Return to Work in Workers’ Compensation

Is a return to work program essential for the employer, employee or both?  The answer to this question depends on the work environment and culture of the employer.  It also depends on the organization obligations under the Americans with Disabilities Act Amendments Act (ADAAA) that is a mouthful that has plenty of substance.

Is there value in a return to work program?  An organization’s workforce is its most valuable asset, and when an employee cannot return to work due to an injury it impacts the productivity of the entire organization

Should everyone be afforded the opportunity to participate in the organizations return to work program?

When you look at the small example of questions above, you get a general idea of all the involved players; it might be forward thinking to say “how might a return to work program look?”


A 33-year-old female, full time Registered Nurse injured her left shoulder while assisting a patient on and off a commode.  She is diagnosed with a left shoulder sprain/strain and returned to work with no lifting over 20 pounds and no pushing or pulling over 20 pounds for two weeks.  The Nurse is right-hand dominant.

The question is:  Can this employee’s work restrictions be accommodated?  And if so, what will she do and where can she perform those duties?  Will the modified work help or hinder the organization and employee?

Restrictions Accommodated:  For the next two weeks, the Registered Nurse will assist the other nurses with the smaller tasks that will allow the injured worker to continue to come to work (organizational structure still intact) instead of sitting at home feeling sorry for him/herself (loss of self-worth).

The above scenario is just a small example of how a return to work program may look.  One of the goals of a quality return to work program should be that all parties involved have an understanding of their

roles during this transitional period.   It should also assist in keeping the organization and their employees working harmoniously together.

Based on a September 2, 2014, article in Risk and Insurance written by freelance writer Katie Kuehner-Herbert, “Modified Duty and Return to Work Programs” are making a comeback.

The below report for the period 2000-2005 reflects the return to work rate within 12 months of an injury based on the injured body parts.  It will be interesting to see if future reports provide an upward or downward trend.

Past research by RAND and others has shown a direct relationship between return-to-work rates and wage loss. Table 1 below ranks the return-to-work rates for the parts of the body from the highest rate to the lowest rate and shows the current diminished future earning capacity (DFEC) adjustment for each part of the body. If the wage loss study to be conducted in phase two of the PDRS analysis confirms a direct correlation between return-to-work rates and wage loss, this table suggests where there may need to be some adjustments between body parts to restore equity.

Table 1

Part of the Body Current  DFEC  Modifier 12-month RTW  Rate  (2000-2005)
Elbow 2 78.38%
Grip 4 78.26%
Hand 1 77.58%
Toes 5 76.35%
Knee 2 75.58%
Shoulder 7 73.38%
Ankle 2 73.23%
Wrist 4 72.90%
Hearing 8 72.56%
Hip 5 69.55%
Heart 5 69.32%
Leg 5 67.94%
Arm 5 66.75%
Other 2 65.65%
Eyes 1 65.45%
Digestive 6 65.38%
Pulmonary 7 65.10%
Spine 5 60.06%
Head 6 57.14%
Psych 8 52.51%


Understandably, a modified position cannot always be found within some organizations.  We encourage you to think “out of the box.”  Perhaps find a positon in another department or a different shift.  Some organizations have even had success by placing an injured worker at a community-based non-profit that can use their skills within the restrictions.  With creativity almost, any situation can be accommodated!

The employer, employee, injured worker, modified work, transitional work, return to work, how will all these can work together for all involved –  KEEP THE LINES OF COMMUNICATION OPEN and let your claims administrator know when and how you will or will not have a return to work opportunity.



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