🔄 Return-to-Work / Modified Duty Playbook
Get injured workers back on the job safely and quickly. A structured return-to-work program reduces lost time, controls insurance costs, speeds recovery, and keeps your best people on the team.
Why Return-to-Work Programs Matter
| Without a RTW Program | With a RTW Program |
|---|---|
| Injured worker sits home for weeks or months | Worker stays engaged and productive within restrictions |
| Lost-time claims spike your EMR | Modified duty claims have minimal EMR impact |
| Workers' comp costs escalate ($40,000+ per lost-time claim avg.) | Claims close faster, costs stay controlled |
| Worker feels forgotten — hires an attorney | Worker feels valued — stays loyal |
| Replacement labor costs + overtime for remaining crew | Injured worker handles meaningful tasks that still need doing |
| Recovery takes longer without structure and purpose | Studies show workers on modified duty recover 2× faster |
Every Day Counts
The probability of an injured worker never returning to full duty increases dramatically with time away. After 6 months off work, there is only a 50% chance of return. After 12 months, it drops to 10%. Getting someone back on modified duty within 24–48 hours changes the outcome entirely.
Cost Impact: Lost Time vs. Modified Duty
| Scenario | Claim Type | Avg. Cost | OSHA Recordable? | EMR Impact | Days Away |
|---|---|---|---|---|---|
| Worker sprains ankle, stays home 3 weeks | Lost-time claim | $38,000–$55,000 | Yes — Days Away case | High — counts as lost time | 15+ days |
| Same injury, returns next day on modified duty | Modified duty claim | $8,000–$12,000 | Yes — Restricted duty case | Lower — restricted, not lost time | 0 days away |
| Same injury, no treatment beyond first aid | First aid only | $200–$500 | No | None | 0 days |
The EMR Math
Your Experience Modification Rate (EMR) compares your claims costs to your industry average. Lost-time claims carry the heaviest weight. A single lost-time claim can increase your EMR by 10–30 points, which directly increases your insurance premiums by thousands of dollars per year — and can disqualify you from bidding GC work. Modified duty claims still appear on the OSHA 300 log but carry significantly less financial weight.
Definitions
| Term | Definition |
|---|---|
| Full Duty | Worker performs all regular job functions without restriction |
| Modified Duty | Worker performs a temporarily adjusted version of their regular job, within doctor-imposed restrictions |
| Light Duty | Worker performs alternative tasks (not their regular job) that fall within restrictions — often used interchangeably with modified duty |
| Transitional Work | Structured, progressive return from modified duty toward full duty — restrictions gradually loosen over time |
| Maximum Medical Improvement (MMI) | Doctor determines the worker has recovered as much as they will — triggers permanent restriction evaluation or full-duty release |
Roles and Responsibilities
| Role | Responsibilities |
|---|---|
| Safety Director | Oversee RTW program, coordinate with insurance carrier, track metrics, ensure compliance |
| Project Manager / Superintendent | Identify modified duty tasks on the project, assign and supervise modified duty work, communicate with foreman |
| Foreman / Supervisor | Monitor worker daily, ensure restrictions are followed, report progress or concerns, adjust tasks as needed |
| Injured Worker | Attend all medical appointments, follow restrictions, perform assigned modified duty tasks, communicate honestly about limitations |
| HR / Admin | Manage workers' comp paperwork, coordinate with insurance carrier, track modified duty duration, maintain OSHA 300 log |
| Treating Physician | Provide written restrictions, estimate duration, re-evaluate at set intervals, communicate work capacity |
Step-by-Step Return-to-Work Process
Step 1: Injury Occurs — Immediate Response
- Provide first aid and/or transport to medical facility
- Complete the incident report per the Incident Reporting Playbook
- Notify Safety Director and HR within 2 hours
- Tell the worker: "We want you back as soon as you're able. We'll find work within your restrictions."
Set Expectations Early
The conversation at the time of injury shapes everything. If the worker hears "take as much time as you need," they will. If they hear "we value you and we'll work with your doctor to get you back safely," they return faster. The message matters.
Step 2: Medical Treatment and Restrictions
- Worker sees treating physician (your company's designated clinic if allowed by state law)
- Get written restrictions — Do not rely on verbal instructions. The doctor must provide specific, written physical restrictions:
- Lifting limits (e.g., "no lifting over 10 lbs")
- Positional restrictions (e.g., "no climbing, no overhead reaching")
- Duration limits (e.g., "no standing more than 2 hours at a time")
- Duration of restrictions (e.g., "restrictions in place for 2 weeks, re-evaluate on [date]")
- If the doctor writes "no work," ask: "What CAN the worker do?" — Push for specific capabilities, not just limitations
Step 3: Modified Duty Assignment (Within 24 Hours)
- Review the doctor's restrictions
- Match restrictions to available modified duty tasks (see task bank below)
- Document the modified duty assignment in writing:
- Worker name and injury date
- Doctor's restrictions (attach copy)
- Assigned tasks and schedule
- Supervisor name
- Start date and expected re-evaluation date
- Review the assignment with the worker — confirm they understand and agree
- Notify the insurance carrier that modified duty has been offered and accepted
Step 4: Modified Duty Task Bank
These are construction-specific tasks that injured workers can typically perform within common restrictions:
| Task Category | Modified Duty Tasks | Common Restrictions Accommodated |
|---|---|---|
| Safety | Safety observations, fire watch, barricade/signage checks, muster point monitor | No lifting, no climbing, limited standing |
| Inventory | Tool inventory and organization, material counts, supply ordering, small tool maintenance | No heavy lifting, seated work available |
| Receiving | Material receiving and documentation, delivery verification, photo documentation | Limited lifting, no climbing |
| Cleanup Supervision | Direct housekeeping crews, inspect cleanup quality, waste sorting oversight | No lifting, no bending, limited standing |
| Training | Assist with toolbox talks, organize training materials, prepare safety meeting content | Sedentary, no physical labor |
| Documentation | Filing, data entry, daily report assembly, photo organization, plan markup | Sedentary, office/trailer work |
| Quality | Punch list documentation, photo documentation of installed work, measurement verification | Limited walking, no lifting, no climbing |
| Gate / Access | Gate access monitoring, visitor sign-in, delivery coordination | Seated, no lifting |
Make It Meaningful
Assigned tasks must be productive and dignified — not "sit in the trailer and watch safety videos." When a worker feels they're contributing, they recover faster and stay engaged. When they feel punished or parked, they disengage and recovery stalls.
Step 5: Monitor Progress
| Frequency | Action | Who |
|---|---|---|
| Daily | Check in with worker — how are they feeling? Any pain? Restrictions being followed? | Foreman |
| Weekly | Review modified duty performance and worker status with Safety Director | Superintendent |
| Per doctor visit | Obtain updated restrictions — are they loosening? Same? Tightening? | HR / Safety Director |
| Bi-weekly | Contact treating physician for progress update (if worker consents) | Safety Director / HR |
Step 6: Transition to Full Duty
- Doctor provides written full-duty release with no restrictions
- Worker returns to regular crew and regular tasks
- Foreman monitors for the first 1–2 weeks — watch for re-aggravation or hesitation
- Close the modified duty file and update the OSHA 300 log
- Close the workers' comp claim when medically appropriate
Communication with the Treating Physician
What to send to the doctor:
- Your company's modified duty program description
- List of available modified duty tasks with physical requirements
- A "Physical Demands" description for both the regular job and available modified duty
What to ask:
- "What specific physical restrictions apply?"
- "What CAN the worker do?" (not just what they can't)
- "What is the expected duration of restrictions?"
- "When should the worker return for re-evaluation?"
- "Are there activities that would help recovery?"
App Integration — Track Modified Duty Time
Use BLDR Time to track modified duty hours separately from regular production hours. Create a modified duty cost code so you can track the total cost of modified duty labor on each project. Use BLDR Pro to document modified duty assignments, attach doctor's restriction letters, and log daily check-in notes from the foreman.
Duration Limits and Re-Evaluation Triggers
| Trigger | Action |
|---|---|
| 30 days on modified duty | Re-evaluate: Is the worker progressing? Are restrictions loosening? Contact physician for updated prognosis. |
| 60 days on modified duty | Escalate: Involve insurance carrier case manager. Consider functional capacity evaluation (FCE). Review alternative positions. |
| 90 days on modified duty | Decision point: Is full-duty return realistic? Discuss permanent restrictions, job reassignment, or vocational rehabilitation with carrier. |
| Restrictions tighten | Immediate re-evaluation — is the current assignment appropriate? Does the worker need to stop working? |
| Worker reports increased pain | Send back to doctor. Do not push through pain — it increases liability and worsens outcomes. |
| Worker misses medical appointments | Contact worker immediately. Missed appointments can jeopardize the claim and delay recovery. |
| MMI reached with permanent restrictions | Evaluate whether permanent restrictions can be accommodated in any available position. |
Workers' Comp Documentation Checklist
| Document | When | Filed Where |
|---|---|---|
| Incident report | Day of injury | Safety file + insurance carrier |
| First report of injury (state form) | Within 24–48 hours (varies by state) | State workers' comp board + carrier |
| Doctor's restriction letter | Each medical visit | Safety file + HR |
| Modified duty offer (written) | Within 24 hours of restrictions | Worker signs, copy to carrier |
| Modified duty acceptance/refusal | Same day as offer | Safety file + carrier |
| Daily modified duty log | Daily | Project file |
| Full-duty release | Upon return | Safety file + HR + carrier |
| OSHA 300 log entry | Within 7 days of recordable injury | OSHA log |
Metrics and Tracking
| Metric | Target | Frequency |
|---|---|---|
| % of injuries with modified duty offered within 24 hours | 100% | Per injury |
| Modified duty acceptance rate | 95%+ | Quarterly |
| Average days on modified duty | Under 21 days | Quarterly |
| % of modified duty workers returning to full duty | 90%+ | Quarterly |
| Lost-time claim rate (vs. total injuries) | Under 10% | Quarterly |
| EMR trend | Declining year-over-year | Annual |
| Modified duty cost per project | Tracked and benchmarked | Per project |
Common Mistakes
| Mistake | Problem | Fix |
|---|---|---|
| No RTW program at all | Every injury becomes a lost-time claim, EMR skyrockets | Establish a written program before the first injury |
| Waiting for the worker to call | Worker feels abandoned, hires attorney, never comes back | Contact the worker within 24 hours, every time |
| "Sit in the trailer" duty | Worker feels punished, disengages, recovery stalls | Assign meaningful, productive tasks from the task bank |
| Ignoring doctor's restrictions | Worker re-injures, massive liability, bad faith claim | Follow written restrictions exactly — no exceptions |
| No written modified duty offer | Insurance carrier can't prove duty was offered, claim stays open | Put every offer in writing, have the worker sign |
| No time tracking for modified duty | Can't measure program effectiveness or project cost impact | Track modified duty hours with a separate cost code |
| Foreman doesn't check in daily | Problems go unnoticed, worker suffers in silence | Daily check-in is mandatory — it takes 2 minutes |
| Letting modified duty drag on indefinitely | Worker settles into a permanent non-productive role | Set duration limits, re-evaluate at 30/60/90 days |
Related Resources
| Resource | Link |
|---|---|
| Incident Reporting Playbook | Incident Reporting |
| Workers' Comp Guide | Workers' Comp |
| EMR Explained Guide | EMR Explained |
| Safety Compliance Guide | Compliance Guide |
| JSA/JHA Playbook | JSA/JHA Process |
| OSHA Recordkeeping Guide | OSHA Recordkeeping |