Return-to-Work
BWC Provides More Tools for Return-to-Work
Getting injured workers back to work requires involvement from the worker, the employer, the
managed care organization (MCO) and medical providers. And, more than ever, the Ohio
Bureau of Workers' Compensation (BWC) expects them to work together to ensure quality
health care, and a timely and safe return-to-work.
"Return-to-work planning must begin as soon as an accident happens," according to Tina
Kielmeyer, BWC's chief of medical management. "We would like to see return-to-work plans
on every potential lost-time claim."
She said this requires employers to identify modified-duty jobs ahead of time, file first reports of
injury (FROI) immediately, follow work restrictions from physicians, and work with the MCO
on return-to-work. As the MCO, University Hospitals CompCare's responsibilities in the process
include: FROI filing and follow-up; medical management; ensuring communication among the
employer, employee and physician; and facilitation of return-to-work.
BWC recently announced several changes in its programs to encourage more aggressive
approaches to return-to-work and remain-at-work. These changes include:
- Introducing the Transitional WorkGRANT$ program, which reimburses employers up to 80 percent of their transitional work-related costs.
- Making vocational rehabilitation services available for all types of claims, not just lost-time cases as in the past.
- Introducing the concept of "presumptive authorization," under which medical providers will have authority to conduct some basic medical procedures early on in a case without MCO
preauthorization.
- Carefully tracking the return-to-work performance and degree of disability management of MCOs, and measuring physician outcomes and utilization.
- Standardizing the MCOs' approach to preauthorization of medical procedures.
- Permitting the use of generic equivalents for prescriptions.
|
