Disability Management Best Practices

DISABILITY MANAGEMENT

Prepared and presented by: Darlene Doricic, B.A., CHRP

Workplace Health and Safety

Bios Darlene Doricic –

• 20 years of experience in several areas of disability management including disability claims adjudication, vocational rehabilitation consulting, and provincial government disability plan administration

• Bachelor of Arts degree

•Certificate of Proficiency in Employee Benefits (CEB)

•Dispute/Conflict Resolution training

•Certified Canadian Human Resources Professional (CHRP)


Awards and Accomplishments


• 2015 Excellence in BC Health Care: Award of Merit for Workplace Health Innovation

• 2015 Canadian HR Awards Finalists for Best Health & Wellness Strategy

• 2014 Canadian HR Awards Finalists for Best Health & Wellness Strategy

• 2010 Excellence in BC Health Care: Award of Merit for Workplace Health Innovation

• 2009 Excellence in BC Health Care: Award of Merit for Collaborative Solutions

• 2008 Excellence in BC Health Care: Golden Apple Award Workplace Health Innovation

• Presenter 2013 Vocational Rehabilitation Association of Canada National Conference

• Presenter 2010 Absenteeism, Accommodation and Disability Management

• Presenter 2010 Vocational Rehabilitation Association of Canada National Conference

• Presenter 2009 BC Health Authorities Employee Health & Safety Conference

• Presenter 2008 WorkSafe BC Conference

June 27, 2013 VRA Canada Conference


Disability Management • Disability Management is a proactive approach to helping injured or ill

employees recover and return to safe and productive work activities as soon as medically possible. Disability Management and early, safe return to work programs have been shown to greatly benefit the recovery of an injured or ill employee.

• The DM programs help the employee maintain income and benefits, retain employment and job skills, and maintain self-esteem, family stability and social ties. They also help to maintain a positive and supportive connection between the employer and the injured or ill employee. The DM programs help the employer by reducing employee turnover and lost time; reduced hiring and training costs; and increased employee morale and productivity.


Roles and Responsibilities DM Professional

• responsible for the development, implementation, maintenance and evaluation of the Disability Management program

• provides case management services that encompass assessing, planning, implementing, coordinating, monitoring and evaluating options available to meet an individual’s health needs

• promotes return to work efforts, early identification of disability claims for coordination of services, and developing modified/alternate work opportunities to mitigate absences due to occupational and non-occupational injury/illness

• Collaborates with HR Professionals, Managers, Union Representatives, Insurance carriers, etc… to ensure integration of services that promote the highest level of physical and mental health for staff

• Advises on the application of the Human Rights legislation as it pertains to the ‘duty to accommodate’ & disabilities

Qualifications of a DM Professional

• Bachelors Degree in a health discipline such as Occupational Health Nursing, Kinesiology, Physiotherapy or Occupational therapy plus five (5) years related experience in a large multi-union environment and/or an equivalent combination of education, training and experience

• Demonstrated knowledge of disability management principles and practice

• Expertise in relevant regulations and legislation and disability management principles and practice.


Roles and Responsibilities HR Professional

• Provides labour relations expertise and knowledge of collective agreements

• Assists with identifying suitable alternative work placements

• Prepares employment contracts/agreements as needed for accommodation placements

Manager/Supervisor

• Provides ongoing support to Employees participating in DM programs

• Encourages RTW and Stay at Work programs

• Supervises work performance and advises DM Professional if Employee is having health related difficulties

• Encourages co-worker participation and acceptance

• Provides options for RTW, job modification and accommodation

Union Representation

• Provides support to employees referred to the DM program

• Meets with Employees at worksite to familiarize them with the terms and conditions of the GRTW and encourage the employee as well as support of other members on site

• Maintains confidentiality of personal information

• Encourages and promotes the identification of either temporary or permanent positions suitable for the accommodation of Employees

• Ensures the rights of all Employees under the collective agreement are maintained


Disability Management Programs

• Early Absence Support (EAS) – Attendance Management

• Occupational DM (work related incidents) - WorkSafeBC (WSBC)

• Return to Work/Stay at Work (Gradual, Modified, Transitional, Trial)

• Duty to Accommodate (DTA) for Alternate Work Placements

• Long Term Disability (LTD)


What is Early Absence Support (EAS)?

• DM professional triages all Employees identified with high level of unplanned sick leave

• Triage involves an extensive phone discussion (approx 30 minutes) with the Employee to review:

• the reasons they are unable to work,

• eligibility for sick leave,

• possibilities for full or modified return to work,

• eligibility for other DM programs

• Manager expected to maintain contact with Employee as a regular part of personnel management however should be supportive in nature & limit discussion to support operational needs


What is Proof of Illness?

1. Nature of Disabling Illness/Injury

(specifics or diagnosis not needed);

2. Following a treatment plan (specifics not needed);

3. Prognosis for safe return to work.

4. Functional limitations/restrictions can also be requested if accommodation is being explored as part of the proof of illness.


Stress Leave/Bill 14 • In the absence of an actual health diagnosis ‘Stress’ is a normal part of everyday

life as are all emotions (managers should discuss other forms of leave with the Employee).

• Managers should never recommend ‘Stress Leave’ as it is a leave which does not exists and confuses the employee about leave entitlements. If time off seems appropriate, then suggest to the Employee that they can take the time off but for it to be considered sick leave, they must be under the care and treatment of a medical practitioner.

• It may not be all about the Employee and their perception, Managers should take time to assess the work environment.

• Whether sick leave or Bill 14 WorkSafe BC claim, specific proof of illness always includes:

– DSM V Diagnosis; Confirmation the Employee is in treatment and compliant with treatment; Prognosis for Return to work


Occupational DM (work related incidents)


All occupational injuries/illnesses are managed on a urgent basis to reduce WorkSafe BC claim costs as well as avoid potential negative consequences to Employee’s claim as a result of delays.

WorkSafe BC Overview • Eligible to all casual, permanent, full or part time Employees whether

contract or not

• Claims are only approved when there is a direct link between the illness/injury and action taken as a normal part of duties

• No-Fault insurance – WorkSafe BC will not decline claims for poor safety practices or when Employees do not follow procedures as this is the Manager’s responsibility as part of performance evaluation and management

• Accepted claims will cover Time Loss (i.e. Wage Loss), Medical Aid or Health Care Only

• Time Loss claims are paid to Employees by WorkSafe BC at a rate of 90% of pre-injury wage for all contracts


WorkSafe BC Facts • WorkSafe BC premiums are invoiced to the Employer annually

• WorkSafe BC premiums are based on an Experience Rating:

The Experience Rating -

o It is based on the Employer’s safety performance (i.e. incident rate) when compared against the industry average.

o Injury rate is defined as the number of claim incidents

o claims duration is the average time employees are off work due to an injury/illness

o If the Employer’s safety performance is less than industry average, the premiums are reduced. If the Employer’s safety performance is higher than the industry average, the premiums are increased.

Early safe return to work plans are the #1 method of mitigating costs associated with WorkSafe BC premiums.


Return to Work /Stay at Work Program

The Canadian Medical Association supports physician recommendations for appropriate RTW plans as noted:

• “Prolonged absence from one’s normal roles, including absence from the workplace, is detrimental to a person’s mental, physical and social well-being. Physicians should therefore encourage a patient’s return to function and work as soon as possible after an illness or injury, provided that the return to work does not endanger the patient, his or her coworkers or society. A safe and timely return to work benefits the patient and his or her family by enhancing recovery and reducing disability.” (Canadian Medical Association, 2001. p.1)

The American Psychiatric Association Committee on Psychiatry in the Workplace noted:

• “Maintaining function is integral to recovery from illness. It is part of medical treatment…Time off must have a specific medical function, such as avoiding weight bearing on a broken leg or spending time in a day hospital program. Unstructured time off does not in itself heal. In fact, the structure of everyday, including getting dressed and going to work can be very therapeutic.” (American Psychiatric Association Committee on Psychiatry in the Workplace, 2004 p, 9-10)


Return to Work /Stay at Work Program

• should never be approached with a one size fits all method

• coordination treated with urgency and priority (within two business days of medical clearance)

• should be productive and essential

• should be monitored by the DM Professional for safety and progress

• monitored by Manager/Supervisor for performance

• Minimizes the disability mindset

• Hurt vs. Harm


Duty to Accommodate(DTA) Program (Alternate Work Placement)

• Program supports and coordinates alternate work for Employees with permanent, chronic and/or prolonged limitations and restrictions as a result of a disabling condition.

• Collaboration between DM, HR, Manager, Union and Employee

• Challenge is finding timely, meaningful and suitable work placement as sick leave/WorkSafe BC or LTD costs increase while Employee is awaiting return to work opportunity

• The longer an Employee is away from work, the more likely psychological barriers (i.e. disability mindset) will impact the success of a return to work


Know your Long Term Disability (LTD) plan

• What are the costs/premiums, administrative fees, etc…? Monitor for increases/decreases in costs in conjunction with your DM program

• What additional services are included in the LTD costs/premiums (i.e. rehabilitation services, pre-LTD early intervention services)?

• What is the relationship with the LTD carrier (silent, collaborative, other)?

• What type of relationship do you want?


Long Term Disability (LTD) Facts

• It is NOT cost effective to delay or prolong LTD claims or LTD sponsored RTW plans for non-medical/safety reasons (i.e. performance or contractual issues)

• It is NOT cost effective to request LTD fund equipment or assessments (i.e. IME or FCE)

• It is NOT cost effective to not have a collaborative relationship with the LTD carrier (i.e. your DM professional is ensuring the insurance carrier is acting in the best interest of the employer and the LTD plan)



• Front line costs are far less than the potential cost of an STD/LTD claim or Sick Leave.

• Managers must consider that the Employee is earning sick leave pay while off work and this cost can be reduced with an earlier return to work.

• Allow Employee s to recover while at work as work duties can often emulate a work hardening/conditioning program.

• The side effect is improved Employee retention through engagement and morale as the Employee feels valued even at a time of difficulty.

• An Employee on a Return to Work plan, even if only working and producing at 50% capacity, is still a benefit to the Employer as well as contributing to speedier recovery for the EE

#1 MOST EFFECTIVE TOOL IN REDUCING SICK TIME AND STD/ LTD COSTS!

Why manage sick leave?

BC Human Rights Duty to Accommodate Disabilities. Disability is a protected ground in all areas covered by B.C.’s human rights legislation.

Disability is not defined in the legislation but has evolved to include protection for people who have, or are perceived to have, mental or physical disabilities whether visible or non-visible, permanent (e.g., a visual or mobility impairment), or temporary (e.g., a treatable illness or temporary impairment which is the result of an accident).

The duty to accommodate is well-established in case law and requires employers and service providers to accommodate special needs short of undue hardship, including those of people with disabilities. While employers and service providers have a legal duty to accommodate, those seeking accommodation also have a corresponding obligation to participate in finding an acceptable solution.

BC Human Rights Coalition

http://www.bchrcoalition.org/files/GroundsProtection.html#Disability


http://www.bchrcoalition.org/files/GroundsProtection.html

http://www.bchrcoalition.org/files/GroundsProtection.html

Measuring a Successful DM Program

Compare Key Performance Indicators on a yearly basis *Overtime use often increases in reaction to high sick leave uses. Employers must consider employee demographics – aging population of workforce particularly in high paid/low education occupations (i.e. unionized labourers/skilled labour) are difficult to accommodate and often result in high sick leave and LTD usage.


PLAN Civilian Costs

% of Civilian Operating Budget

Sworn Costs

% of Sworn Operating Budget

WorkSafe BC (premiums)

$ % $ %

Sick Leave $ % $ %

*Overtime $ % $ %

Long Term Disability

$ % $ %

Common Challenges of DM • Employers will sometimes try to direct a case to the end result they want, rather then the fair and

reasonable resolution.

• Employers will perceive Employees with chronic health conditions resulting in high absenteeism as ‘scamming the system’

• Employers will use employee’s medical reasons against them as a form of managing poor performers.

• Employees feel they are being harassed if Manager calls them while on sick leave

• Co-workers are recognizing sick leave misuse – sense that nothing is happening which sends the wrong message

• Some Doctors will write anything the employee wants on sick notes

• Collective Agreements make it difficult to support alternate/modified return to work plans/accommodation

• Pressure to implement last minute insurer sponsored RTW plans

• Departments do not see the benefit in supporting return to work plans vs. waiting for Employee to be 100% recovered

• Difficult to find alternate work placements


True or False 1. Managers should not communicate with Employees on sick leave as this is

considered harassment. - FALSE

2. Sick leave is an entitlement. - FALSE

3. Calling in sick to stay home for family obligations is not acceptable. - TRUE

4. With Manager approval, sick leave can be used as vacation time. - FALSE

5. Employees should take sick leave to cope with emotions after a difficult workplace interaction (i.e. performance management or interpersonal conflict). - FALSE

6. A Doctor’s note is always valid proof of illness. - FALSE

7. Stress does not equal ‘sick-leave’. - FALSE

8. The longer an Employee is on sick leave, the harder it is to return to work. - TRUE


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Disability Management Best Practices

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