5/1/2018
1
Costco’s
Return to Work Programs
Carolyn Horton
Work Comp Program Manager
Costco’s
Return to Work Programs
Carolyn Horton
Work Comp Program Manager
Costco’s Culture
⬤Provide a family atmosphere and strong core values
⬤Offer good jobs, wages and benefits to drive loyalty
and success
● ↑ employee trust
● ↓ turnover
⬤Offer resources to help employees and families
⬤Reinforce a cost and value-conscious culture
⬤Add new programs seamlessly into benefits offerings
⬤Favor pilots as a way to “try on” new approaches
5/1/2018
2
Costco Today
746 Warehouses Worldwide
518 - U.S. 13 - Korea
98 - CN 13 - Taiwan
37 - Mexico 9 - Australia
28 - UK 2 - Spain
26 - Japan 1 - France
1 - Iceland
Costco’s Code of Ethics
● Obey the law
● Take care of our members
● Take care of our employees
● Respect our suppliers
Costco’s Benefits Philosophy
Goal: Take Care of Our Employees
The right benefit, at the right time, under the
right program
5/1/2018
3
Manager Collaboration
• Starting a claim off on the right foot
•
Encourage
•
Awareness and importance of early
reporting
•
Managers and supervisors to support
and interact with the injured employee
•
Managers to support transitional duty
and or temporary reassignment
2
nd
Opinion2
nd
Opinion
Early Therapy
Intervention
with Peer to
Peer
Consultation
Graduated
Return to
Work Planning
Temporary
Reassignment
Psychosocial
Early
Intervention
Program
Incident
Intervention
Line
Incident
Intervention
Line
Innovative
Case
Management
& Field Nurse
Innovative
Case
Management
& Field Nurse
Transitional
Duty
Transitional
Duty
RTW Job
Coaching
RTW Job
Coaching
EAP
Referrals
HealthCare
Plan
Referrals
(Co-morbids)
Disability
Plan
Referrals
Transitional
Duty
Transitional
Duty
5/1/2018
4
• Transitional Duty Program up to 12 weeks
• Modified duty tasks are available
• Return to own job at conclusion OR
• Temporary Reassignment
• Placement in alternate job
• Duration: Up to One Year
Transitional Duty or Temporary Reassignment
• For employees with a high level of restrictions
• Employee is placed in a local non-profit charity that can
accommodate their restrictions
• Salary and benefits continue
• Is the same as temporary assignment with 12 week limit
• Goal: Increase work tolerance and transition back to Costco as
soon as restrictions allow
• Program is used in conjunction with GRTW Program
Interim Community Employment Program (ICEP)
5/1/2018
5
• Provides stepwise plan to reintroduce employee to
work over a defined time period
• Incorporates client-approved transitional duty tasks
• Incorporate employee-specific factors and job-
specific factors into the RTW plan
• Add experience to the graduated plan based on job
knowledge
• Reinforces Medical Guideline adherence
• Assists with attaining MD agreement
Graduated RTW Program (GRTW)
Example of Successful Graduated RTW
Injured Employee: 47 year old stocker, who was baling cardboard and injured
her low back. Diagnosis: lumbar strain. Taken off of work. Prescribed
Oxycodone. Non-compliant with medication treatment. Disability duration
exceeded guidelines. Subjective complaints outweighed objective findings. MRI
negative. No progression for return to work. Employee complained that she was
not able to stand for more than 30 minutes or walk more than 30 minutes without
having to lay down.
Telephonic Nurse Engagement: Primary Treating Physician (PTP) was
unwilling to provide physical capabilities for modified duty consideration.
Telephonic nurse was assigned. Nurse was able to educate PTP on the Graduate
Return to Work Program (GRTW) and explain the positive impact of RTW.
Results: The PTP approved the plan. Within one (1) month the employee was
back at work, full duty.
• Return to Work Job Coaching
• Communication with case manager and physician
• Communication with location manager
• Maintain communication with the employee
• Individual support of employee
• Identify safe tasks
• Progress restrictions
• Support of Graduated RTW Plan
• Stay at Work Outcomes
• Occupational 94%
Return to Work/Stay at Work
5/1/2018
6
Psychosocial Barriers to RTW
• Psychosocial Issues can stifle a claim
• Costco has implemented programs to directly address
these factors
• Injured employees can have very different reactions to
pain and disability; therefore they may need targeted
resources
Goal of the program:
By introducing a screening process to identify claims at risk of delayed recovery
early in the disability period and intervening via a Resource Coach to address
issues, we can potentially:
● Reduce overall length of disability
● Decrease the total impact & duration of medical treatment
● Reinforce commitment to injured worker recovery and improve their outcome
Job Coaching Sessions
:
● Identify & explore injured worker’s concerns
● Develop action plan for injured worker & resource coach
● Stress importance of injured worker communication with supervisor/manager &
staying engaged with workplace
● Coach injured worker in relevant strategies to address identified risk factors
● Provide recommended home follow-up activity
Early Intervention Program
The Accommodation
Process
Julie Frazier
Integrated Leave Ops Manager
The Accommodation
Process
Julie Frazier
Integrated Leave Ops Manager
5/1/2018
7
Accommodation Process
What is the accommodation process?
● When an ee has permanent restrictions we start the accommodation
process. The accommodation process is what Costco uses to
determine if they can provide a reasonable accommodation that will
allow the employee to return to or remain at work.
How did we determine what the process should look
like?
The Regs!
2 items
ADA
2 items
INSERT
INSERT
2 items
2 items
INSERT
INSERT
2 items
IN
ADA
Workers
Comp
TRICKY
Americans With Disabilities Act (ADA)
● Federal Law
● Prohibits discrimination based on disability
● Prohibits harassment based on disability
● Includes history of a disability and presumed disability
● Prohibits discrimination based on employee’s relationship with a
person with a disability
● Prohibits retaliation for requesting reasonable accommodation
5/1/2018
8
Americans With Disabilities Act (ADA)
● Requires employer to provide reasonable accommodation to an
employee or job applicant with a disability
● Broad definition
● Limits ability to ask medical or disability-related questions of
applicants and employees
● Requires medical information to be kept confidential
Recognize a trigger
● Employee or other reliable source says employee is having difficulty
doing job because of health condition
● A vendor or employee provides a note with restrictions
● Employee requests an accommodation
Next step Job Assessment Meeting…
Job Assessment Review Meeting
What
● Discuss possible non-temporary accommodations
Involves
● Location Manager (only)
● RWI- Meeting Facilitator
● ILAS
● Employee
● Payroll clerks should not participate
5/1/2018
9
Prior to the Meeting
Clarified restrictions?
Paint us a picturePaint us a picture
Prior to the Meeting
Clarified restrictions?
●
What are the restrictions, not the tasks the ee can perform.
●
Timeframes on lifting, stand/walk/sit, bending/stooping.
●
Standing or walking or how long on feet?
●
Schedule requests, why?
● Lifting, only on weight.
Prior to the Meeting
Clarified restrictions?
● Can seldom walk?
○ Can walk/stand for 45 minutes every hour then must sit 15
minutes.
● Can not lift more that 10 lbs on a constant basis?
○ Can lift up to 25 lbs on an occasional basis, 15 on a frequent…
● Must be allowed to have breaks of sitting throughout the day?
○ Must be able to sit as needed, I anticipate a total of 3 hours max
per day. Can get up as needed to help customers.
5/1/2018
10
Prior to the Meeting
Clarified restrictions? (CONT)
● Can work 5 days a week no weekends?
○ Understood but can keep ee out of job. Why?
● Limited interaction with people?
○ Other ee’s or customers? How much can they have?
● Can not push cart may perform other functions of FE assistant?
○ Can’t push more than 15 lbs of force.
The Job Assessment Meeting (JAM)
The following may be addressed at a job assessment review meeting:
1. Can the employee perform the essential functions of their job with or without
accommodation?
2. If not, can the employee perform the essential functions of another posted
position at their location with or without accommodation (not a
promotion/needs to be qualified)?
3. If not, does the employee want to review reassignment to another location?
4. Does the employee have leave available?
5. Send postings
6. Goal, return the employee to work.
Questions Questions
5/1/2018
11
Costco’s Culture
⬤Provide a family atmosphere and strong core values
⬤Offer good jobs, wages and benefits to drive loyalty
and success
● ↑ employee trust
● ↓ turnover
⬤Offer resources to help employees and families
⬤Reinforce a cost and value-conscious culture
⬤Add new programs seamlessly into benefits offerings
⬤Favor pilots as a way to “try on” new approaches
Costco Today
746 Warehouses Worldwide
518 - U.S. 13 - Korea
98 - CN 13 - Taiwan
37 - Mexico 9 - Australia
28 - UK 2 - Spain
26 - Japan 1 - France
1 - Iceland
Costco’s Code of Ethics
● Obey the law
● Take care of our members
● Take care of our employees
● Respect our suppliers
5/1/2018
12
Costco’s Benefits Philosophy
Goal: Take Care of Our Employees
The right benefit, at the right time, under the
right program
Manager Collaboration
• Starting a claim off on the right foot
•
Encourage
•
Awareness and importance of early
reporting
•
Managers and supervisors to support
and interact with the injured employee
•
Managers to support transitional duty
and or temporary reassignment
2
nd
Opinion2
nd
Opinion
5/1/2018
13
Early Therapy
Intervention
with Peer to
Peer
Consultation
Graduated
Return to
Work Planning
Temporary
Reassignment
Psychosocial
Early
Intervention
Program
Incident
Intervention
Line
Incident
Intervention
Line
Innovative
Case
Management
& Field Nurse
Innovative
Case
Management
& Field Nurse
Transitional
Duty
Transitional
Duty
RTW Job
Coaching
RTW Job
Coaching
EAP
Referrals
HealthCare
Plan
Referrals
(Co-morbids)
Disability
Plan
Referrals
Transitional
Duty
Transitional
Duty
• Transitional Duty Program up to 12 weeks
• Modified duty tasks are available
• Return to own job at conclusion OR
• Temporary Reassignment
• Placement in alternate job
• Duration: Up to One Year
Transitional Duty or Temporary Reassignment
• For employees with a high level of restrictions
• Employee is placed in a local non-profit charity that can
accommodate their restrictions
• Salary and benefits continue
• Is the same as temporary assignment with 12 week limit
• Goal: Increase work tolerance and transition back to Costco as
soon as restrictions allow
• Program is used in conjunction with GRTW Program
Interim Community Employment Program (ICEP)
5/1/2018
14
• Provides stepwise plan to reintroduce employee to
work over a defined time period
• Incorporates client-approved transitional duty tasks
• Incorporate employee-specific factors and job-
specific factors into the RTW plan
• Add experience to the graduated plan based on job
knowledge
• Reinforces Medical Guideline adherence
• Assists with attaining MD agreement
Graduated RTW Program (GRTW)
Example of Successful Graduated RTW
Injured Employee: 47 year old stocker, who was baling cardboard and injured
her low back. Diagnosis: lumbar strain. Taken off of work. Prescribed
Oxycodone. Non-compliant with medication treatment. Disability duration
exceeded guidelines. Subjective complaints outweighed objective findings. MRI
negative. No progression for return to work. Employee complained that she was
not able to stand for more than 30 minutes or walk more than 30 minutes without
having to lay down.
Telephonic Nurse Engagement: Primary Treating Physician (PTP) was
unwilling to provide physical capabilities for modified duty consideration.
Telephonic nurse was assigned. Nurse was able to educate PTP on the Graduate
Return to Work Program (GRTW) and explain the positive impact of RTW.
Results: The PTP approved the plan. Within one (1) month the employee was
back at work, full duty.
5/1/2018
15
• Return to Work Job Coaching
• Communication with case manager and physician
• Communication with location manager
• Maintain communication with the employee
• Individual support of employee
• Identify safe tasks
• Progress restrictions
• Support of Graduated RTW Plan
• Stay at Work Outcomes
• Occupational 94%
Return to Work/Stay at Work
Psychosocial Barriers to RTW
• Psychosocial Issues can stifle a claim
• Costco has implemented programs to directly address
these factors
• Injured employees can have very different reactions to
pain and disability; therefore they may need targeted
resources
Goal of the program:
By introducing a screening process to identify claims at risk of delayed recovery
early in the disability period and intervening via a Resource Coach to address
issues, we can potentially:
● Reduce overall length of disability
● Decrease the total impact & duration of medical treatment
● Reinforce commitment to injured worker recovery and improve their outcome
Job Coaching Sessions
:
● Identify & explore injured worker’s concerns
● Develop action plan for injured worker & resource coach
● Stress importance of injured worker communication with supervisor/manager &
staying engaged with workplace
● Coach injured worker in relevant strategies to address identified risk factors
● Provide recommended home follow-up activity
Early Intervention Program
5/1/2018
16
The Accommodation
Process
Julie Frazier
Integrated Leave Ops Manager
The Accommodation
Process
Julie Frazier
Integrated Leave Ops Manager
Accommodation Process
What is the accommodation process?
● When an ee has permanent restrictions we start the accommodation
process. The accommodation process is what Costco uses to
determine if they can provide a reasonable accommodation that will
allow the employee to return to or remain at work.
How did we determine what the process should look
like?
The Regs!
2 items
ADA
2 items
INSERT
INSERT
2 items
2 items
INSERT
INSERT
2 items
IN
ADA
Workers
Comp
TRICKY
5/1/2018
17
Americans With Disabilities Act (ADA)
● Federal Law
● Prohibits discrimination based on disability
● Prohibits harassment based on disability
● Includes history of a disability and presumed disability
● Prohibits discrimination based on employee’s relationship with a
person with a disability
● Prohibits retaliation for requesting reasonable accommodation
Americans With Disabilities Act (ADA)
● Requires employer to provide reasonable accommodation to an
employee or job applicant with a disability
● Broad definition
● Limits ability to ask medical or disability-related questions of
applicants and employees
● Requires medical information to be kept confidential
Recognize a trigger
● Employee or other reliable source says employee is having difficulty
doing job because of health condition
● A vendor or employee provides a note with restrictions
● Employee requests an accommodation
Next step Job Assessment Meeting…
5/1/2018
18
Job Assessment Review Meeting
What
● Discuss possible non-temporary accommodations
Involves
● Location Manager (only)
● RWI- Meeting Facilitator
● ILAS
● Employee
● Payroll clerks should not participate
Prior to the Meeting
Clarified restrictions?
Paint us a picturePaint us a picture
Prior to the Meeting
Clarified restrictions?
●
What are the restrictions, not the tasks the ee can perform.
●
Timeframes on lifting, stand/walk/sit, bending/stooping.
●
Standing or walking or how long on feet?
●
Schedule requests, why?
● Lifting, only on weight.
5/1/2018
19
Prior to the Meeting
Clarified restrictions?
● Can seldom walk?
○ Can walk/stand for 45 minutes every hour then must sit 15
minutes.
● Can not lift more that 10 lbs on a constant basis?
○ Can lift up to 25 lbs on an occasional basis, 15 on a frequent…
● Must be allowed to have breaks of sitting throughout the day?
○ Must be able to sit as needed, I anticipate a total of 3 hours max
per day. Can get up as needed to help customers.
Prior to the Meeting
Clarified restrictions? (CONT)
● Can work 5 days a week no weekends?
○ Understood but can keep ee out of job. Why?
● Limited interaction with people?
○ Other ee’s or customers? How much can they have?
● Can not push cart may perform other functions of FE assistant?
○ Can’t push more than 15 lbs of force.
The Job Assessment Meeting (JAM)
The following may be addressed at a job assessment review meeting:
1. Can the employee perform the essential functions of their job with or without
accommodation?
2. If not, can the employee perform the essential functions of another posted
position at their location with or without accommodation (not a
promotion/needs to be qualified)?
3. If not, does the employee want to review reassignment to another location?
4. Does the employee have leave available?
5. Send postings
6. Goal, return the employee to work.
5/1/2018
20
Questions Questions
