Desjardins fights absenteeisme by demedicalizing disability

By Alain Thériault | November 18 2013 06:47PM

To counter absenteeism both in its own ranks and for clients, Desjardins Insurance is being proactive. The insurer is implementing an approach where the employer, the employee, and the physician collaborate to find a solution that favour a return to work or avoid absence, and they do so without relying solely on the medical aspects.
In an approach it describes as holistic and comprehensive, Desjardins unites the various parties involved in disability cases in order to find a solution that is more social than medical. Lucie Cormier is vice-president of disability insurance and the customer contact centre for association and group insurance at Desjardins. She has been given the task of putting this new approach into action.

“The responsibility for disability does not rest with the employer, the employee, or the doctor. It rests with all the stakeholders,” she commented at a health and well-being conference that took place this spring.

Ms. Cormier believes that the world of group insurance is changing. Both in her advice to clients and within the insurer’s own group plan, she trains and encourages managers to come to conclusions quickly in order to act quickly; at least at the onset of disability, and ideally before.

“Ten years ago, our work was limited to managing disability insurance benefits. We received a form with a period of sick leave, a benefit was paid, and we waited for the next one to act. Today, we must transform ourselves into disability managers. We are implementing new approaches that go beyond the medical report,” comments Ms. Cormier.

The insurer has designed a telephone interview method that is specifically adapted to the type of disability and the individual involved. The goal is to obtain information without being offensive, explains Ms.Cormier. “While we are collecting this information, we are on the lookout for any opportunity to avoid or shorten a disability,” she adds.

Going beyond the medical report, Ms. Cormier finds that physical disabilities often have psychological causes. She also realizes that, in many cases, the solution lies in simple initiatives that can lower costs significantly.

“Calling allows us to find out things. If an office worker is off work for a broken foot, perhaps the employer can make things easier for him by paying for a taxi while he is recovering instead of leaving it to the insurer to pay benefits, says Ms. Cormier. Allowing an employee to remain at work is a winning situation for everyone. “Simply by making a telephone call, we can avoid a disability.”

A significant change

The principle of demedicalization is a significant change in itself. “Before, insurers talked about symptoms, limitations, and deficiencies. They did not pay much attention to the other factors that influence disability. We waited for the doctor’s report, and we acted in accordance with it. Rehabilitation, that was in two years,” recalls Ms. Cormier, who has worked at Desjardins since 1995 and also trained as a nurse.

Today, the insurer relies on a better understanding of the employee’s experience and environment. “The employee knows his workplace and his experience. He knows what is feasible. It’s a matter of making it possible for us to talk about it, of asking questions like ‘How do you see your return to work?’, ‘Are there things that frighten you?’ and so on.”

In her opinion, the insurer should take the opportunity to look into the matter more closely and support the individual. It is important to change one’s way of speaking, and talk about abilities rather than limitations.

If you need to make sure the employee has everything he needs in order to regain his health and energy, you must also seek the employer’s cooperation and make a thorough assessment of any potential barriers to a return to work.

Overall, this demedicalization approach reduces the cost of insurance, because it increases job satisfaction and reduces occasional absences, says Ms. Cormier. It improves employees’ productivity and efficiency. The doctor becomes an active stakeholder and is no longer alone at the heart of the decision-making process. This approach generates less conflict because it encourages people to deal with events promptly.

The company or the insurer that wants to maximize the chances of making this type of change successfully should recruit people who are suited to this kind of approach: those with interpersonal skills, and those who are innovative and proactive. These are people who focus on the employee’s capabilities and build a solution that is suited to the situation. They should be open to unusual situations and able to adapt.

Interpersonal skills

Being close to the client is the key. “We are going one step further by hiring professionals with different profiles, for example, people with interpersonal skills because we want to keep in touch with people,” said Ms. Cormier.

These are the qualities that have enabled Desjardins to resolve certain situations. Last year, a woman in her thirties who had been disabled since August 18, 2012 was experiencing, according to the medical report, difficulties adjusting because of problems at work. “In our form, we try to find out where the problem originates. The person had a secondary diagnosis of hypothyroidism with fatigue.”

The date for her return to work was undetermined, and the case was supposed to be reassessed on October 30th of the same year. “In the past, we would have waited until the next medical form to know what to do.”

But Desjardins took it one step further. “At the meeting in mid-October, our counsellor found that the person was not very comfortable with her position. The different parties were willing to discuss it. They arranged for the employee to return gradually. The employer agreed to modify her responsibilities while she applied for another position. When the parties are open to things and there are options available, everything comes together. The return to work went well and the employee now holds another position.”

In a second case from 2012, a young woman in her mid-thirties had been on disability since June 6th of that year because of difficulties adjusting to a new position. There had been performance issues, and she had obtained a less demanding job. The employee wanted a less stressful position. She has a medical history. The situation escalated into a harassment complaint.

After two meetings with the counsellor, a solution emerged: to reassign the employee to the same position she had in the past, but this time with limitations. The employer provided the employee with a two-week period linked to the insurance claim and two weeks of vacation as a transition. She agreed and then returned to work.

Damning statistics

The issue of absenteeism is significant, notes Ms. Cormier. In Canada, half a million Canadians are absent each day due to mental health issues, which cost more than 20 billion dollars per year.

In Quebec, 30% of absences occur due to mental health problems, she adds. “One statistic that has made a particular impression on me: 83% of employees hold their workplaces responsible for their psychological health. Employees have expectations, but each side has responsibilities towards the other,” she comments.

At Desjardins, absences for psychological reasons have a shorter average duration than those from physical causes, but they account for 31% of benefits paid.

“It is important to work on reducing the length of the absence, since the longer the employee is away, the more difficult it is to return. We go on vacation for four weeks and we are disoriented when we return. Imagine when it is an even longer absence, sometimes with conflict and a whole personal history in the background,” she says.

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