Stay At Work/Transitional Return-To-Work Programs


By Lori Dickson, MSN, RN, MSCC, CLCP, CNLCP, Director of Clinical Operations

Stay At Work/Transitional Return To Work Programs

Effective Stay-At-Work (SAW) and Transitional Return-To-Work (TRTW) programs are designed to add financial and intrinsic value by accomplishing three important business goals: 1) reduce disability leave costs, 2) maintain productivity of employees and work units, and 3) comply with disability-related legislation. 

Workplace absences appear to be directly linked to lower organizational productivity. Research conducted by The Society for Human Resource Management found that the average co-worker providing coverage for a workplace absence is 29.5% less productive while their supervisors are 15.7% less productive. Furthermore, the indirect cost of lost productivity due to workplace absences, as a percentage of payroll, was 6.7% while the direct costs, including wages for paid time off, overtime and replacement workers, as a percentage of payroll, was 15.4%.[1] 

SAW/TRTW programs help to reduce these costs by minimizing the impact of an employee’s injury or disability, including the cost of lost productivity, permanent loss of an employee and the use of disability related leave benefits. Studies have shown that SAW/TRTW programs do not only reduce lost work time, but also reduce claims costs by up to 70%.  One study by Johns Hopkins Hospital observed that an effective SAW/TRTW program reduced the number of lost workdays by 55 percent. Employer benefits include reduced direct and indirect costs such as overtime, litigation, hiring, and training costs, to name a few.[2] 

SAW/TRTW programs are designed to create proactive opportunities to manage illnesses and injuries, in some instances, before an employee spends any time away from work. When an injury or illness does result in time away from work, these programs help individual employees safely transition back to work in a manner that maintains their productivity and protects their earning power, while also boosting the organization's output.  By enabling employees to remain employed, these programs minimize the employees’ loss of skills and workforce value, while also providing employees with the financial stability that prevents the psychological impact of an unexpected loss of income. Keeping employees active and engaged also reduces the impact of other psychological effects of disability, including emotional isolation and depression, which may lead to the development of a disability mindset.   

Finally, well designed SAW/TRTW programs help organizations ensure compliance as well as reduce costs and penalties associated with disability-related legislation such as the Americans with Disabilities Act (ADA), the Family and Medical Leave Act (FMLA), the Occupational Safety and Health Act (OSH Act), workers’ compensation and other state laws.  For example, The Americans with Disabilities Act Amendments Act (ADAAA), signed in 2008, called for a broader interpretation of the term “disability,” originally outlined by The Americans with Disabilities Act (ADA).[3] The ADAAA effectively made it easier for individuals seeking protection under the ADA to establish that they have a disability. Since this new definition of “disability” potentially encompasses a much wider field of employees, it’s likely that employers will face a greater demand for accommodations. Plus, the recent expansions of state leave laws mean that more employees are now eligible to take paid leave. SAW/TRTW programs help employers minimize the duration and impact of these absences.  By providing accommodations that encourage employees to return to work as soon as they can, rather than when their leave time is exhausted, employers can increase productivity and reduce costs, all while creating a more rewarding work experience for their employees.  If your organization is interested in Stay-at-Work or Transitional Return-to-Work Services; or, if you have any questions about our case management or Return to Work consulting services please contact us at

About Lori Dickson

Lori is a Registered Nurse with over 30 years of experience in the medical field. She holds a Masters in Nursing with a focus in research and curriculum development.  Lori is also CNLCP, CLCP, and MSCC certified. She has worked within the MSP Compliance industry since 2004 and has provided oversight in a variety of areas including Life Care Planning, Medical Cost Projections, and MSA development. Lori has worked with ExamWorks Clinical Solutions and its predecessor companies for over 14 years. She is a contributing author to the Scope and Standards of Practice for Nurse Life Care Planning. Prior to coming onboard with ECS, Lori worked within in several clinical settings including neonatal/pediatric nursing, psychiatric nursing, and research. She taught for University of Texas College of Nursing as a senior lecturer.

Lori is based in the Lawrenceville, Georgia area and be reached at 678-256-5008 or via email at

[1] Source: SHRM and Kronos, “Executive Summary: Total Financial Impact of Employee Absences in the U.S.” (2014)


[3]  U.S. Equal Employment Opportunity Commission,