Disability management: best practices well known but seldom applied

By Alain Castonguay | December 02 2014 11:10AM

The direct cost of absenteeism in businesses was estimated at $16.6 billion in 2012. Insurers can help employers adopt best practices in human resources management to shorten disability leave.At the 16th Solareh convention in Mont-Tremblant, Quebec, Michelle Verschelden director, Life and Disability Settlements, Group Benefits at Industrial Alliance, Insurance and Financial Services, presented data on absenteeism gathered by the Conference Board of Canada. Average absenteeism per permanent job was 9.3 days per year in 2011. The average rate has hovered at between nine and ten days since 2002.

The Conference Board survey of 401 companies in June 2012 also finds that barely 46% of respondents say they know the absenteeism rate in their business, and only 15% claimed to know the costs. Absenteeism is highest in the 55 to 64 age group, averaging 13 days per year per employee.

“Most employers are aware of the problem, but many do not measure their absenteeism rate. If you don’t measure it, you won’t act.” Absenteeism awareness is higher at larger companies, which tend to have collective agreements and labour relations departments, she points out.

Another study shows that the longer the disability leave, the poorer the chances of return to work. After 12 weeks, the probabilities of return to work are barely 50%. After half a year, they plunge below 20%. The proportion of long-term disabilities linked to mental illness is constantly rising, Verschelden adds.

Mental health

Regardless of duration, an estimated 30% absences are linked to a psychological health problem. This proportion reaches 50% of disabilities for unionized federal government employees. In 2013, in the group plan of a very large commercial client of IA, about 60% of long-term disabilities were associated with psychological or mental health problems. Drawing on her 25 years’ experience in group insurance, Verschelden says “off the top of my head, about 40%” of disabilities are caused by psychological conditions.

Organizations that want to introduce an absenteeism management program face myriad challenges. Prevention is costly and is rarely a priority, Verschelden notes. Managers sometimes lack the tools or knowledge, and healthcare is
difficult to access. The capacity to accommodate employees who are returning to work is not always evaluated well.

Commitment by top management is crucial, she insists. An absenteeism management program often identifies “presenteeism” – employees who are present but not productive. “When we notice this, we can take actions to prevent this problem from ending in disability,” she says.

Poor implementation

Many employers are unaware that a person who returns to work after suffering a disability linked to a mental health problem may experience cognitive aftereffects. Employer ignorance can then trigger a relapse, Verschelden says.

The industry may know about best practices but does not always apply them, Verschelden points out. In disability management, frequent telephone contact with disabled employees and an action plan that favours return to work are the most important practices, she says. Insurers can help a business prepare for employees’ return to work by considering temporary or permanent functional limitations.

The insurer also relies on rehabilitation experts to ease an employee’s recovery. Verschelden mentioned the case of an employee assigned to reception and shipping who took leave because of a back sprain coupled with a herniated disc. The rehabilitation team helped the person find appropriate care, leading to a return to work in good health.

Some psychological health problems are not linked to the work context. Personal problems may also prevent employees from working.

Verschelden gave the example of a 49-year-old mechanic whose home was burned down. This hardworking employee had been at the same company for 30 years. His boss worried that the disabled employee was taking time off so that he could work on rebuilding his home, which was false.

Return to work

In fact, snags with claim settlement and litigation with the municipality created adjustment problems. After his medication was adjusted, the employee was gradually able to return to work in a less stressful position.

Often, a work conflict caused by a minor accident can trigger a major depression in someone grappling with other personal problems. Caregivers are particularly susceptible to this. Verschelden mentioned the case of an employee who had to take care of his ailing mother. Through preparatory work and cooperation from the attending physician, the insurer convinced the employer to move the employee to another subsidiary, where he could be closer to his mother.

The insurer is there to help employers manage temporary disability. For permanent disability it plays its more conventional role of insurer. “There’s not always a happy ending, but most cases end in successful returns to work,” Verschelden concludes.

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