By implementing a stay-at-work/return-to-work program (SAW/RTW), you can
minimize or eliminate lost work time, speed recovery, improve both medical
outcomes and employee satisfaction and preserve production capacity. A SAW/RTW
program is critical to protecting your experience modification factor (EMF),
which ultimately determines the cost of your workers’ compensation
Studies show that the vast majority of injuries require no more than a few
days off work for injured employees, and that many injuries require no time off
at all. If an employee is away from work unnecessarily, the negative impact is
felt by everyone: the employee loses pay, the employer loses production and may
incur increased costs and others may have to fill in or work overtime to get
the job done.
SAW/RTW programs are a great way to keep most injured employees on the job
and productive, and to help those with more serious injuries ease back into
their job; they provide workers with temporarily modified jobs that consider
physical restrictions, skills, interests and capabilities. They also function
as part of a disability management program. Every dollar paid in claims – both
medical and lost wages – affects your future workers’ compensation
Program Objectives and Benefits
Many businesses recognize and use SAW/RTW programs. Although variations exist,
they all share common characteristics.
Nearly all SAW/RTW programs focus on the following objectives:
- address the physical, emotional, attitudinal and environmental factors that
hinder the return-to-work process
- facilitate temporary or permanent job reassignment or job
- identify alternative employment, consisting of modified duties
- reduce the number of workers' compensation injuries within your
- decrease the number of lost work days
- increase employee morale and motivation to return to and remain at
- assist in compliance with the Americans with Disabilities Act
Effective SAW/RTW programs benefit employers by:
- promoting good will and enhancing corporate image
- allowing active participation of management in the employee's recovery
- reducing costs associated with replacing valuable skilled workers with
temporary or replacement workers
- maintaining an experienced work force
- minimizing productivity slow-downs
- improving employee/management relations
- promoting employee morale and security
- improving work ethic
- decreasing potential of re-injury
- uniting workers, supervisors and management
SAW/RTW programs benefit employees by:
- eliminating or reducing loss in pay and benefits
- providing a sense of security and stability
- reinforcing management commitment to employee welfare
- reinforcing a positive self-image to the injured worker
- providing positive reinforcement to the injured worker while easing back
into the workforce
- encouraging normal working relationships with other employees
- reinforcing a daily work habit
The Team Approach
An effective SAW/RTW program is enhanced by a strong team dedicated to keeping
injured employees at work as the first priority, and otherwise bringing
them back to work as quickly as possible. Together with your injured employee,
the supervisor, the insurance company and medical personnel, you can create a
winning situation for everyone.
The steps you can take to get your SAW/RTW program underway
- establishing a policy statement detailing your management's commitment,
responsibility and support for the program
- appointing a coordinator with strong communication skills. The coordinator
represents your company and acts as liaison between the managing supervisor and
employee, the labor representative, the insurance company and the physician.
Active communication reaffirms the employee’s value to the company, prompting
the injured employee to continue working or to return to work in a timely
- developing position descriptions that identify essential job functions.
This identifies those jobs performed by able-bodied employees that can be
modified to accommodate disabled workers.
- developing a task inventory that catalogs the individual tasks that could
fill the work day for an injured worker. The task inventory enables the
supervisor to quickly identify and combine many tasks to fill up an injured
employee's allowed work time. Change assignments as your employee's condition
- being creative with alternative work assignments. Don't limit them to
production tasks; consider maintenance, clerical, charity work and other tasks
within prescribed medical restrictions.
- orienting and training your employees and management team on the elements
of the SAW/RTW program, including a review of the applicable workers'
compensation system being employed, management commitment, position
descriptions and identification of standard and modified job tasks.
- using hazard identification and controls to detect loss exposures which,
when corrected, reduce the likelihood of employee injury or illness. The
objectives of such a program are to maintain a safe and healthful work
environment, reduce or eliminate the risks of injury and maintain operational
profitability for the employees and company.
- setting a positive tone for employees who come into daily contact with the
injured worker. The injured worker needs to feel wanted and secure; a positive
psychological state is tremendously important at this stage in the worker’s
Your SAW/RTW program requires the cooperation of others, too. For
- Your insurance company:
- maintains active verbal and written communication with you and the disabled
- answers benefits questions
- provides loss control services such as industrial hygiene and ergonomics
evaluations, job hazard analysis, loss control policy, program review and
employee/supervisor safety training
- The treating physician reviews, evaluates, documents and treats your
employee's disability. The physician needs access to your position descriptions
to review current and modified job functions and to recommend additional
modifications and work restrictions where warranted.
- Your injured employee has a responsibility to report the injury immediately
to a supervisor, complete all paperwork according to company policies, follow
the physician's directions and maintain contact with you to provide health
Return-To-Work Offer, Medical Limitations and Modified Duties
A formal return-to-work offer is not required if the injured employee stays
at work, and most times a formal offer is not needed when time away from work
is limited to a few days or weeks. If time away exceeds a few weeks and there
is any resistance from the employee or treating physician, then a formal offer
should be made.
Your company’s return-to-work offer should describe the temporary work
conditions and outline expectations for your employee and supervisor. The offer
can be made by mail or phone and the employee can start right away. Follow up
with a letter.
Medical restrictions prescribed by the treating physician or other medical
practitioner must be in writing, and must be specific enough for you to
determine what alternative work assignments are appropriate. Make the physician
aware of your company’s policy regarding the SAW/RTW program and the degree of
accommodation your company can make. Discuss the matter with the physician
before a return-to-work evaluation form gets completed. The specific
limitations regarding lifting, bending, standing or contact with various
substances need to be identified by the physician. Supervisors must understand
and implement the limitations when your employee returns to work.
Your injured employee may return to:
- modified work: an existing job that is not as physically taxing or
demanding as the employee's normal job
- restricted work: the employee's normal job, with restrictions assigned by
- modified duty or total accommodation: a specifically created position that
accommodates the injured employee's restrictions
Job modifications and accommodations should meet the restrictions
recommended by the treating physician. It may involve changes in training,
tools, machine design, workstation design or work procedures.
The following are some simple, yet effective, ways to implement job
- minor workstation modifications – simplify the workflow process and
eliminate unessential features
- job task redesign – rearrange task sequence, eliminate tasks or distribute
them to more than one worker
- ergonomic or physical accommodations – provide adjustable chairs, hydraulic
pallets, clamping devices and ergonomic or electric tools
- environmental accommodations – rotate workers to limit exposure to
Keep SAW/RTW Positive
- Check in with injured employees regularly to give encouragement and offer
extra help that may be needed due to medical restrictions or job tasks. Do your
best to make sure that employees who have medical restrictions do not suffer an
aggravation of their injury or a new
injury during their recovery by insisting they follow doctor’s orders.
- Communicate daily to ensure the employee is comfortable with the assigned
position, and make modifications to the job if needed.
- Make sure your supervisors understand that keeping and returning to work
injured employees aids the employee's recovery and your business' economic
welfare. Supervisors must diligently make sure employees abide by any medical
restrictions they may have.
Cincinnati’s loss control services are free to our policyholders. Let us tailor
a loss control program for your business. For more information, or to schedule
a meeting with a Cincinnati loss control representative, please contact your local independent agent representing
Our loss control service is advisory only. We assume no responsibility for
management or control of customer loss control activities or for implementation
of recommended corrective measures. These materials were gathered from trade
services and public information. We have not tried to identify all exposures.
We do not warrant that this information is consistent with Cincinnati
underwriting guidelines or with any federal, state or local law, regulation or
ordinance. All information adapted with permission of Insurance Services
Offices Inc.; Engineering and Safety.