel Robeson, Ida Norrell, and Angela Norrell iv ACKNOWLEDGMENTS I wish to thank my advisor and mentor, Dr. Bruce Growick, for his patience and understanding as I pursued my doctoral study in Rehabilitation Counseling. I am grateful for his kind assistance and guidance. I would like to express my sincere appreciation for the generous help I received from Professors Klein and Walsh. They were very instrumental in my development as a student and professional in the field of Rehabilitation Counseling. I wish to thank Robert Lawson and Edward Irelan for agreeing to provide their data about the Early Return to work programs they developed and managed in their perspective cities. I also thank Robert Lawson for sharing his wisdom and knowledge in risk management and workers’ compensation. I am grateful to Dr. Francine Michel for her encouragement and friendship, and to Judge Allan J. Ramsay for his support in my early years in graduate school. I also thank Dana Weldon, who read through countless drafts of my chapters and gave me valuable feedback, Dr. Joyce Miller, who helped me with the statistical analyses of my data, Dr. Müge Galin for her help in writing and editing these chapters, and Dollie Curry, for her formatting expertise in putting it all together. Finally, without the support of my family and friends who stayed close to me, none of this could have been accomplished. I am grateful for my association with them, and I owe a very special thanks to Angela Norrell for her unwavering support and for believing in me and never allowing me to lose sight of my ultimate goal. v VITA May 30, 1950 ……………… Born – Smithers, West Virginia 1972 …………………………B.A. Political Science, Oakland University, Rochester, MI 1974 …………………………M.A. Vocational Rehabilitation Counseling, Michigan State University, East Lansing, MI 1996 – Present ………………Employability Assessor, The Industrial Commission of Ohio, Columbus 1991 – Present ………………President, Transitional Work Systems, Inc., University Heights, Ohio 1989 – 1991…………………Program Administrator Industrial Commission of Ohio, Cleveland 1979 – Present …………… Vocational Expert Social Security Administration Office of Hearing and Appeals, Cleveland 1986 – 1989…………………Rehabilitation Consultant Industrial Commission of Ohio, Cleveland 1978 – 1986…………………Rehabilitation Supervisor/Vocational Rehabilitation Counselor Ohio Rehabilitation Services Commission Cleveland, Ohio 1975-1978………………… Rehabilitation Administrator Goodwill Industries Cleveland, Ohio FIELDS OF STUDY Major Field: Education vi TABLE OF CONTENTS Page Abstract......................................................................................................................... ii Dedication..................................................................................................................... iv Acknowledgements....................................................................................................... v Vita ............................................................................................................................... vi List of Tables ................................................................................................................ ix Chapters: 1. Introduction....................................................................................................... 1 Disability management ..................................................................................... 2 Statement of problem........................................................................................ 4 Purpose of the study.......................................................................................... 5 Significance of study......................................................................................... 5 Research questions............................................................................................ 6 Research variables ............................................................................................ 7 Limitations ........................................................................................................ 7 Internal validity..................................................................................... 7 External validity.................................................................................... 9 Highlights of each city’s ERTW programs....................................................... 14 Definition of terms............................................................................................ 15 Summary........................................................................................................... 17 2. Review of the literature..................................................................................... 18 Ohio workers’ compensation system................................................................ 19 Inception/rationale of disability management................................................... 23 Components of a disability management program ........................................... 25 Early return to work programs as a component of a disability management program........................................................................................ 28 vii Characteristics of an effective early return to work program ........................... 31 Top management support/program evaluation ................................................. 31 Incentive ............................................................................................... 31 Network of providers ............................................................................ 32 Early intervention.................................................................................. 32 Disability types and return to work....................................................... 35 3. Methods............................................................................................................. 38 Research questions............................................................................................ 39 The agencies...................................................................................................... 39 Characteristics of two programs ....................................................................... 41 Sample frame .................................................................................................... 41 The participants................................................................................................. 43 The data for this study....................................................................................... 43 Data collection.................................................................................................
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