Primary care physicians play an important role in the recovery, return to work, and disability management of patients who have a workplace injury or illness.[1,2] Evidence shows that having conversations early and maintaining connections and communication with the workplace can facilitate a positive return-to-work journey for patients. Having conversations and encouraging your patient to stay in touch with their workplace is helpful in protecting their livelihood.

For physicians interested in helping with return-to-work coordination by reaching out to your patient’s workplace, there is a fee code (19950) to support this. We recommend that you use this code in the first few weeks of the claims process. With your patient’s consent, you can contact their employer or supervisor to develop a return-to-work plan. This can be done during the first or a subsequent office visit, on a phone call, or using whatever method of communication you and your patient decide on. Larger employers may be more likely to have alternative duties for your patient.

In developing a return-to-work plan, your patient’s employer needs to understand how your patient’s workplace condition affects their ability to work and for what length of time, so the employer can provide accommodations. They do not need to know confidential medical information (although patients may share this with employers). Employers receive the accepted claim diagnosis from WorkSafeBC, but they otherwise receive only the information necessary to run their workplace.

Tips to create a return-to-work plan

• With patient consent to contact their place of employment, arrange a call with an individual your patient identifies at the workplace to discuss the plan and find opportunities for safe work for your patient. If you have questions about contacting the employer, speak with a medical advisor from WorkSafeBC. Don’t hesitate to make a RACE request by phone or through the app to reach a medical advisor to discuss, and bill WorkSafeBC fee code 19930 for the discussion (please do not bill an MSP fee code for a WorkSafeBC RACE call). Visit www.raceconnect.ca for more information.
• Document that you had a call/conversation with the workplace on a Form 11 (in the clinical information area).
• If you are able to have the employer and the patient on the same call (best practice for all parties to provide information and find consensus), do not bill for the patient encounter. Instead, bill 19950 and the form fee. If you bill for a patient encounter, the 19950 fee code will be rejected.
• Ask your patient what they could do today/tomorrow at the workplace—they may be helpful in identifying tasks or duties for you and the employer—but remember that the employer may not be able to accommodate all the patient’s requests. Be open to whatever meaningful jobs the workplace has available to connect your patient back to their workplace in a timely way.
• The plan should specify hours, activities, and progression of activity, including the expected date of full return to work. A plan is typically not started at fewer than 4 hours per day. For most conditions, a plan would not last longer than 4 to 6 weeks.
• The plan does not need to start at the beginning of your patient’s workweek. In fact, arranging the return to work for midweek allows your patient a break after the first couple days back.
• Ensure you have a start date, graduated duties, and an end date documented on a Form 11 (in the clinical information area). WorkSafeBC will not end or close the claim if the plan does not work out as anticipated and will look at other options with the patient/claimant.
• Your fee will be paid even if the claim is ultimately not accepted.

For more information, visit our return-to-work information page for health care providers at www.worksafebc.com/en/claims/recovery-work/health-care-providers-return-to-work-information.
—Olivia Sampson, MD, CCFP, MPH, RCPSC
Medical Services Manager, WorkSafeBC
—Celina Dunn, MD, CCFP, CIME
Medical Services Manager, WorkSafeBC

hidden

This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

1.    Furlan AD, Harbin S, Vieira FF, et al. Primary care physicians’ learning needs in returning ill or injured workers to work. A scoping review. J Occup Rehabil 2022;32:591-619.

2.    Canadian Medical Association. The treating physician’s role in helping patients return to work after an illness or injury (update 2013). Accessed 29 September 2023. https://policybase.cma.ca/link/policy10754.