REWARD Report Making “Return to Work” Work

Making “Return to Work” Work: Practical Strategies for Employers After a Work-Related Injury

By Anastasia Settle, RN, CCM

Returning to work after a work-related injury isn’t just about compliance—it’s about culture, care, and communication. Employers who succeed in motivating injured workers back to safe, meaningful roles do three things consistently: they communicate clearly and often; they provide flexible pathways back to productivity; and they proactively address barriers before they become roadblocks. Below is a practical playbook designed to help you keep employees engaged, supported, and progressing—especially when return to work (RTW) with restrictions is the best next step.

Start with Communication—Early, Regular, and Empathetic

The tone and cadence of communication will set the trajectory for the RTW process. At the beginning, reach out promptly after the injury to express genuine care and explain what comes next: benefits, timelines, points of contact, and RTW options. Avoid jargon; use plain, supportive language. After each physician appointment, check in to confirm new restrictions, clarify expectations, and discuss possible duties or adjustments. This helps the employee feel seen and avoids misalignment between medical guidance and workplace plans. When concerns arise, respond quickly to frustrations or confusion. Silence or negative communication can significantly hinder progress. Typical frustrations include lack of communication or a negative tone, delayed or confusing benefit delivery, loss of benefits while off work, and lingering anger about the accident itself. Meeting these head-on with timely information and empathy can make all the difference.

Make Restricted Duty a Real, Respected Option

RTW with restrictions should be more than a checkbox—it should be an available, meaningful pathway that respects medical limits while sustaining engagement and value. Think outside the box. Consider reduced hours or limited days, transitional assignments, micro-projects, light administrative tasks, mentoring, training documentation, auditing, quality checks, or safety observations. Creativity keeps the employee progressing and prevents deconditioning. Align tasks with restrictions. Partner with clinical providers such as case managers and physical therapy providers to help identify which restrictions translate into employer-specific needs, so that return to work can become a reality. Document the plan and review regularly to adjust as needed. A strong RTW program reduces lost time and helps maintain connectivity to the workplace.

Build Structure: Your Return-to-Work Program

Formalizing your approach improves consistency and confidence across the organization.

Core elements to include:

• A written RTW policy with leadership support
• A directory of transitional duty tasks
• A clear process for receiving and applying medical restrictions
• Communication scripts/templates for managers and HR
• Benefit guidance and escalation pathways for employees
• Metrics to track RTW participation, duration, and outcomes.

If bandwidth is limited, consider partnering with case management or physical therapy providers to design and monitor the program. This is often a high-return investment. If that’s not feasible right now, a specialized service can help place workers in transitional roles that align with restrictions while maintaining engagement and purpose. 

Reconnect Before the Return: The “RTW Luncheon”

A simple, human-centered intervention—a return to work luncheon—can lower anxiety and remove obstacles. Host it several days before the employee returns so they can reconnect with teammates, hear updates, and discuss any restrictions openly. This fosters understanding, reduces stigma, and sets expectations about modified duties, pace, and safety.

Use a Buddy System to Sustain Momentum

Pair the returning employee with one or more buddies who check in daily, help navigate tasks, and watch for warning signs (pain, fatigue, frustration, confusion). Buddies can also suggest additional safe activities that match restrictions and reinforce teamwork. This setup accelerates problem identification and supports continuous adjustment, minimizing interruptions in the rehabilitation process.

Reinforce Positives: Incentives and Recognition

Positive reinforcement strengthens culture and outcomes. Use shared-success models. Consider sharing a portion of cost-savings from reduced lost time with the team or the returning employee through recognition, small bonuses, or wellness funds. In addition, public acknowledgment can be very motivating. Celebrate milestones—first day back, completion of a transitional assignment, or adherence to safety plans. Recognition validates effort and encourages engagement.

Care Beyond the Job: Practical Support During Recovery

When an injured worker is off work, coordinating a few meals, household assistance (physical or monetary), and get-well cards can be powerful. This does not need to be a heavy lift; appoint someone with strong administrative/communication skills to coordinate offers of support across the team. Small gestures reinforce that the employee is valued and remembered.

Anticipate Challenges with Universal, Fair Assessments

Some employees signal risk early; others are “silent problems.” Use validated, universal tools, such as the Functional Recovery Questionnaire or Biopsychosocial Questionnaires, to assess concerns like fear, pain beliefs, psychosocial stressors, or low confidence. If you deploy these tools, apply them consistently to everyone to ensure fairness and improve trust. When a difficulty is identified, increase communication. Do short, frequent check-ins, where task lists are clarified and progress is reinforced. Designate one person and a back up for this role, and ensure they understand the limits of what should/should not be discussed, particularly if an attorney is involved. Further, escalate thoughtfully. Loop in the case manager, PT/OT, or RTW specialists early.

Manager Checklist: Keep It Simple and Consistent

• Reach out within 24-48 hours post-injury with care and clarity.
• Confirm benefits, timelines, and points of contact; avoid gaps that lead to mistrust.
• After each medical visit, update the RTW plan and communicate changes.
• Offer restricted-duty options, including reduced hours/days and transitional tasks.
• Schedule a pre-return luncheon to reconnect and align expectations.
• Assign a buddy and set daily/weekly check-ins.
• Recognize progress publicly; consider small incentives tied to reduced lost time.
• Provide practical support (meals, errands, cards) coordinated by a capable admin.
• Use universal assessment tools; act quickly on identified matters.
• Engage case management/PT, or leverage services, if internal bandwidth is tight.

The Bottom line

A successful return to work is built on trust, flexibility, and proactive support. When employees feel cared for, informed, and included—and when restricted duty is respected as a smart, temporary pathway—recovery accelerates, morale improves, and outcomes follow.   Excerpts from Presentation: Tried & True: Successful and Ethical Return to Work Strategies

About Anastasia Settle

Anastasia earned her nursing degree from Indiana University in 1991 and began her career in hospital care before transitioning to Workers’ Compensation in 1998. She achieved her Certified Case Manager (CCM) credential in 2000 and has since provided case management services in both community and Workers’ Compensation settings across Indiana, Kentucky, Tennessee, Georgia, and Florida. Currently, Anastasia serves as Case Management Liaison at Carlisle Medical, collaborating with a multidisciplinary team—including Case Managers, DME Specialists, and Pharmacists—to ensure exceptional care for clients and their employees. Passionate about community service, Anastasia’s interest in ethics began during nursing school when she served on a hospital Ethics Board. She later pursued further studies in Ethics at Southern Baptist Theological Seminary. A skilled and engaging speaker, Anastasia has presented at numerous conferences, including State Safety, SHRM, and Workers’ Compensation events, covering topics such as Case Management Processes, Ethics, Workplace Violence, and Mental Health. She looks forward to sharing insights that are both informative and impactful.

R.E.W.A.R.D. PROGRAM: RETURN EMPLOYEES TO WORK AND REDUCE DISABILITIES

To be effective, transitional assignments must be meaningful and take into consideration an employee’s skills and experience as well as physical restrictions that are necessary while the recovery continues. For more information regarding transitional assignments, download the REWARD Program Toolkit.

MEET WITH LIKE-MINDED EMPLOYERS

Save the date for the next virtual meeting on Thursday, March 19, 2026 at 10 AM (Central Time). Anastasia Settle, RN, CCM, the author of this article, will discuss ideas to reduce downtime, boost morale, and create smoother return to work experiences for everyone.

Disclaimer: Views expressed in the REWARD Report are solely those of the authors and may not reflect the official policy or position of the Tennessee Bureau of Workers’ Compensation, the Tennessee Court of Workers’ Compensation Claims, the Tennessee Workers’ Compensation Appeals Board, or any other public, private, or nonprofit organization. Information contained in the REWARD Report is for educational purposes only.