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Monthly Archives: October 2009

Do Your Return-to-Work Durations "Measure Up"?

Tape MeasureWith millions of dollars at stake, employers, insurers and third-party administrators carefully track return-to-work durations (the length of time employees are absent due to short-term disability, long-term disability, workers’ compensation and FMLA).

But simply tracking those numbers isn’t enough. How can your organization use its data to know whether you’re doing all you can to quickly get employees back to work and health?

Our new data analytics service can give you a no-cost way to benchmark your return-to-work data against Reed Group’s extensive MDGuidelines database of more than two million cases.

Our new MDGuidelines Measure Up service will provide — at no charge — benchmarks in seven categories:

  • Overall Average (statistical mean)
  • Gender
  • Age Group
  • Job Class (indicating degree of physical demands, typically U.S. Dept. of Labor classifications)
  • Co-morbid Conditions (additional health problems that extend recovery times)
  • Program Type (short-term disability, long-term disability, workers’ compensation)
  • Geographic Area

Benchmarking return-to-work durations is absolutely critical for companies that want to reduce the huge cost of employee absence, improve productivity and help employees quickly get back to normal, productive endeavors. MDGuidelines Measure Up will show employers and others whether they’re doing a great job or whether and where they need to improve.

Data must be sent to Reed Group in an easy-to-use standard file format; no personal or HIPAA-controlled data will be required. Participants will get a written benchmarking report and, if they choose, additional consultation from Reed Group experts on what their results mean and how they can use the benchmarks to improve.

To request our no-cost MDGuidelines Measure Up benchmarking report, contact John Nelson, director of guidelines, Reed Group, at 303.404.6600 or email

Comorbid Conditions Mean More Time Off the Job

Why do some employees take much longer to recover than predicted by the average return-to-work duration for their conditions? There are many reasons why this can happen, but one of the most important to look at is the existence of comorbid conditions.  Comorbid conditions are other existing medical factors that can greatly extend the time needed to recover.

Experienced case managers know that a diabetic employee with a lacerated toe will probably take longer to heal and require more care than a non-diabetic employee. Common comorbid conditions besides diabetes include clinical depression, obesity, arthritis, high blood pressure, back or spinal problems and asthma.

Our new MDGuidelines Predictive Modeling Tool allows case managers to factor in comorbid conditions when determining return-to-work durations. If you’d like to see a demonstration, please contact John Nelson, director of sales, Guidelines at 866.889.4449 or

Chronic Pain and Return to Work

The August/September issue of Case in Point Magazine ran an excellent article by Mary Harris on how to identify and manage the variables of chronic pain in return-to-work situations.

In her article, Ms. Harris talks about the role that fear, depression and anxiety often play in making it harder for employees with chronic pain to return to work. She also discusses the range of therapeutic intervention available to treat these psychosocial comorbid conditions.

Ms. Harris’ real-world expertise as a case manager is soundly backed up by our data at MDGuidelines. So much so, that we formulate our data to show both physiological return-to-work durations as well as normative durations that include psychosocial components. When case managers address both the physical and the psychosocial aspects therapeutically, employees often return to work sooner, thus avoiding the additional depression related to loss of work and the social contacts from employment.

In her article, Ms. Harris also talks about the time when despite all planning and effort, an employee cannot return to their former job because the employer cannot accommodate their work restrictions. “When this occurs,” she says “I find that it is useful to view this as a fork in the road, not the end of the road.”

I find this to be a wise and caring approach. At Reed Group, we sometimes see durations data that is skewed a bit longer than it should otherwise be because of the reluctance of employers and/or case managers to recognize that an injured employee will simply not ever be able to return to their former work. Regarding the situation as a “fork” and not an “end,” as Ms. Harris says, can make a huge difference in when and how that difficult decision is made.

To read “The Forest For the Trees: How To Identify the Variables of Chronic Pain To Achieve Holistic Return to Work” by Mary Harris, MS, CRC, click here. Then scroll down to “Case in Point Highlights” and click on “Read This Month’s Issue” and go to page 35.

Workplace Injury of the Week: Rotator Cuff Tear

rotatorcufftearIf you know a lot of tennis or baseball players, you probably know someone who’s torn their rotator cuff.

Rotator cuff tears also are common in those who perform overhead work (e.g., warehouse workers, laborers, carpenters, painters, construction workers).

Men are twice as likely as women to sustain them, mostly because more men work in heavy-labor jobs.

The rotator cuff is a group of four muscles that surround the ball-like humeral head of the upper arm. The tendons of these muscles come under stress from repeated activities that require lifting and rotating the arm. Any abnormalities of the shoulder joint can aggravate the stress, especially joint looseness (laxity), rubbing of the front edge of the shoulder blade (acromion) on the rotator cuff (impingement syndrome), bone spurs, and bursitis. As the tendons become irritated, inflammation develops (tendinitis). Circulation to the rotator cuff decreases with age and the tendons themselves degenerate over time. Eventually, this can lead to weakening and even tears in the rotator cuff.

Tears are described as either partial thickness tears or complete rupture, depending on the amount of tissue damage. Partial tears do not go all the way through the cuff, although a large surface area may be involved. Complete tears create a gap in the cuff with concomitant loss of function.

Conservative treatment of small rotator cuff tears (less than 3 cm) of short duration (less than 6 to 12 months) results in a good return to normal functioning for 40% to 90% of individuals (Felsenstein). However, the rehabilitation process may take 6 months or longer and requires an ongoing commitment to a home exercise program to prevent recurrence. Younger individuals are more likely to regain complete function than older individuals. However, athletes are not always able to return to previous levels of competition, especially after a full-thickness rotator cuff tear.

The median return-to-work duration for rotator cuff tear is 72 days.