This paper provides the Public Sector Safety Professional with knowledge of a risk management approach to worker's compensation. This paper focuses on a risk management model developed in an academic environment for applying risk criteria to the problems associated with returning injured employees to work thereby controlling compensation costs.
This method was developed for an action learning event for an Executive Leadership Development Program. None of the participants in this learning event were safety professionals. The author, as a safety professional, developed the concept for and served as the executive sponsor for the team. The end product of the action learning event was a report and a presentation made to the Safety and Occupational Council of an Executive Agency of the Federal Government.
There are a number of issues within the realm of workers' compensation that include:
Third party involvement
Dead compensation recipients who continue to receive benefits
Surviving spouse's of dead compensation recipients who have remarried and are no longer eligible for benefits, but still receiving them
Missing medical documentation needed to determine if an employee can return to work,
Return to work of able compensation recipients
Investigation of fraud
Federal civilian employees, as well as some contractors and volunteers for the federal government, receive workers' compensation payments in accordance with the Federal Employee's Compensation Act (FECA), Title 5 Part III, Subpart G, Chapter 81, Subchapter I. The requirements for this program are further codified in 20 Code of Federal Regulations, Part 1–199. The Federal Employees' Compensation Act provides workers' compensation coverage to three million Federal and Postal workers including wage replacement, medical and vocational rehabilitation benefits for work-related injury and occupational disease (FECA, 2008, 1).
Compensation recipient's medical expenses are paid in full, while income compensation is 66.67 percent of gross wages for employees with no dependents, and 75 percent for those with dependents (Injury Compensation for Federal Employees, DOL, 2007, 40) Each federal agency incurs the costs of its own workers' compensation recipients, but relies on the Department of Labor (DOL) to administer the FECA program. Agencies provide DOL with detailed information about compensation recipients. DOL then processes the claims and bills the agencies annually for reimbursement through the use of "charge back" reports.
The "silver bullet" for worker's compensation is to return the compensation recipient to work. Unfortunately, there are a lot of people involved in the process as well as legal restrictions. There are as many ways to return a compensation recipient to work as there are claims. Some work and others don't; however, most are very subjective. The key areas that can be used to determine if an employee should be targeted for return-to-work are:
Employee interest in returning;
Amount of leave already taken;
Employee's physical condition; and
Reassignment factors.
