Return to Work Program

First MCO’s Return to Work process begins with the report of injury call to our 24-hour 800 number Intake line.

A priority appointment is scheduled with a physician, who is asked to address the client’s return-to-work status at that first appointment.

The physician completes a work abilities form, and the restrictions that are noted, are compared immediately with the job analysis that the case manager obtains from the employer at their initial contact.

The employer is also questioned by the case manager, as to the availability of modified duty, the employee’s work history, and any accommodations the employer would be willing to make to facilitate the employee’s return-to work.

If, at the first medical appointment, the physician advises that the employee remain out of work seven or more days, and this does not meet our nationally recognized guidelines, the physician is asked to see the patient again in two to three days, so that work capabilities can be clarified. (State law specific)

Upon receipt of the physician’s treatment form after each visit, the return to work status is addressed and compared with nationally recognized guidelines on a continuing basis.

On-going communication with the employer and physician relative to work capabilities and medical restrictions results in returning the employee to work in a capacity within his capabilities until transition to full-duty is accomplished.

To summarize, to get the full benefit of the Managed Care program on a Lost Time/Indemnity case, the case manager will aggressively monitor that injured worker and assist him in return to work, as soon as possible. Some of the cost savings tools utilized are as follows:

  • As allowed by state law, direct the injured worker immediately to a Physician Specialist, who is familiar with Workers’ Compensation and the need for Early Return to Work.
  • Maintain the injured worker within the network to ensure Diagnostic, Durable Medical Equipment, Pharmacy, Surgeries, and Hospitalization discounts.
  • Immediately implement a Return-to-Work program with the treating physician. Supply the physician with a job description and have him evaluate the worker’s physical capacity to return to work.
  • Identify claimants.
  • Alert the employer to the need for alternative duty and work with the employer to develop an alternative duty program.
  • Set-up Functional Capacity Evaluations as needed.

    • For more information please contact our team of specialists.