Effective Strategies for Employers to Manage Claims and Facilitate Return-to-Work Programs (CLM)

Effective Strategies for Employers to Manage Claims and Facilitate Return-to-Work Programs

Friday, March 15th, 2024 Insurance Industry Litigation Risk Management Workers' Compensation

Employers can significantly reduce their claims costs and mitigate litigation risks by strategically managing return-to-work programs for injured employees. Preparing for these situations before accidents occur is crucial. This involves having a valid panel of physicians and a clear accident reporting process. Identifying potential light-duty jobs that align with work restrictions can streamline the return-to-work process. Once an injury is reported, timely communication and a structured offer of treatment and light-duty work are essential.

When an employee is injured, the employer must quickly determine if the prescribed work restrictions can be accommodated. If not, income benefits should be started promptly to avoid penalties. Employers should make written job offers to ensure clarity and legal compliance. The WC-240 process is a formal method for returning an employee to work, requiring a job description that fits the employee’s restrictions to be approved by the treating physician.

Employers must navigate the regulations carefully, especially when an injured employee refuses to return to work. Unjustified refusal can lead to the suspension of benefits, but the employer must maintain the offered position or potentially start income benefits. Monitoring the injured employee’s work and ensuring compliance with restrictions can prevent aggravation of injuries and provide evidence in disputes over the suitability of employment.

Employers should leverage surveillance and employee witnesses to support their case in potential litigation, demonstrating the offer of suitable employment and the injured employee’s response. This strategic approach not only aids in managing costs but also in fostering a safer and more adaptable workplace environment.


External References & Further Reading
https://www.theclm.org/Magazine/articles/the-best-medicine-strategies-for-employee-return-to-work-after-injury/2881
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