WorkCompWire
Full article on: workcompwire.com
Lana Sellner, MS, CRC, CEAS II, REAS, Manager, Vocational Case Management
Brenda Lovely, Dedicated Program Manager, Transitional Return to Work
Vocational services are rooted in the core purpose of the workers’ compensation system— helping injured workers recover and successfully return to gainful employment. When they happen, workplace injuries are extremely disruptive events. They impact a person’s ability to be a productive member of their family and community. By keeping return-to-work at the center of the care journey, vocational support is designed to restore purpose and support meaningful recoveries.
To adapt to changing workplace needs and a growing understanding of the broader behavioral and psychosocial picture surrounding workplace injuries, vocational services need to be positioned to deliver a more holistic, recovery-focused approach. In contrast to traditional vocational rehabilitation processes designed around expediency, a true vocational recovery model must incorporate a continuum of services ranging from vocational case management to virtual support to transitional return-to-work.
By understanding why this evolution is necessary—and the many ways it benefits both injured workers and stakeholders—our industry will be better equipped to meet fundamental objectives in a more person-centered, outcome-driven way.
Changing Needs for a Changing System
For injured workers and workers’ comp professionals alike, vocational rehabilitation too often has a negative stigma. While intended to provide the skills and resources necessary to either return to a previous job or find suitable new employment, the traditional system is generally regarded as falling short of that goal. In case after case, injured workers report encountering a “check-the-box” mentality from these services that provides only superficial help in a largely impersonal way.
Instead of truly supporting recovery, the process has become more oriented toward rushing people through the steps needed to declare them rehabilitated so the case can be closed. While this creates certain incentives for some carriers and providers, it hurts both injured workers and the system over the long term. A vocational rehabilitation system that doesn’t truly rehabilitate can sharply increase the risk—and associated costs—of undesirable issues including reinjury, behavioral issues, and long-term disability.
Vocational services that meet their intended purpose of meaningful return to work must be more closely aligned to each person’s medical recovery. Through an approach that works in tandem with medical providers dedicated to holistic, biopsychosocial care, we should be committing to vocational recovery structures that can replace traditional vocational rehabilitation models.
Vocational Case Management—The Foundation of Recovery
In addition to the injury itself, injured workers face substantial physical, psychological, and behavioral risks simply from being off the job. Loss of identity and confidence, social isolation, reduction in work stamina and skills, and incentives surrounding secondary gain can all contribute to a disability mindset that hinders recovery. Early intervention and dedicated, consistent support is critical during this time to ensure that people get the care they need to stay focused on returning to health and full function.
Vocational case management is a proactive service line that can help mitigate these risks while providing personalized, expert-based recovery planning from the very beginning of the injury. Immediately upon referral, expert case managers with specialized training will work to identify the vocational potential and needs of each injured worker. By coordinating with medical providers, the injured workers, and stakeholders, vocational case management serves as an important first step on the vocational recovery journey, ensuring appropriate goal setting and placement within the return-to-work continuum.
Building Pathways to Vocational Success
From the outset, vocational recovery services need to correctly identify where each injured worker is within the hierarchy of return-to-work goals. The workers’ compensation hierarchy is divided into the following categories:
- Same job with the same employer
- Modified or different job with the same employer
- Similar job with a different employer
- Different job with a different employer
- New Job via skill enhancement or retraining
- Self-employment
Vocational specialists will help with all necessary steps, including ergonomic assessments and re-establishing soft skills, as well as traditional services such as assessment, testing, placement, and retraining. It is also beneficial for vocational recovery models to include consultative services that provide evidence-based analysis to employers and claims professionals based on labor market surveys, employability metrics, and expert testimony that ensures all return-to-work decisions are objectively grounded and based on proven outcomes.
The Difference-Maker—Transitional Return to Work
In situations where employers are unable to accommodate the physical restrictions of an injured worker, it can still be possible to find work that provides purpose and helps keep a recovery mindset. Transitional return to work (TRTW) programs provide expert-selected, medically appropriate job placement with partner organizations, including nonprofits and remote work opportunities. By matching workers with suitable duties and providing all necessary training, TRTW specialists can help build viable skills and start to overcome critical barriers to returning to work.
These programs provide opportunities for injured workers to readjust to the workplace and learn new skills while helping to maintain self-esteem, sense of productivity, and routine. TRTW providers can ensure consistent communication with both the host jobsite and the injured worker to effectively manage expectations and facilitate a smooth, positive experience. For many employers, transitional return to work is a lower cost alternative that offers significant savings and an increased chance of returning to full-time, regular employment.
Embracing Recovery-Focused Technology
In the same way that telehealth services are delivering real-time assessment and treatment in the healthcare space, virtual services offer tremendous opportunities to expand the reach of vocational recovery. Through face-to-face interactions over a secure platform, vocational recovery providers can build a bridge between the reach and flexibility of telephonic services and the increased engagement of in-person interactions. Virtual services can play a key role in enabling a broader reach, timely intervention, and cost-effective case management without compromising quality.
With these services increasingly being recognized and approved by national certification bodies, including the Commission on Rehabilitation Counselor Certification (CRCC), more and more professionals have the training and skills necessary to perform core job functions through these platforms. In fact, many states are now conducting hearings virtually, making remote capabilities not just a luxury, but a necessity for high quality vocational support.
Timely Intervention for Timely Return to Work
Successful vocational recovery programs are inextricably linked to early identification of return-to-work potential. When an injured worker is off work for three months or more, the chance of a return to full employment begins to drop significantly. This can leave employers and plan managers with increasing claim costs, and injured workers trapped in a mindset of disability and a lost sense of purpose.
Vocational case management, TRTW, and other services should be initiated as soon as a release is anticipated through early referrals to providers committed to a person-centered, outcomes-driven vocational recovery model. In most situations, early intervention results in cost-effective outcomes and better recovery trajectories for both injured workers and stakeholders.
By working toward a holistic vocational services model that is aligned with medical recovery, biopsychosocial needs, technological innovation, and evidence-based practices, our industry can help injured workers take the appropriate steps they need to get back on the job.
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