RETURN TO WORK POLICY

ProStat Inc. has adopted this Return-to-Work policy with the intent of utilizing eligible injured workers in a productive capacity while they are recovering from an injury. The purpose of Modified Duty is to provide a progression of job duties that will return injured workers to their regular jobs.

The Safety Coordinator will be responsible for coordinating our Return-to-Work program. The designated alternate/backup coordinator will be the Assistant Safety Coordinator.

The attached Return-to-Work program will be followed when an employee sustains a work-related injury or illness.

1.  All injuries will be reported immediately to the employee’s direct supervisor at the facility in which he/she is working.

2.  All injuries will immediately be reported to the ProStat Inc. supervisor who will notify the designated Coordinator. Injuries will be filed via phone or fax to Laundry Owners Insurance within 24 hours.

3.  The designated Coordinator will at that time call the injured employee and provide him/her with the Premier Comp Toll Free Number 1-888-594-4001 for assistance in scheduling an appointment with a Panel Physician in the injured employee’s location. If the injuries require emergency treatment, the injured employee will be instructed to go to the nearest emergency facility. Follow up care must be coordinated through a designated medical provider. ProStat Inc. and/or Laundry Owners Mutual may not pay for medical expenses incurred by the injured worker, if he/she seeks unauthorized treatment from a non-designated medical provider. When possible, follow up medical appointments are to be made before or after work hours. Time off for medical appointments will be treated consistently with other personnel policies.

4.  The injured worker will deliver a copy of the medical provider’s work-status report to the designated Safety Coordinator within 24 hours of the medical visit.

5.  The designated Safety Coordinator is responsible for maintaining regular contact with the injured worker and the medical provider, and obtaining recovery status information and work restriction updates.

6.  The designated Safety Coordinator will maintain a list of Modified Duty Tasks. Once ProStat Inc. is ready to make a job offer to the injured worker, the Safety Coordinator sends the proposed tasks to the treating physician for approval, in accordance with the formal job offer process.

7.  During the Modified Duty period, the Safety Coordinator will provide to Laundry Workers Mutual records of wages paid to the injured worker.

8.  Modified Duty will be allowed as long as it is realistic for the job to continue, or until the injured worker receives a Release to Full Duty or reaches Maximum Medical Improvement.

9.  The Safety Coordinator will monitor and document the injured workers performance while on modified duty. While on modified duty, the injured worker will be held to all existing personnel policies and will be responsible for maintaining acceptable performance standards as a condition of continued employment. Modified Duty assignments are designed to be temporary and transitional in nature. They will be reviewed jointly by the supervisor, injured worker, and relevant staff to address increasing work duties and overall performance. This will be completed once a month.

FORMAL MODIFIED DUTY PROCESS

STEP 1: On ProStat Inc. letterhead, write the Task Letter. Tasks must be approved, signed and dated by the Licensed Treating Physician. The Licensed Physician must co-sign signatures from a Physician’s Assistant or Nurse Practitioner.

STEP 2: A copy of the Task Letter must be delivered to all parties- Physician, injured worker, Laundry Owners Mutual and injured workers attorney {if applicable} – in the same manner and on the same day.

STEP 3: Once the Physician approves the Task Letter, on ProStat Inc. letterhead, write the Formal Job Offer Letter. The letter must be signed, dated and mailed at least 7 business days before the injured worker’s start date.

Using both Certified and Regular Mail, send a copy of the approved Task Letter and job offer to the injured worker

If the injured worker is represented by an attorney, send copies of both letters using Certified Mail.

Keep a copy of each letter for the files

Fax a copy of each letter to Laundry Workers Mutual with a receipt for the Certified Letter.

ProStat, Inc. 1817 Bernville Rd. Reading, Pa 19601 │Tel: 610.736.9000 │Toll Free: 866.736.7306

Fax: 610.736.9006 │Email: │www.prostathealthcare.com