Modified Work Program for Local 79 Members

Introduction

The enclosed policy outlines the City’s approach to dealing with all employees’ injuries and illnesses.

The Modified Work Program provides disability management to practices to facilitate an early and safe return to productive employment.

The Modified Work Program supports a multi-disciplinary team approach to Integrated Disability Management and case management meetings.

Policy Statement

The City of Toronto is committed to a fair and consistent process to minimize the impact of all injuries and illnesses on its employees and the workplace by:

    • Protecting the health and safety of its employees through the prevention of accidents, injuries, and illnesses
    • Meeting or exceeding legislative and contract requirements
    • Applying best disability management practices
    • Facilitating optimal recovery through positive intervention and accommodation
    • Facilitating early and safe return to productive employment
    • Developing individualized accommodation plans that recognize and utilize each employee’s abilities
    • Respecting and maintaining confidentiality in keeping with legislative requirements
    • Facilitating the appropriate use of benefits and services as entitle
    • Working cooperatively with employees and the union to support and facilitate a safe return to work.

Application

To Local 79 members

Authority

Workplace Safety and Insurance Act
Ontario Human Rights Code
Occupational Health and Safety Act
Municipal Freedom of Information and Protection of Privacy Act
Collective Agreements
LTD Contracts
Applicable City of Toronto Policies

Index

Standard Case Management

A. Initial documentation steps in Workplace Safety and Insurance Board cases
B. Initial documentation steps in illness or non-occupational injury cases
C. Case management steps for both Workplace Safety and Insurance Board and illness/non-occupational injury cases

Special Circumstances

A. When the initial return to work information indicates that the employee is not yet able to participate in any type of work
B. When the absence is more than four weeks
C. When suitable transitional modified duties are not available in the employee’s work division
D. When a suitable and safe transitional accommodation plan cannot be developed because of missing or conflicting information regarding the employee’s medical and/or functional status
E. When difficulties are encountered in following the transitional accommodation plan
F. When permanent alternate work is medically required
G. When the employee refuses transitional accommodated work or permanent alternate work
H. When the employee does not cooperate with the IDM process
I. When a Long Term Disability application form has been submitted
J. When there is a concurrent medical condition that may pose a barrier to work or which may affect entitlement to WSIB benefits
K. When there is a pre-existing condition that may affect entitlement to initial or ongoing WSIB benefits

Standard Case Management

A.____Initial documentation steps in Workplace Safety and Insurance Board Cases

  1. Immediately upon learning of the injury, the supervisor completes the Supervisor’s Report of Injury/Accident and conducts an accident investigation sufficient to complete the form. If the injury is a recurrence of a previous compensable injury, the Supervisor also completes the Supervisor’s Recurrence Report. Refer to the Guidelines for Completion of the City of Toronto’s Supervisor’s Report of Injury/Accident
  2. The supervisor arranges for completion of the Witness Report (where applicable).
  3. The supervisor provides Injury Reporting/Return to Work information to the employee in person immediately upon report of the accident, or, if the employee is not available at the workplace, the supervisor sends the package immediately to the employee’s home address. Includes:
    • Employee instructions;
    • Notification that appropriate modified work is available;
    • Form 6 (Employee’s Report of Injury/Accident);
    • Covering letter to the treating health professional;
    • City of Toronto’s Health Professional’s Report of Worker’s Function form
    • Job demands analysis of the employee’s job, if available, to be inserted in the package by the supervisor.


    Note: All materials used in steps 1-3 should be packaged together at the workplace for ease of access. A flow chart should be included to outline procedures and responsibilities. Appropriate Job Demands Analysis should be kept at each workplace to facilitate insertion in the employee’s package.

  4. The supervisor forwards completed documents as follows:
    • Immediately forwards the Supervisor’s Report of Injury/Accident and the Recurrence Report and Witness Report to those assigned responsibility within the division for completing Workplace Safety and Insurance Board, Form 7’s;
    • Immediately upon receipt of the completed Health Professional’s Report of Worker’s Function form, the supervisor takes a copy and forwards the original to the designated Human Resources case coordinator.
  5. If the Health Professional’s Report of Worker’s Function form has not been received within 5 days, the supervisor calls the employee to follow up and also contacts the case coordinator to advise of the delay.

B.____Initial documentation steps in illness or non-occupational injury cases

  1. The employee notifies the supervisor of any absence related to illness in accordance with the relevant Collective Agreement and divisional procedures. Employees calling in who do not speak directly to their supervisor must provide a telephone number where they can be reached later the same day.
  2. The supervisor documents the following during the initial phone call made on the first day of absence:
    • Confirms reason for absence;
    • Establishes when the employee is likely to return;
    • If appropriate, advises that modified work is available;
    • Informs employee of the requirement for a medical certificate per Collective Agreement.
  3. The supervisor maintains regular contact with employee (weekly, biweekly, or monthly, as appropriate).
  4. If modified work is identified as a possibility, either from the telephone contact or from the medical certificate, the supervisor sends a covering letter and the Health Professional’s Report of Worker’s Function form to the employee and the Health Professional’s Report of Worker’s Function form is to be completed by the employee’s treating health professional.

C.____Case management steps for both Workplace Safety and Insurance Board and illness/non-occupational injury cases

The employee will be reminded that they can involve their Union at any stage of the return-to-work process.

  1. Upon receipt of the Health Professional’s Report of Worker’s Function form (or other medical documentation that the employee may present from his/her treating health professional), the supervisor reviews the information, compares any restrictions to the demands of the worker’s job, and discusses the information with the employee in person or by telephone.
  2. When the supervisor determines that job accommodation is required, he/she consults with the employee and contacts the case coordinator to discuss possible accommodation measures.
    • If the supervisor and case coordinator agree that the accommodation is appropriate, the supervisor implements the accommodation plan immediately and proceeds directly to step 6;
    • Where further information is required prior to developing an accommodation plan, the case coordinator may complete steps 3,4,5 and/or 6 prior to further discussion with the supervisor.


    Note 1: Steps 3,4,5 and/or 6 may not be required in all cases.

    Note 2: Whenever the employee receives assessment or treatment services, the employee is asked to provide an informed consent to allow verbal and written findings/recommendations relevant to the return to work to be shared with appropriate members of the Integrated Disability Management team and WSIB, if appropriate.

  3. As part of the team case review process, the case coordinator brings forward for review with the health & rehab consultant situations where:
    • Clarification of medical and/or functional information is required to assist in developing the transitional accommodation plan:Should there be any need for clarification of the above information this would only be done by Employee Health and Rehabilitation.
    • Assistance in referral to assessment or treatment resources such as medical specialist, physiotherapy and/or 3rd party assessment. Additional information of a medical nature is required from the employee’s treating health professional.
  4. If appropriate, the case coordinator completes and forwards an Ergonomics Service Request form asking the ergonomics consultant to provide consultation in job demands analysis and/or accommodation measures. The ergonomics consultant reports back to the case coordinator.
  5. The supervisor consults with the case coordinator and the employee where appropriate to determine accommodation arrangements. The supervisor or case coordinator makes a record of accommodations of less than one-week duration.
  6. If the accommodation lasts longer than one week, the supervisor or case coordinator should record the transitional accommodation plan to include the following information:
    • Time frame;
    • Funding arrangements;
    • Follow-up schedule;
    • Job accommodation measures.
  7. The plan is copied to:
    • The employee;
    • At employee’s request, employee’s union representative;
    • The case coordinator (if involved);
    • The health consultant (if involved).
  8. The supervisor, in consultation with the case coordinator when necessary, monitors the employee’s return to transitional work.
  9. At the pre-determined intervals specified in the transitional accommodation plan, the supervisor provides a follow-up Health Professional’s Report of Worker’s Function form to the employee for completion by the employee’s treating health professional, along with a copy of the existing transitional accommodation plan for information. The case coordinator monitors this process.
  10. The employee is responsible for returning the completed follow-up Health Professional’s Report of Worker’s Function form to the supervisor, prior to the next scheduled change in the transitional accommodation plan.
  11. If the follow-up Health Professional’s Report of Worker’s Function form indicates that changes are required to the plan:
    • The supervisor, employee and case coordinator discuss the changes;
    • The supervisor (or case coordinator) revises the plan and copies all involved parties;
    • Situations where the transitional accommodation plan is extended will be brought forward as part of the case review process (or combined in general re case review).
  12. The employee resumes full-time, non-accommodated duties at the completion of the transitional accommodation plan unless there are medically supported contraindications.

Special Circumstances

Please note that each circumstance is separate and may occur independently of other circumstances.

A.____When the initial return to work information indicates that the employee is not yet able to participate in any type of work:

  1. The supervisor sends a copy of the Health Professional’s Report of Worker’s Function form to the case coordinator.
  2. The supervisor and case coordinator discuss the case and decide when a follow-up Health Professional’s Report of Worker’s Function form will be sent to the employee.
  3. As part of the team case review process, the case coordinator brings forward for review with the health & rehab consultant situations where:
    • Clarification of medical and/or functional information is required:Should there be any need for clarification of the above information this would only be done by Employee Health and Rehabilitation.
    • Assistance in referral to assessment or treatment resources such as medical specialists, physiotherapy and/or 3rd party assessment
    • Additional information of a medical nature is required from the employee’s treating health professional
  4. The supervisor maintains periodic contact with the worker, as appropriate.
  5. If the Health Professional’s Report of Worker’s Function form has not been received within 5 days of having been sent, the supervisor calls the employee to follow up and also contacts the case coordinator to advise of the delay.
  6. When the employee is able to resume work duties, refer to the Standard Case Management.

B.____When the absence is more than four weeks:

  1. At four weeks of absence, the supervisor contacts the case coordinator to inform the case coordinator of the absence.
  2. As part of the team case review process, the case coordinator brings forward for review with the health & rehab consultant situations where the case coordinator determines that the employee is to be contacted to:
    • Clarify medical and functional information;
    • Assist in referral to 3rd party assessment or treatment resources, external and/or internal;
    • Assess return to work potential. When appropriate, sends the Health Professional’s Report of Worker’s Function form to the employee for completion by the treating health professional.

    If appropriate, case coordinator/health consultant suggests employee explore alternative benefit options.

  3. When there is an indication that a return to work may be possible, the supervisor and case coordinator and health consultant consult concerning the return to work process. If further clarification is required, the case coordinator/health consultant obtains the employee’s informed consent to share with appropriate members of the Integrated Disability Management team and WSIB, if appropriate, any verbal and written findings/recommendations regarding the accommodation and return to work.
  4. The case coordinator consults with the supervisor/health consultant and the employee where appropriate to determine accommodation arrangements.
    • If the supervisor/case coordinator agree that the accommodation is appropriate, the supervisor implements the accommodation plan immediately.
    • If appropriate, the case coordinator completes and forwards an Ergonomics Service Request form asking the ergonomics consultant to provide consultation in job demands analysis and/or accommodation measures. The ergonomics consultant reports back to the case coordinator.

C.____When suitable transitional modified duties are not available in the employee’s work Division:

  1. The supervisor and case coordinator work together to identify alternate transitional placement opportunities elsewhere in the base division.
  2. Funding arrangements for the alternate transitional placement within the base division are the responsibility of the base division. The case coordinator facilitates the process.
  3. When required, the case coordinator contacts the placement specialist to assist in identifying suitable alternate transitional placements across the corporation.
  4. When a suitable placement is found in another division, a transitional accommodation plan is completed and copied to the base supervisor, the receiving supervisor, the employee and the case coordinator.
  5. The case coordinator or placement specialist liaises with the receiving supervisor and updates the base supervisor of the employee’s progress and status.
  6. When the employee is able to return to duties in the original work unit, the case coordinator and base supervisor arrange and document another transitional accommodation plan or return to full duties.

D.____When a suitable and safe transitional accommodation plan cannot be developed because of missing or conflicting information regarding the employee’s medical and/or functional status:

  1. The supervisor/case coordinator informs the employee of what information is missing in order to plan the return to work, and they request that the information be provided in order to move forward with the plan.
  2. If assistance is required of the employee health and rehabilitation unit, as part of the team case review process, the case coordinator brings forward for review with the health & rehab consultant the information available in the file. They review whether more information is required to ensure the development of a transitional accommodation plan that provides the opportunity for suitable and safe work.
  3. The case coordinator/health consultant makes the appropriate referral to an external service provider for an Independent Medical Examination and/or Functional Abilities Evaluation. For WSIB cases, independent medicals are authorized under Section 36(1) of the Workplace Safety and Insurance Act.
  4. The case coordinator/health consultant notifies the employee and the employee’s treating health professional that an assessment has been scheduled, and obtains the employee’s informed signed consent to release verbal and written findings/recommendations for accommodation purposes to appropriate members of the Integrated Disability Management Team and WSIB, if appropriate.

E.____When difficulties are encountered in following the transitional accommodation plan:

  1. The supervisor discusses the situation with the employee and case coordinator to identify barriers to the employee’s progress, which may be related to either the employee’s ability and/or operational constraints in the workplace.
  2. If the difficulties are related to the employee’s ability, the case coordinator brings forward for review with the health & rehab consultant as part of the team case review and together they work to identify the medical, functional and/or job related information that is required to determine the next step in the disability management process. The employee is informed of the information required from his/her health provider. This could include any of the following actions:
    • A review of the current medical and functional information;
    • A review of the match between the employee’s job demands, medical restrictions and functional abilities;
    • Obtaining further medical and/or functional information from the treating health professional;
    • Obtaining further information about the job duties/tasks and job demands;
    • Referral to assessment or treatment resources, such as medical specialists, physiotherapy and/or 3rd party assessment.
  3. If the case coordinator/health consultant has referred the employee to assessment or treatment resources, and with the employee’s informed consent, the case coordinator/health consultant shares any verbal and written findings/recommendations relevant to the accommodation and return to work process with the appropriate members of the Integrated Disability Management team and WSIB if appropriate.
  4. If ergonomics consultation is required regarding job demands analysis, accommodation measures, and/or work suitability:
    • The case coordinator contacts the ergonomics consultant, completes an Ergonomics Service Request form where appropriate and monitors the consultation process;
    • The ergonomic consultant submits a written report to the case coordinator and health & rehab consultant.
  5. If changes are required to the transitional accommodation plan:
    • The supervisor, employee, case coordinator and health consultant if appropriate, discuss the changes;
    • The supervisor or case coordinator revises the transitional accommodation plan and copies all involved parties.

The goal is to accommodate and return employees to their own job, but if this is not medically feasible, suitable alternate work will be sought.

F.____When permanent alternate work is medically required:

  1. The case coordinator brings forward as part of the team case review process for confirmation, the information from the health provider that supports the need for permanent alternate work. When required the placement specialist is consulted as part of the case review, where it is confirmed that a permanent alternate work placement is required.
  2. When appropriate, the case coordinator/health consultant arranges a Functional Abilities Evaluation to determine the employee’s ability to perform work tasks.
    • The case coordinator/health consultant notifies the employee and the employee’s treating health professional that a Functional Abilities Evaluation has been scheduled, and obtains the employee’s informed consent to release verbal and written findings/recommendations to the appropriate members of the Integrated Disability Management team and the WSIB, if necessary.
  3. When appropriate, the case coordinator and placement specialist meet with the employee to discuss accommodation needs, transferable skills, aptitudes, etc.
  4. When appropriate, the case coordinator works with the employee and placement specialist to identify suitable alternate placements with the division or the corporation.
  5. The placement specialist/case coordinator works with Staffing to access any vacant positions.
  6. Once the receiving division has assessed that the employee’s functional abilities and job skills match the job requirements, the employee shall be placed in the position. If more than one employee meets the functional abilities and job skills of the position, seniority shall be the deciding factor.
  7. If the employee is placed in the position it is on a work trial basis for three months. The salary paid to the employee is determined by the provisions of the Collective Agreement, the Workplace Safety and Insurance Act, if applicable, and/or relevant policies.
  8. The supervisor monitors the employee’s attendance and performance during the work trial period. The supervisor keeps the case coordinator and placement specialist informed of the employee’s status.
  9. If problems arise during the work trial period, the case coordinator meets with the employee/placement specialist/supervisor. The case coordinator involves other internal or external resources as required. The option for extension of the work trial for further training may be considered.
  10. Upon successful completion of the work trial period, the employee is permanently placed in the position. The salary is determined by the provisions of the Collective Agreement and/or the Workplace Safety and Insurance Act, and/or other relevant policies.
  11. If the work trial is not successful because of the employee’s medical/functional restrictions, an alternative work trial will be sought within the employee’s functional abilities and job skills.

G.____When the employee refuses transitional accommodated work or permanent alternate work:

  1. The supervisor/case coordinator/health consultant/placement specialist contacts the employee to discuss the situation and reminds the employee that they can involve their Union.
  2. Upon the employee’s contact with the Union, the appropriate member of the IDM Team reviews the situation with the Union.
  3. As part of the team case review process, the case coordinator brings forward the situation to review the match between the employee’s job demands, medical restrictions and functional abilities to ensure the work offered is suitable based on the available information. The ergonomics consultant is consulted as part of the team as required.
  4. When appropriate, the case coordinator and employee meet with the health consultant, supervisor and other parties to discuss the situation.
  5. The case coordinator or health consultant, with informed consent, contacts the employee’s treating health professional to discuss the situation.
  6. When necessary, the case coordinator/health consultant refers the employee for an Independent Medical Examination or a Functional Abilities Evaluation – see Special Circumstance E(2) & (3) for process.
  7. With informed consent, the case coordinator/health consultant and other appropriate members of the Integrated Disability Management team review relevant verbal and written findings/recommendations to make a determination on the suitability of work. In Workplace Safety and Insurance Board cases, if it is determined that the work offered is suitable and the employee continues to refuse the placement, the case coordinator notifies the Workplace Safety and Insurance Board to take further action.
  8. When appropriate, the case coordinator consults with Labour Relations.
  9. If necessary, the case coordinator arranges a meeting with the supervisor, appropriate Integrated Disability Management team members and employee including the employee’s union representative, if requested.

H.____When the employee does not cooperate with the IDM process:

  1. The case coordinator contacts the employee to clarify the employee’s employment obligations and to clarify that the worker’s cooperation is a necessary component of the accommodation process and reminds the employee that they can involve their Union.
  2. Upon the employee’s contact with the Union, the appropriate member of the IDM Team reviews the situation with the Union.
  3. If the situation is not resolved, the case coordinator notifies Workplace Safety and Insurance Board (if applicable) and documents rehabilitation efforts for the division’s further action.
  4. If necessary, the case coordinator arranges a meeting with the supervisor, appropriate Integrated Disability Management team members and employee including the employee’s union representative, if requested, to discuss the issues.
  5. When appropriate, the case consultant consults with Labour Relations.

I.____When a Long Term Disability application form has been submitted:

  1. The health consultant or Finance notifies the case coordinator of the Long Term Disability application.
  2. The health consultant monitors the Long Term Disability process through regular Long Term Disability meetings with the insurance carrier.
  3. The health consultant notifies the case coordinator of upcoming Long Term Disability meetings so that the case coordinator can provide appropriate input, including attendance at the meeting, if necessary.
  4. The health consultant advises the case coordinator of any changes in Long Term Disability status.
  5. Through regular contact with the Long Term Disability carrier, the health consultant advises the case coordinator of any potential for return to work.
  6. If potential for return to work is identified, follow Special Circumstance B (3) and (4).

J.____When there is a concurrent medical condition that may pose a barrier to return to work or which may affect entitlement to WSIB benefits:

  1. In order to meet return to work obligations and to ensure cost containment of the WSIB claim file, where there is a concurrent medical condition, the case coordinator/health consultant will ask the employee for an informed consent in order to obtain and release medical report/documentation and findings/recommendations (verbal or written) to the appropriate members of the Integrated Disability Management team and the WSIB.
  2. If inadequate information is provided in order to develop a safe return to work program the employee should be informed of what information is required from the health care provider.
  3. If the case coordinator/health consultant is unable to obtain the informed consent, the case coordinator will write to the WSIB asking the WSIB to investigate and obtain medical reports/documentation and findings pertaining to the concurrent medical condition.

K.____When there is a pre-existing condition that may affect entitlement to initial or ongoing WSIB benefits:

  1. If a pre-existing medical condition becomes known to the case coordinator, he/she will advise the employee of the information that is required. If not received he/she will ask the employee for an informed consent in order to obtain medical documentation/reports/findings pertaining to the pre-existing medical condition. With informed consent, the document will be released to the WSIB for adjudication purposes.
  2. If the case coordinator is unable to obtain an informed consent, the case coordinator will write to the WSIB asking the WSIB to investigate and obtain medical documentation pertaining to the pre-existing medical condition.

Approved by

Mediated Memorandum of Agreement with Local 79

Date Approved

July 9, 2004

Related links

Form 6