The Transitional Return-To-Work (TRTW) Program supports the mission of the University by maximizing human and financial resources and complying with applicable Federal, State and UC disability regulations. The TRTW Program achieves this by providing uniformity, and by coordinating the program to help UCLA Campus employees who have work-incurred injuries or illnesses, return to work as soon as possible. The TRTW Program can also be applied for non-industrial injuries.
- Demonstrate University concern and commitment for industrially injured employees and assist with their speedy recovery.
- To minimize the employee’s transition period from partial disability to full duty.
- Maintain high workplace productivity.
- Prevent deterioration of employee work skills, conditioning, and attitudes that could result in extending periods of disability and decreasing morale.
- Comply with applicable State, Federal and UC regulations regarding temporary work restrictions and return-to-work.
- Reduce the disability costs of Workers’ Compensation (WC) claims.
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TRTW Job Assignment - A TEMPORARY work assignment within the injured employee's department, which complies with all medical restrictions indicated by the employee's treating physician or treating health care professional (TP/THP). A TRTW Job Assignment may involve:
- Modification of the injured employee’s job duties, i.e., tailoring work duties to the injured employee’s medical limitations and vocational abilities to maximize recovery, or
- Alternate work that is compatible with the employee's job skills and experience, and is in compliance with the employee's temporary medical restrictions.
The TRTW Job Assignment is documented by a Transitional Return-To-Work Agreement (Attachment D) that is written for a period not to exceed 90 calendar days. The TRTW Agreement is signed by the injured employee and Department Supervisor or Representative (DS/R).
Occupational Injury or Illness - Any injury or illness arising out of, in the course of, or during the course of employment with the University of California, Los Angeles (UCLA) and compensable under the WC laws of the State of California.
Temporary Partial Disability (TPD) - A disability resulting from an industrial injury or illness which prevents an employee from performing one or more of his/her regular job duties, but does not prevent the employee from performing work that is dependent on capabilities not affected by the disability.
Permanent & Stationary (P&S) - A medical statement from the injured employee's TP/THP stating that the employee's condition is now stable and will not get appreciably better or worse. At this point, the injured employee is released to return to work with or without work restrictions, or is medically determined to be precluded from engaging in his/her usual and customary occupation or the position in which s/he was engaged in at the time of injury.
Treating Physician/Treating Health Care Professional (TP/THP) - A physician or other health care professional who has examined the injured employee at least once for the purpose of rendering or prescribing treatment and has thereafter monitored the effect of the treatment. In the event of a conflict between the medical disability information provided by treating physicians or health care professionals, disability medical information provided by the Primary Treating Physician (PTP) as defined in Labor Code Section 9785, shall control.
Extended Sick Leave (ESL) - A University benefit that supplements an employee's WC disability benefits up to 80% of normal earnings, for up to 26 weeks. ESL begins after an eligible injured employee has exhausted all sick leave credits. The difference between 80% of the employee’s normal earnings and the temporary disability rate is paid by the department. This benefit applies to any one injury or illness.
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It is a Campus WC Program policy to provide TRTW Job Assignments to all eligible Campus employees as soon as possible following the onset of an industrial disability. By provisions of the California Labor Code, employees who do not accept TRTW Job Assignments are subject to the loss of WC temporary disability benefits. Employees not receiving WC temporary disability benefits are not eligible for University ESL benefits.
Who Is Eligible
All UCLA Campus employees with temporary partial disabilities are eligible for TRTW Job Assignments if they are anticipated to progress in their recovery from an industrial injury or illness and require temporary, short-term modification of their job duties.
Employees must obtain written medical documentation from their TP/THP indicating their specific work restrictions, preferably using the Functional Capacity Evaluation (FCE) form (Attachment B). The FCE provides a description of the injured employee’s current physical limitations, capacities, and abilities as given by the TP/THP.
Employees with restrictions that would permanently prevent him/her from returning to the job and hours worked at the time of their injury are not eligible for participation in the TRTW Program.
In no event shall the TRTW Job Assignments for casual or temporary employees exceed the period of duration of the casual/temporary appointment. All TRTW Agreements must end no later than the last day of an employee’s casual or temporary appointment.
TRTW Program Procedures
A. Notification to Employee and Physician of TRTW Program
- DS/R reminds all work-injured employees of Campus TRTW Program. DS/R informs employees of their obligation to obtain and give to their DS/R written documentation of all work restrictions and any anticipated period of disability, as given by the TP/THP, as soon as the injured worker receives such information.
- DS/R directs all work-injured employees to OHF to obtain a completed FCE. In addition, DS/R advises injured workers to get a copy from OHF, of all work restrictions and an estimate of any periods of temporary partial disability or authorization to be off work.
- Third Party Administrator (TPA) Octagon Risk Services (ORS) informs the injured employee’s TP/THP that UCLA Campus has a TRTW Program. ORS sends TP/THP the TPA letter to Treating Physician re: TRTW Program (Attachment A) and FCE form.
- Vocational Rehabilitation Counselor (VRC) sends the Letter to Employees re: TRTW Program, (Attachment C) to all employees who miss five consecutive days of work without a definite return-to-work date.
B. Development of TRTW Job Assignment and TRTW Agreement
- DS/R contacts VRC immediately upon receipt of any new or revised medical restrictions or releases. VRC and Department review restrictions, discuss temporary job modifications, and develop a TRTW Job Assignment that is in compliance with the employee’s work restrictions and is feasible for the Department.
- DS/R meets with injured employee (and VRC as required) to engage in an interactive discussion of proposed temporary job modifications for the TRTW Job Assignment. DS/R asks employee for suggestions on temporary job modifications that would enable him/her to continue working. DS/R prepares written documentation of the meeting, including solicitation of employee input and employee responses. If any job modification proposed by the employee could not be incorporated in the TRTW Job Assignment, the reasons are also included in the written documentation.
- DS/R prepares TRTW Agreement (Attachment D) using the information obtained from VRC consults and the employee meeting, to cover a period not to exceed the shorter of the length of the employee's UC appointment or 90 calendar days. The TRTW Agreement designates dates, hours (if applicable), restrictions, and modified duties, and serves as employee’s written offer of TRTW Job Assignment. If employee accepts TRTW Job Assignment, both DS/R and employee must sign TRTW Agreement. Department gives a copy of TRTW Agreement to employee and faxes copies to VRC and the University TPA, Octagon Risk Services. If employee declines TRTW Job Assignment, DS/R makes written documentation of the outcome, and sends copies of documented declination to VRC and TPA.
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C. Implementation of TRTW Job Assignment
- TRTW program is to be implemented Campus-wide for all employees who have work-incurred injuries or illnesses.
- DS/R directs injured employee who has signed TRTW Agreement as to date and time to report to work for TRTW Job Assignment. Department notifies TPA and VRC upon employee's actual, confirmed return-to-work on TRTW Assignment.
- Under the TRTW Program, the Campus does not intend to create long-term jobs to accommodate permanent disability. Thus, all employee participation in the TRTW program will be for a period of not more than 90 calendar days.
D. Monitoring of TRTW Job Assignment
- The Return-To-Work (RTW) Coordinator works with employee’s supervisor to monitor appropriateness of TRTW Job Assignment, as needed. RTW Coordinator brings any serious issues regarding the Assignment to attention of VRC
- DS/R monitors employee progress in the TRTW Job Assignment to ensure employee compliance with TP/THP medical restrictions and satisfactory performance of the clearly defined job duties. DS/R confirms that TRTW Job Assignment does not exceed the end date in the TRTW Agreement or ninety (90) calendar days, whichever occurs first. DS/R notifies VRC and TPA immediately of any changes in the TRTW Agreement, any problems the employee may have in performing the TRTW Job Assignment, or if the employee reports that he/she is unable to continue working.
E. Employee work hours/compensation while on TRTW Job Assignment
- Any change in regular days off or work hours is at the option of the injured employee's department. No overtime will be permitted while the employee is participating in the TRTW Program.
- Employees eligible to participate in the TRTW Program may not substitute paid sick leave simply because he/she does not feel ready to perform a TRTW Job Assignment. In order for a TRTW qualified employee to use paid sick leave as an alternative to TRTW Program participation, the employee must be eligible for Family and Medical Leave Act (FMLA) benefits and provide the department with a medical opinion that qualifies the employee for FMLA leave.
- An injured employee’s WC TTD benefits will stop while the employee is participating in the TRTW Program, provided the number of hours being worked under the TRTW Job Assignment is equal to the employee's regularly scheduled work hours.
- Full-time employees, who return to a part-time TRTW Job Assignment, will remain eligible for WC wage loss benefits (TPD). They may supplement TRTW earnings and TPD with sick leave, for up to 100% of their regular earnings.
- Employees will be paid at their current rate of pay regardless of the TRTW Job Assignment
F. Medical Appointment Leaves during TRTW Program
Employees participating in a TRTW Job Assignment shall schedule medical appointments during non-working hours. Otherwise, with supervisor approval, sick leave or vacation time will be used.
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G. Termination of TRTW Program
All TRTW Programs shall terminate on the earliest of the dates specified below:
- The end date specified in the TRTW Agreement.
- The date the injured employee is determined to be P&S and a qualified injured worker (QIW).
- Ninety calendar days from the begin date specified in the TRTW Agreement.
- The last day of a temporary or casual employee's University appointment.
- Upon receipt by the University of a Medical Report indicating that the employee will be unable to return to the job the employee performed at the time of injury.
- The employee's acceptance of disability retirement.
- The University's grant of FMLA to the injured employee.
Roles & Responsibilities
I. Department Supervisor or Department Representative (DS/R)
1. Directs injured employees to OHF for initial medical treatment.
2. Reminds employees with work-related injuries or illnesses of the UCLA Campus TRTW program. Notes that every effort will be made to accommodate all temporary medical restrictions. Advises employees to request written documentation from their physician (preferably on the FCE form–Attachment B) indicating the employee’s work capacities. Reminds employees to provide such documentation to the DS/R immediately.
3. Contacts VRC immediately upon receipt of any employee release to return to work-with new or revised-medical restrictions. Agrees to review the restrictions, discuss temporary job modifications, and develop a TRTW Job Assignment that complies with employees work restrictions and is feasible for the Department.
4. Meets with injured employee (and VRC as required) to engage in an interactive discussion of proposed temporary job modifications for TRTW Job Assignment.
5. Prepares TRTW Agreement (Attachment D) using information obtained from VRC consults and the interactive employee meeting, which covers a period not to exceed the shorter of the length of the employee's UC appointment or 90 calendar days. Designates dates, and hours (if applicable), of TRTW Job Assignment. Makes written offer of TRTW Job Assignment to employee.
6. Monitors employee progress in the TRTW Job Assignment to assure employee compliance with TP/THP medical restrictions and satisfactory performance of the clearly defined job duties. Assures that the TRTW Job Assignment does not exceed the end date in the TRTW Agreement or ninety (90) calendar days, whichever occurs first.
7. Advises appropriate staff members, only as deemed necessary, that the injured employee is in a TRTW Program. Provides appropriate staff members with information about the employee's modified duties and what assistance, if any, may be required for the injured employee.
8. Keeps accurate records of days and hours worked.
9. No later than 14 calendar days before the end of the TRTW Agreement, contacts VRC to determine what action to take upon expiration of the TRTW Agreement.
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II. Injured Employee
1. Notifies DS/R immediately if TP/THP takes employee off work. Obtains written documentation from TP/THP of his/her current medical status and work restrictions (if any), and informs DS/R of such information.
2. Notifies DS/R immediately of any difficulty in performing TRTW Job Assignment. If having difficulty with modified duties, goes to OHF as directed by DS/R for medical evaluation of current job restrictions.
3. Notifies DS/R immediately if TP/THP releases employee to return to work with or without job restrictions. Obtains written medical documentation from TP/THP, which describes the nature of the temporary job restrictions. Provides written documentation of a release to return to full duty, if TP/THP releases employee to return to regular job duties with no restrictions. Returns to work as soon as s/he is medically released to do so, by the TP/THP.
4. Obtains periodic medical status reports from TP/THP, no less frequently than every 30 calendar days. Provides written documentation of medical progress to DS/R.
5. Discusses medical restrictions and possible job modifications with the DS/R and VRC as needed.
6. Signs TRTW Agreement to indicate acceptance of the TRTW Job Assignment.
III. Vocational Rehabilitation Counselor (VRC)
1. Contacts injured employees and their DS/R, when employees have been off work for 5 days or more with no definite return-to-work date to come in for discussion of possible TRTW assignment. Sends employees Letter to Employees re: TRTW Program, (Attachment C).
2. Consults with DS/R in the development of acceptable TRTW Job Assignments by reviewing current employee medical status and work restrictions. Modifies present job duties or investigates alternative work options to comply with employee’s work restrictions.
3. Reviews proposed TRTW Agreements for compliance with employee work restrictions. Consults with Departments on proper completion of and any necessary changes to the TRTW Agreement.
4. After given a referral by the TPA, conducts a JA (FCE) of the injured employee’s regular job duties, by meeting with both DS/R and injured employee.
5. Meets with DS/R and injured employee as required, engaging in an interactive discussion of potential job modifications that comply with employee's temporary job restrictions. Also, discusses how employee’s work restrictions would affect a potential TRTW Job Assignment.
6. Arranges for ergonomic work-site evaluations to be conducted by the Occupational Therapist (OT) in Environmental Health and Safety (EH&S) on an "as needed" basis.
7. Maintains computer system tracking of TRTW Job Assignments for injured employees on the University WC claims system, Valley Oak Systems (VOS).
8. Informs TPA when employee actually begins and ends work on the TRTW Job Assignment.
9. Provides medical information to DS/R about job restrictions, as may be required, if an employee maintains that s/he is unable to perform TRTW job duties. Consults with TPA and DS/R on obtaining additional documentation of employee work capacities.
10. Maintains periodic contact with DS/R and employee (at least once every two weeks) to monitor employee’s medical progress, success of the TRTW Job Assignment, and if the Assignment should be continued for additional periods (not to exceed 90 calendar days). Consults with the TPA and DS/R on any problems with, and any needed extensions for, the employee's TRTW Job Assignment.
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IV. Third Party Administrator (TPA)-Octagon Risk Services (ORS)
1. Advises TP/THP that UCLA Campus has TRTW Program by means of TPA Letter to Treating Physician re: TRTW Program, (Attachment A) Provides TP/THP (if other than Occupational Health Facility (OHF)), with copies of employee's JA, and FCE form (Attachment B). Requests TP/THP to fax a completed FCE form, which will promptly advise TPA of any job modifications that would allow the injured employee to return to work.
2. Notifies DS/R and VRC of employee's release to return to work-with or without restrictions. Also advises them of any injured employee’s work restrictions, estimate of time off work or on restricted duty, and required job modifications, as soon as such information becomes available to TPA. Faxes FCE forms completed by employee's TP/THP, to DS/R and VRC. Consults with VRC and provides medical information, as may be required, to assure that TRTW Program is implemented promptly and that the employee's TRTW Job Assignment complies with all TP/THP employee work restrictions.
3. Notifies DS/R and VRC of any change in an employee's medical restrictions. Advises VRC of any change in an employee’s medical condition that would affect the period of the employee's TPD, as soon as such information becomes available. Notifies the VRC immediately when the TP/THP declares the employee to be P&S.
4. Informs injured employees that refusal to accept TRTW Job Assignments, which comply with the employee's current work restrictions, may put into jeopardy an employee’s eligibility for WC disability benefits (TTD, TPD).
5. Provides appropriate WC benefits to industrially injured employees.
6. Requests JA’s from VR counselor for review by TP/THP, for any injured employee off work for more than 7 calendar days and who does not have a definite return-to-work date.
V. Occupational Health Facility (OHF)
1. Provides medical treatment and evaluation for Campus employees who have work-related injuries. Reviews for adequacy, any medical documentation from the TP/THP prior to employee participation in TRTW Job Assignment.
2. Reviews any employee JA provided by TPA to determine appropriate work restrictions and temporary job modifications that will enable an injured employee to return to work.
3. Provides injured employees with written medical restrictions. Gives an estimate of any period of time that employee must be off work or on restricted duty. Provides written documentation of any temporary job modifications needed for employee to return to work. Faxes copies of medical restrictions, estimate of time off work or on restricted duty, and required job modifications to TPA and VRC.
4. Completes FCE form (Attachment B) upon initial examination of employee and when there are any changes in employee’s work restrictions. Faxes copies of FCE to TPA and VRC. Immediately provides written documentation to TPA of any employee work restrictions and temporary job modifications that would permit an employee to return to work.
5. When acting as TP, performs all functions stated below for TP/THP.
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VI. Treating Physician/Treating Healthcare Professional (TP/THP)
1. Complies with Provider Panel Participation Agreement provisions regarding medical treatment and reporting requirements.
2. Completes FCE form (Attachment B) upon initial examination of employee and upon any changes in employee’s work restrictions. Faxes copies of FCE to TPA. Immediately provides written documentation to TPA of any employee work restrictions and temporary job modifications that would permit an employee to return to work.
3. Reviews any employee JA provided by TPA to determine appropriate work restrictions and temporary job modifications that would enable an injured employee to return to work.
4. Provides injured employees with written medical restrictions. Estimates any period of time that employee must be off work or on restricted duty. Provides written documentation of any needed temporary job modifications to enable an employee to return to work. Faxes copies of medical restrictions, estimate of time off work or on restricted duty, and required job modifications to TPA.
5. Continues treatment until employee is deemed P&S, and is either released to return to full duties or determined to be a QIW, entitled to vocational rehabilitation benefits. Provides immediate written documentation to TPA of employee’s full release to return to work or of any residual disability that results in employee’s QIW status.
VII. Occupational Therapist (OT)
1. Performs ergonomic evaluations of employee work sites/stations upon request of VRC, TPA, or DS/R. Provides written report of recommendations regarding adequacy of work site/station, need for upgrades, appropriate ergonomic equipment to be used, and appropriateness for funding from Ergonomic Workstation Fund (EWF).
2. Consults with VRC, DS/R, and Worker’s Compensation Program Manager (WCPM) regarding any recommendations and in procurement of ergonomic furniture and equipment.
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VIII. Return-To-Work Coordinator (RTWC)
1. Initiates contact with I/W’s and/or Supervisors to discuss the Campus TRTW Program. Provides information about the interactive discussion meeting for the TRTW Job Assignment.
2. Receives reports from VRC, OHF, or TPA indicating current employee medical restrictions. Assures that DS/R is advised of and understands restrictions and their effect on TRTW Job Assignment. Regularly confers with VRC regarding TRTW matters.
3. Monitors ongoing TRTW Job Assignment for continuing appropriateness. Notifies VRC, TPA, DS/R, and WCPM of any issues or problems an employee may have with his/her TRTW Job Assignment.
4. Maintains database on TRTW program, including employee’s name, department, and number of working days saved/employee, and potential dollars saved through the TRTW program.
5. Maintains documentation in Valley Oaks System (VOS) to communicate about employees’ restrictions, impact on usual & customary duties, accommodations made, release to full duty, and any special circumstances that may arise.
6. Works closely with the TRTW Team-VRC, DS/R, TPA, OHF, and WCPM, communicating information among TRTW Team members, as needed.
7. Assists VRC with determining whether or not injured employees should continue participation in a TRTW Job Assignment.
IX. Workers' Compensation Program Manager (WCPM)
1. Prepares quarterly statistical report of TRTW Program effectiveness and cost/benefit analysis for Director/Associate Director OIRM.
2. In conjunction with VRC and WCCC, provides procedures manual, OIRM web-site information, and department training on TRTW policies and procedures.
3. Annually reviews TRTW Program with Director/Associate Director, VRC, TPA, and OHF to evaluate performance of Program’s effectiveness in reducing time periods for industrially injured employees’ disability and WC disability costs. In conjunction with TRTW Team, makes required refinements in TRTW Program procedures.
4. Monitors tracking of TRTW Program with VRC to maintain TRTW Program database on University VOS system.
X. Workers’ Compensation Claims Coordinator (WCCC)
1. Coordinates with TPA and DS/R regarding use of University WC-related benefits, such as sick leave, vacation days, ESL, and/or wage loss, if the employee qualifies.
2. Coordinates with the TPA, VRC, WCPM, and DS/R, ensuring that industrially injured employees are considered for placements in the TRTW program, when medically appropriate.
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