Most employers view a Return-To-Work program as a stand-alone step for returning injured workers to the workplace. Bringing a worker back into the workforce as soon as possible after an injury is common practice for reducing workers’ compensation costs. What is most often overlooked is the fact that when the injured worker is placed into a temporary position, modified duty, transitional duty or back into their original position without an ergonomics (ERG) evaluation, the temporary assignment may be doing more harm than good. This error of ERG-Omission is a frequently overlooked aspect of an effective Return-To-Work program.

At a conference, I asked a Return-To-Work specialist, “What is the relationship between Return-To-Work and ergonomics?” The reply was, “Return-to-Work and ergonomics do not relate to each other because the employer is only placing the worker in a temporary position.” One might call this “temporary transitional thinking.” Placing an injured worker back into the workforce without considering ergonomics is only half a solution. How functional is a half-built bridge? How great is half a movie? How protective is wearing only one shoe?

Ergonomics

Ergonomics is the relationship between people and their workstation, computers and equipment. The goal of ergonomics is injury prevention by fitting the workstation to the worker, which includes returning the injured worker to a safe working environment. Repetitive motion injuries build up slowly over time. If one worker from a particular work environment has an injury that may be viewed as cumulative trauma, it is only a matter of time before other co-workers could develop signs and symptoms. An injured worker should be a signal to management that some aspect within that job may not be ergonomically correct and presents an excellent opportunity to fix the problem and reduce future claims.

Correcting the error of ERG-Omission involves:

1. Placing the injured worker into an ergonomically safe “temporary, transitional” job.

2. Correcting the situation or job that contributed to the initial injury (there is a reason for the claim).

3. Preventing injury to others who perform the same job.

Specificity of the task

Just as the effectiveness of any employee training is only as strong as its specificity to its target audience, ergonomic solutions must be specific to the task. In ergonomics, one size does NOT fit all, and that includes different departments and their workstations. An employer cannot just throw one solution at a department and hope all goes well. Each process of a job, especially one where an injury has occurred, must be observed and solutions offered. For example, if there is a high-risk job where multiple claims have presented themselves, an error of ERG-Omission might be to implement a “stretching” program, which would not address what was actually causing the problem/injuries.

Best intentions — unintended consequences

In the quest to return the worker to the workplace as soon as possible, one unintended consequence might be a longer recovery. An error of ERG-Omission occurs when an injured worker is placed into a temporary assignment without considering the ergonomics of the new temporary work. If a worker with a wrist injury is placed into a temporary assignment counting paper clips, that activity is still wrist-intensive and may delay the recovery process.

It is important to look at the task that caused the initial injury and not place workers in a temporary position that uses similar high-risk physical maneuvers.

RTSW Program: Return to Safe Work

Step 1 — Do an ergonomics evaluation of the area where the injured worker was hurt. Take the time to observe the work habits and pace of the employees. Talk to the employees about where THEY think the problem lies. Measure reaching distances and look for awkward postures. Managers who do not feel confident in this area should consult a specialist who is certified in ergonomics.

Step 2 — Solicit solutions. The solutions can come from fellow employees, a safety committee, and maintenance or facilities staff. Most often, the best solutions come from the workers who perform the same tasks. They know the job and how to get it done effectively. Trust them.

Step 3 — Purchase wisely. An engineering fix (one that usually requires a monetary commitment) is a more successful way to fix the problem, but often it is the last implemented. Employers will usually implement an administrative solution first because it is cheaper. Administrative solutions include job rotation, job enlargement or stretching. Many times, these solutions work initially because the issue and its proposed solution have the direct attention of the safety leadership and management focusing on the employees. Months later, when the attention drops, so does the success of the administrative solution.

Step 4 — Train employees. When retraining the injured worker, train the entire group! Remember that people are creatures of habit, and that may be part of the problem. Performing tasks exactly the same way over time can lead to fatigue and overuse injuries.

Step 5 — Reinforce. Information retained from training is minimal, so be diligent and keep the information coming all year. This might include safety “bites” as a paycheck stuffer, safety newsletters, bulletins, etc. Highlight employees working correctly and using equipment properly.

Step 6 — Re-evaluate. Once an ergonomic solution is put in place, interval-based follow-ups are critical. Again, one person’s ergonomic solution might be another person’s nightmare. Follow up every four to six weeks, talk with employees, and take action to recognize and correct their concerns.

Return-To-Work programs are an effective way to successfully bring workers back to work after injuries and minimize claim costs. Without involving ergonomics in the Return-To-Work program, it can be a costly error of ERG-Omission. The goal is to return injured workers to SAFE work (RTSW) by correcting the problem that initially caused the injury and protecting all workers who perform similar high-risk tasks. While broad RTW programs can be successful, incorporating an ergonomics strategy into the implementation of a Return-To-Safe-Work program can significantly enhance loss control effectiveness.

Why wellness promotes return to SAFE work

Healthy employees have fewer work-related injuries, return to work sooner because of shorter recovery times, are more aware of safety efforts, and more apt to mentor and encourage others to get healthy. The easy part of wellness is establishing a program and offering it to employees. The hard part is engaging employees. Remember, enrollment is not the same as engagement. Employee empowerment is the goal, not employee entitlement. Keep the focus of a wellness program on the employee taking responsibility and ownership of their own health.

Wellness programs come in many different packages, and one challenge is creating an integrated wellness program that is supported by benefits, risk management, workers’ compensation and employee assistance programs. Through this joint effort, combined resources are focused on injury prevention, finding safety hazards to avoid injuries, and returning workers to the job after injuries occur. The cost of an employee injury is directly related to the health and conditioning of the injured worker. The rule of thumb is the healthier the employee is in the pre-injury state, the quicker the recovery, post-injury.

Kathy Espinoza, MBA, MS, CPE, CIE is a board-certified professional ergonomist. She has worked with Keenan & Associates for seven years providing workstation assessments, solutions and employee training. She has more than 12 years of experience coordinating and teaching a chronic back pain program and wellness program for a major hospital. She has published 33 articles in the field of ergonomics, safety and workplace issues. Espinoza recently wrote a Govpro item on ergonomics issues and police duty belts.

Keenan & Associates is a full-service insurance broker providing products and services that add value, increase reliability and provide financial security for health care entities and school districts. The company serves employee benefits, workers’ compensation, and property and liability programs.