Even in the best of times, managing absence and

disability presents both opportunities and challenges

for employers. And over the past number of months,

we have heard how employers are struggling with the

current economy and the impact that it is having on

employees who are away from work due to illness

and/or injury. Now, more than ever, it is critical that we

work together to focus on the fundamentals of disability

management. At Manulife Financial, we are here to help.

A number of factors affect long-term disability trends

and absenteeism in the workplace including, but not

limited to, the following: the industry you operate in,

the age of your workforce, and external factors

impacting your workplace such as lay-offs or work-

shortages. While there has been little long-term objective

analysis on the impact a recession may have on a specific

plan’s disability experience, research and our experience

at Manulife Financial suggest that group disability claim

incidence rates will climb and durations will increase.

More recent research suggests that in a quick economic

Benefits BulletinMay 2009

This information is intended to assist with the administration and management of group benefits plans. It is not intended for public use.

decline, absenteeism may actually improve as employees

are often nervous to be away from work; however,

returning employees to work is a challenge for

employers due to situations such as downsizing,

outsourcing, or shift reductions.

Listening to your concerns, Manulife Financial brought

together our network of experts in Group Disability and

Absence Management Solutions to provide a practical

resource for individuals in your organization who are

involved in your disability management program. This

resource highlights some of Manulife’s fundamentals

and our proactive strategies in disability management,

relating those strategies to opportunities in the current

economy. Inside this bulletin, you will find helpful tips

and tools you can use and share within your workplace.

As always, we welcome your feedback and we look

forward to working with you. Please contact your

Manulife Financial representative if you wish to discuss

this bulletin or explore strategies for your workplace.

Being WellConnected®

Donna Carbell joined Manulife in 2000 and holds an MBA from Wilfrid Laurier University.Donna has held a variety of senior leadership roles within Group Benefits and currently Donna is Vice President for our Life, Disability and Absence Management Solutions team.

Information Update for Group Benefits Plan Sponsors and Plan Advisors

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Manulife’s partnership withan employee and employerresults in a successful returnto work in a new andrewarding position

Colleen Bradbury is a graduate of the PhysicalEducation program at the University of NewBrunswick and is currently pursuing her Masters inDisability Management. Prior to Manulife, Colleenworked as Assistant Director for a comprehensiverehabilitation company managing their clinics inSouthern Alberta; as an Exercise Therapist; and as a Disability Health Consultant for a wide rangeof industries.

The challenge“Allan” was a 53 year old Able Seaman diagnosed

with bilateral Carpal Tunnel Syndrome, preventing him

from being able to continue the heavy physical demands

of his job in extreme, outdoor conditions. Allan was

scheduled for surgery in the next three to six months

and would remain away from work until his surgery

and treatment were completed.

Manulife’s Case Manager identified that Allan had a

lengthy 22 year work history in his occupation as an

Able Seaman, and his transferable skills were limited.

The Case Manager reviewed the file with the

Rehabilitation Specialist, who reinforced the importance

of returning Allan to his current role once he had

recovered in order to avoid a lengthy disability.

Following surgery, however, Allan’s medical outcome was

considered poor, and it was determined that he would be

unable to return to his current role on a permanent basis.

SolutionHaving already discussed the file with Manulife’s

Rehabilitation department, the Case Manager quickly

referred Allan’s file for rehabilitation assistance. This

helped Allan and his employer consider alternate

positions within the workplace which suited his new

physical ability. Following his recovery, the Rehab

Specialist, along with Allan, found a suitable alternate

occupation with his employer, a role that was not as

physically strenuous as Allan’s previous position. Allan’s

employer agreed to hire him into the new role if he

could complete the required training program.

ResultsManulife’s Rehabilitation department partnered with

Allan’s employer in sharing the cost of Allan’s retraining

and in supporting his gradual return to full-time work

five months ahead of plan. This, along with Allan’s

immense motivation and engagement, reinforced his

employer’s partnership with Manulife Financial. In

addition, there was a positive impact on the employer’s

plan experience. The LTD claim resolved approximately

5 months earlier than expected for someone who had

a permanent condition preventing him from performing

his own occupation.

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Identifying the ability in disability

Rebecca McPhee is a graduate of the HumanKinetics program at the University of Guelph andworked in a clinical setting for several years as aKinesiologist while working on her specialization inergonomics. Rebecca worked as an ergonomistconsultant in both office and industrial settingsbefore coming to Manulife Financial as a CaseManager. Rebecca’s current role with Manulife is as a Supervisor within our Absence ManagementSolutions department.

Canadian organizations spend an average of more than

$10.5 million a year in total absence claims (Watson Wyatt,

2007). Disability management is an effective tool to manage

the overall cost of disability to both an organization and

to the individual. The traditional approach to disability

management is to allow the ill or injured worker to recover

as much as possible before reintegrating them into the

workplace; however, an employee can have adequate

functional abilities to allow them to return to work before

complete recovery is achieved. Changing focus to look at

what an employee can do and supporting return to work

based on ability not only helps them to stay active and

productive, but will also help to speed healing times and

potentially decrease the chance of a long-term disability.

The functional approach to disability management focuses

on reintegrating the disabled worker in a safe and timely

manner. Doing so also minimizes the overall cost of disability.

The traditional modelHistorically, absences of ill or injured workers have been

managed using the “medical model” based on the premise

that diagnosis equals disability. This model focuses on

restrictions and limitations, and it can reinforce a disability

mindset in the absent worker by asking the question:

“What can’t you do?” The limitation in using the “medical

model” is that it seeks to restore an individual to “normal”

– a goal that may not possible with a chronic condition or

permanent disability. This model also encourages the

employee and employer to wait until the disabled

employee has reached 100 per cent recovery before

returning to work, unnecessarily prolonging the absence

and contributing to excess disability costs.

Focus on abilityThe Manulife WellConnected® approach to disability

claims management uses the “functional model” of

disability management. In contrast to the medical model,

this approach focuses on finding the “ability in

disability” or identifying the disabled worker’s abilities by

asking the question: “What can you do?” This approach

recognizes that work, as part of a normal routine, is an

essential part of a person’s health and well-being and as

such, uses work as an integral part of the rehabilitation

process. With a goal of maximizing an individual’s

function and ideally achieving a successful return to

work, the Manulife Case Manager ensures that care is

focused on recovery. Focus is placed on gaining an

understanding of your employee’s functional abilities as

they relate to the essential duties of their occupation.

Planning a successful implementation of any return to

work plan requires collaboration from the various

stakeholders in the process. You, as the employer, play an

integral role. Working closely with your Manulife Disability

Management team, you assist in not only identifying the

essential duties of your employee’s occupation, but also in

finding safe accommodations and/or modifications in the

workplace. Your Manulife Case Manger will work closely

with your employee and their treating physician(s) to

identify their functional abilities and will partner with you

in developing creative solutions to bring about a safe and

timely return to work.

Reducing costsCost savings become even more important when

organizations and individuals feel increasing economic

pressure. Incidence of disability is observed to rise in

times of economic hardship and uncertainty, so finding

ways to decrease the costs of disability is that much

more critical. Successful reintegration of ill or injured

workers, and consequently the decrease of both

disability costs and the financial burden to the worker,

can be achieved by following the functional model of

disability management. Focusing on collaboration and

communication among all stakeholders in the process,

Manulife’s WellConnected approach is an effective tool

to decrease both the human and economic hardships

of disability.

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Absence Management Access

Being WellConnected® in turbulent times

Godfrey Jerry came to Manulife Financial in 2002with a Bachelor of Science degree and experience infunctional ability evaluations. Godfrey has a range ofexperience in disability and is currently a Supervisorwith the Absence Management Solutionsdepartment of Manulife.

In today’s economy, employers are looking at their group

disability plan to ensure it provides them with value while

continuing to provide their employees with the benefits

they require. Short term disability absences during this

time will continue to occur; however, the duration of

these absences can be addressed by being

WellConnected® and ensuring that effective early

intervention practices are in place.

For employers that self-insure and administer a salary

continuance plan for short-term disabilities, Manulife’s

Absence Management Access (AMA) allows an

employer to tap into Manulife’s network of disability

experts to manage an absence and/or accommodation

during the salary continuance period as they need it.

A multi-disciplinary team of Case Managers, each with

a health care background, will be available upon request

to speak to the ill or injured employee about their

disability and identify the issues that are preventing an

employee from returning back to work. AMA also

provides access to the variety of external experts and

treatment providers Manulife partners with throughout

the life cycle of a claim.

Seeking the assistance of a Manulife Case Manager

will provide an employee with third party support to

assure employees that their privacy is maintained during

this difficult time in their lives and allow the employee to

openly identify what is affecting their absence and/or

ability to return to work. The Case Manager will work

with the employee and their physician to identify both the

medical and non-medical issues impacting their return to

work. Non-medical issues are factors that have no medical

basis, but contribute to an employee’s absence and could

hinder return to work, such as interpersonal conflicts with

colleagues or supervisor, social issues like child or elder

care or training gaps that have not been addressed and

are creating a stressful work environment because the

employee is not working efficiently or productively.

Communication is essential to this program and the

employer is regularly updated and coached on next

steps, accommodation opportunities, and return to work

planning. By accessing this early intervention resource,

the employer may decrease the duration of an absence,

support the employee in a safe and timely return to

work, and as a result can reduce the costs associated

with disability. By accessing Manulife Financial as a

resource in managing the absence, employers can focus

on the core competencies critical to the success of their

business, but also be assured that their employees are

well-connected to the support they require.

Plan Sponsor Statementcompletion

Amy Williams is a graduate of the Kinesiologyprogram at the University of Western Ontario. Amy brought her experience in clinical settings, aswell as her background as a rehabilitation specialist,to Manulife. Amy progressed through the AbsenceManagement Solutions department of ManulifeFinancial as a Case Manager, Specialist andSupervisor. Amy’s current role is as Supervisor ofour National Disability Practices team.

Frequently asked questions The Plan Sponsor Statement is a critical component of

the overall new claim assessment for long term disability

benefits. Here are some commonly asked questions and

answers that will assist with the completion of this form:

Q: What is a Plan Sponsor Statement?

A: A Plan Sponsor Statement is a form that provides

information regarding your employee’s benefit

coverage, earnings, work schedule and work duties.

This form is required as part of your employee’s

application package for disability benefits with

Manulife Financial. It is used by the Case Manager

as part of the assessment of the claim.

Q: When do I complete the Plan Sponsor Statement?

A: The LTD Plan Sponsor Statement should be completed

6 to 8 weeks prior to the date your employee is

eligible to receive LTD benefits, or as soon as you

know that your employee will not be expected to

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return to work prior to this date. This form should be

completed even if your employee has applied for, or has

been accepted for, a worker’s compensation benefit.

Q: Who completes the Plan Sponsor Statement?

A: The Plan Administrator for your group is required

to complete this form; however, the information

regarding the work duties (Sections 14-18) should be

completed in conjunction with the employee’s direct

supervisor/leader if the Plan Administrator is not

familiar with the occupation and specific work duties.

Q: How long will it take me to complete this Plan Sponsor Statement?

A: The length of time to complete this form will depend

on the details that are readily available regarding your

employee. The work duties section (Sections 14-18)

should take 10 to 15 minutes to complete.

Q: What are considered primary job duties for my Employee?

A: Primary job duties (otherwise known as essential duties)

are duties that, if removed or modified, would prevent

your employee from being able to perform the

occupation or the requirements of the job. For

example, an employee may help out their team by

unloading boxes when their co-worker is on lunch,

however, this would not be considered an essential

duty of their own occupation. If you have a detailed job

description for your employee you should consider

including this for the assessment.

Q: What if I am unable to answer some of thequestions on the Plan Sponsor Statement?

A: If you are unsure of an answer on this form, it is

recommended that you keep it blank and discuss it

further with your Case Manager when he or she

contacts you.

Q: What is a physical/psychological demands analysis (PDA)?

A: A PDA is a formal document that quantifies and

evaluates all of the physical, psychological and

environmental components of a job. It will break down

the occupation into individual tasks. If you have a

document such as this for your employee, please

include it with your Plan Sponsor Statement.

Q: How does Manulife use this information in its assessment?

A: The completion of the Plan Sponsor Statement is a

critical component of the Case Manager’s assessment

process. Along with the Plan Member’s Statement

completed by your employee, the Case Manager will

use this information to determine benefits coverage,

earnings, and work schedule. The Case Manager will

also use this information to determine the essential

duties of your employee’s occupation and compare it

to your employee’s activities of daily living and overall

level of functioning.

Q: Why is the Case Manager asking more questionswhen I have already completed this form?

A: The information provided in this form is critical to the

Case Manager’s assessment, so they may contact you

to seek additional information or clarify discrepancies

between the information provided in the Plan

Sponsor Statement and that in the Plan Member

Statement. For example, an executive assistant

identifies climbing stairs as an essential duty for their

occupation, however, the employer does not indicate

this on the form and it has become the main

limitation in preventing a return to work. Through

conversations with both parties, the Case Manager

identifies that the stair climbing was not an essential

part of the employee’s occupation since this task was

only completed to provide refreshments for board

meetings on an upper floor. In addition, the Case

Manager may contact you to explore opportunities

for accommodation of your employee’s restrictions

and limitations on a temporary or permanent basis.

Q: What type of information should I include under“Other information”?

A: Upon completion of the Plan Sponsor Statement, if

you have any additional information that you would

like to share with your Case Manager it should be

provided here. Any information regarding other

factors that may be affecting your employee’s ability

to return to work (e.g. performance or interpersonal

issues, lay-offs, home/lifestyle issues, etc.) should also

be included in this section.

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Disability dictionary: essential duties

Susan Mitchell is the Manager of Trainingobjectives and initiatives for Group Disability. Susanhas over 20 years experience in both group andindividual insurance in a variety of leadership roles.

Understanding the essential duties your employees are

required to perform is critical in assessment of disability.

The Disability Case Manager assesses whether the

functional limitations of your employee prevent him

or her from performing the essential duties of their

occupation; and further, if any accommodations could

be made to help the employee return to the workplace.

What are “essential duties”?Essential duties include physical and cognitive duties

that are required for the performance of an occupation

and which cannot be reasonably omitted or modified.

They are fundamental to the job and are performed at

a frequency and duration that, if modified or omitted,

would not permit the employee to fulfill the

requirements of the occupation.

How do we determine the essentialduties of your employee?This component of our disability assessment is intended

to be a collaborative effort between Manulife, you as

the Plan Sponsor/Employer, and your employee.

Together, we can work toward a safe and timely return

to the workplace. There are several ways that your Case

Manager can gather information to determine the

essential duties of your employee:

a) New claim assessmentYour Case Manager will work closely with you and

your employee to determine those duties that would

be considered essential. The work information and

job requirements portions of the initial Plan Sponsor

Statement that you complete are critical to this

assessment. The member’s statement completed by

your employee will also provide information about

the essential duties of their occupation.

b) Telephone interviewUpon receipt of your employee’s claim forms, the

Case Manager may have additional questions about

the duties outlined on the form. At Manulife Financial,

we believe that using the telephone to communicate

with you and your employee is efficient, timely and

helps to ensure that there are ‘no surprises’. As part of

the New Claim Assessment, the Case Manager may

conduct a telephone interview with you and your

employee to better understand the essential duties,

available accommodations, and whether there are

opportunities for an early return to the workplace.

We recognize that there may be situations where you

do not have first hand knowledge of the duties an

employee performs. If it is appropriate, your Manulife

Case Manager will speak with your employee’s direct

supervisor for additional clarity on essential duties.

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c) Additional ResourcesIf your Case Manager requires further clarity about

the essential duties of your employee’s occupation,

there are additional resources to support this process.

A Physical Demands Analysis (commonly referred to

as PDA), which assesses the specifics of the

employee’s occupation at your workplace and the

National Occupational Classification (NOC) are

valuable tools available to your Case Manager.

Essential duties case studyThe new claim assessment completed by the Case

Manager indicates that the employee is a laborer, who is

required to inspect packages. From the work information

and job requirements portions of the Plan Sponsor

Statement, the Case Manager identifies that the

occupation requires frequent standing and/or walking,

lifting 0 – 10 lbs frequently, and carrying 21 – 50 lbs

infrequently. Based on the functional medical assessment

the employee is able to lift up to 15 lbs.

The Case Manager contacts the Plan Sponsor to clarify

the essential duties and the discussion reveals that the

employee inspects 1 lb packages. He takes a package

from a box next to his workstation, inspects the package

and places it on a conveyer belt. Four times daily the

employee lifts a box that weighs 24 lbs (24 X 1 lb

packages are in each box) from the central work area to

his work station. This function occurs only if the

employee needs additional packages to inspect while a

co-worker takes his break.

In this illustration the lifting of 24 lbs is not an essential

duty. The employee is able to complete the inspection of

1 lb packages without lifting 24 lbs. The duty is

infrequent, and only required when the co-worker takes

a break. The co-worker could ensure that the box is at

the employee’s workstation before he takes a break.

ConclusionClearly understanding the essential duties of an

employee’s occupation enables the Case Manager to

facilitate workplace accommodation and accurately

complete the claim assessment.

Disability dictionary: job ready

Michelle Faassen began her career at ManulifeFinancial in 1995 and progressed through both the short-term disability and long-term disabilityCase Manager roles, becoming a DisabilitySpecialist in 2000. She has been a Trainer andSupervisor who has managed one of our long-termdisability teams dedicated to a large financialservices client. Michelle has worked with ourToronto and National Corporate clients since 2006.

Successfully managing your workplace absences calls

for a close partnership between you as the employer and

Manulife as your disability case management team. It is

important we work closely to achieve our common goal

– to return your employees to healthy living and to assist

them in getting “job ready”.

What does it mean when youremployee is “job ready”?Your employee is considered job ready when he or she

is medically, functionally and vocationally ready to return

to work. Whether this means a return to his or her own

occupation, a modified or alternate job with you, or

re-entering the workforce with a different employer,

the following three elements are being continually

reviewed by your Manulife Case Manager to create a

proactive plan with you and your employee.

Medical reviewManulife Financial respects the role of the treating

physician and/or specialist in a safe and timely return to

work. Case Managers don’t ask the physician whether

an employee can or cannot work, as the doctor may

not be aware of your employee’s occupation, work

history, or prior education and training. The Case

Manager will rely on the physician’s assessment and

diagnosis and ensure treatment is evidence-based and

appropriate to promote recovery. Manulife believes in

working with the treating physician to support any work

hardening or return to work initiatives that will assist in a

healthy recovery and ultimately improve your employee’s

level of functioning.

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Functional review The Manulife Case Manager takes the information

received from the treating physician and/or specialist and

reviews the employee’s abilities along with his or her

restrictions and limitations and compares them to the

essential duties of the employee’s occupation (please

reference Disability Dictionary: Essential Duties).

Sometimes there may be a gap with regards to the

employee’s ability to perform the essential duties of his

or her occupation. In this situation, your Case Manager

will work closely with you and your employee to

determine if accommodations could be made to allow

them to return to meaningful work in a safe and

appropriate manner.

Vocational reviewIn other situations, where your employee may have a

permanent functional restriction and cannot return to

your workplace, “job ready” means looking at what they

can do in consideration of their prior education, training

and experience. Based on this information, they may be

able to perform at alternate occupations outside your

organization, or if necessary, we may provide vocational

support to increase your employee’s chances of being

able to perform alternate jobs in the workplace. During

the ‘own occupation’ time period, if there is no work for

your employee to return to (i.e., due to restructuring/

layoff etc.), your Case Manager will assess your

employee’s functional ability to return to the essential

duties of their own occupation.

Job ready in action:A 45 year old assembly line worker with English as

a second language was unable to work following a

heart attack. While this employee was off work

recovering from his condition, the Case Manager

was informed by the employer that, unfortunately,

the employee’s role became redundant. The Case

Manager assessed that during the ‘own

occupation’ timeframe the employee was

functionally unable to perform the essential duties

of his own occupation. As part of their assessment

for the employee’s ability to perform any

occupation, the Case Manager recognized that a

gradual work hardening program would be

beneficial for his recovery and therefore referred

the employee to a Manulife Rehabilitation

Specialist. The Rehabilitation Specialist worked

closely with the employee’s family doctor and

cardiologists to ensure the employee was placed in

a cardiac rehabilitation program with a focus on

vocational rehabilitation. During this program, the

Rehabilitation Specialist also had the employee

participate in an English training program to

improve language skills. Upon recovery, the

employee was able to successfully return to a

different occupation with a new employer.

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Disability dictionary-workhardening

Sean O’Neill is currently the Director of theVancouver Group Life & Disability operationsfollowing his experience as a RehabilitationSpecialist and Rehabilitation Supervisor withinManulife Financial. Sean came to Manulife with a degree in psychology and experience as aKinesiologist. Sean currently sits on the BritishColumbia Collaboration for Health, Productivity and Disability Management.

Returning to work following an extended absence can,

even at the best of times, be overwhelming. Think of

how overwhelming this return might be for an individual

who continues to experience symptoms related to an

illness or injury. There are many strategies you can adopt

to retain top employees and keep them engaged in the

workplace. Work hardening is a strategy that supports

your employees while they transition back into the

workplace and gradually improve their level of

functioning following their time away from work.

What is work hardening?Work hardening is a program that is strategically

designed to help workers re-enter the workplace and

perform either regular or modified work duties. Your

employee is able to perform work tasks and increase

his or her work duties as function gradually improves.

This creates opportunities at the workplace and might

include work tasks within their own work area, or a

completely new area. It may also include training as

part of their new role.

Work hardening is often confused with work conditioning,

which is a program designed by health care providers like

Physiotherapists and Kinesiologists to improve function in

a clinical setting, focusing on specific exercises and work

simulation activities.

Why consider a work hardeningprogram?Rather than lose an employee who is familiar with and

trained in many aspects of your business, you could

retain that employee by developing their abilities to work

in another area. Work hardening is one way of testing

their function, providing them with an opportunity to try

new things, and gaining skills on the job. It is also a cost-

saving effort as the employee is positively contributing to

your business and not solely receiving a disability benefit.

How does Manulife work with myemployee when there is no job forthem to return to?Work hardening works with employers and employees

to assist an employee to return to a job with their

current employer. This is ideal, as the employee already

knows and understands your business. At times,

however, workers who are away from work do not

have a job to return to. Perhaps they have been laid-off,

or their role has become redundant due to restructuring.

When this happens, it can be a very trying experience

for your employee as they lose their routine and sense

of accomplishment.

When focusing on a return to work to any occupation,

Manulife Financial will work with that employee and

help them find alternate vocational opportunities.

Although there may be no job available with their

current employer, the employee may be capable and

have the skills to perform other jobs. In these cases,

Manulife will help them engage in functional

improvement and skill development for the purpose

of securing alternate work. This may include volunteer

programs or resume development. It may also include

career counselling and job search activities. As employees

learn from these types of scenarios, they build upon

their skill sets, enabling themselves to become active,

productive employees once again. During the assessment

of your employee’s ability to return to their own

occupation, if there is no job for your employee to return

to, your Case Manager will assess your employee’s

functional ability to return to the essential duties of their

own occupation to determine eligibility for benefits.

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Illustration:Mary had a successful career as a nurse for many

years. She also had a long standing drug abuse

problem that began at the age of 12, and was off

work for a prolonged period of time due to her

abuse and depression. Her addiction was so

significant that she engaged in prostitution.

Mary’s claim was referred to a Rehabilitation

Specialist with Manulife Financial in an effort to

facilitate treatment. Her recovery process was

long and she had many relapses, though eventually

she showed some signs of abstinence. The

Rehabilitation Specialist supported Mary through

refresher courses and had her volunteer at a local

community centre. She then began a job search

and was successful in securing a very good job as

a nurse in a local care centre. Following up with

Mary a year later, she remained abstinent and was

still gainfully employed in the centre.

The evolution ofaccommodation: the newgeneration of creativity

Victoria Jollimore is a graduate with her Mastersdegree in Kinesiology and is currently pursuing herMasters in Business Administration. Victoria came toManulife Financial 10 years ago with a backgroundin a clinical setting and as a private rehabilitationconsultant. Victoria’s current role with Manulife is asthe Manager of the Halifax Group Life and Disabilityoperations and currently is a member of theCanadian Pension and Benefit Institute.

Intuitively, we know that having healthy and productive

employees in our workplaces is the best case scenario for

everyone involved. As an employee, work is part of our

identity and, besides paying the bills, being gainfully

employed offers a sense of pride and accomplishment.

From an employer’s perspective, having healthy

employees who are at work and contributing is the key

to success. What can quickly confound this thinking is

the external pressures companies experience when

economic times are tough. From an employer’s

perspective there are several key benefits to

11

accommodating those who are not present at work due

to illness or injury. These benefits include reduced plan

experience, lower staff replacement costs (e.g., hiring

and training), increased productivity, and positive

employee relations. There is no doubt that in harsh

economic times systems are challenged. However, it

becomes more important than ever for employers to

experience the positive by-products of supporting their

employees’ return to work.

According to biologists, evolution is a process that

creates traits that are helpful for survival. In this

economic environment, success hinges on our ability

to use creativity and offer new solutions to the familiar

exercise of accommodating employees as they return to

work from an illness or injury. Accommodation strategies

need to evolve to survive. Creativity is the single most

important element. Implementing a “hierarchy of return

to work priorities” is a great strategy for channeling your

creative energy.

Hierarchy of RTW prioritiesOnce the hierarchy is established, it is important to

ensure the options associated with each priority are

developed in such a way that it becomes a process of

elimination. The key is exhausting all possibilities before

moving to the next priority. This is where your creativity

comes in.

1. Pre-disability roleThe first priority should always be to return an

employee to their pre-disability occupation. A return

to the role an employee knows produces the most

successful results. The expectations are familiar, there

is little or no training required, and the manager

has a good understanding of how the employee

performed in the role prior to his or her disability.

So, the employee is returning to what they know

best and there are no surprises. The familiar role

and expectations make it easier to fine tune the

return to work plan and create the most potential

for a successful result. When developing the return

to work plan it may be discovered that the employee

requires modifications to the job and/or the hours

worked – either temporarily or permanently

depending on the employee’s prognosis for

further improvement.

2. Alternate role with current employerThe second priority is to consider returning an

employee to another occupation that matches their

ability to function within your organization.

This change may allow the employee to return to

work full time with no restriction more quickly.

However, modification of hours and/or duties may

be required temporarily or permanently to bolster

the employee’s level of function. Again, the length of

the modifications will depend on the prognosis for

further improvement.

3. Work trialA third priority may be to provide a work trial to

gain more information about the employee’s level of

function. In this scenario, the employer develops a

creative combination of duties and responsibilities,

each uniquely designed for a particular employee.

The goal is that the work offers real value to the

organization. In the absence of value, there is little

motivation on the part of the employer to

accommodate, the employee may not experience a

much needed sense of accomplishment, and the

perceptions of his or her colleagues may be harmed.

This alternative allows the employee, employer, and

even physicians to learn more about realistic, long-term

options for return to work.

Manulife’s Disability Management Consultants,

Case Managers, Rehabilitation and Return to Work

Specialists are available to provide their expertise to you

in developing a hierarchy of return to work priorities,

creative solutions or if you have questions about your

role in supporting accommodation.

12

Accommodation quickreference

By Amy Williams

The following is a quick overview of some of the job

accommodations that may be useful in returning

someone to work following an injury or illness.

Remember that this list is not exhaustive and appropriate

accommodations depend on the specific individual, his

or her impairments and your business needs.

Physical accommodationsA motor skill is an action that involves the movement of

muscles in the body. The following is a list of fine and

gross motor accommodations you may want to consider

to facilitate a safe and timely return to work for these

types of impairments.

Fine motor impairment

Fine motor skills are smaller actions that require more

dexterity (e.g., keyboarding, reporting, documenting,

and gripping).

• Implement an ergonomic workstation design

• Provide alternative computer access

(e.g., speech recognition software, foot mouse)

• Provide alternative telephone access

(e.g., voice amplifier)

• Provide writing and/or grip aids

• Provide a page turner and/or book holder

• Provide ergonomic tools, tool balancers, and

tool wraps

Gross motor impairment

Gross motor skills are larger movements involving the arm,

leg, or feet muscles or the entire body (e.g., reaching,

bending, lifting, transferring, sitting, walking, or climbing).

• Rearrange items so that heavy and frequently used

materials are accessed at waist level

• Raise individuals or lower materials to comfortable

working levels

• Provide aerial personal lifts, rolling safety ladders, work

platforms, lift tables, height adjusters, reachers, and

order pickers

• Provide area and time for stretching prior, during, and

after scheduled work

• Allow transition between sitting and standing

• Provide mobility aid if walking cannot be reduced

(e.g., scooter)

Cognitive accommodationsCognitive restrictions and limitations may present with

both psychological and non-psychological conditions.

The following is a list of cognitive accommodations you

may consider to facilitate a safe and timely return to work

for these types of impairments.

Fatigue/weakness

If fatigue/weakness is a barrier for an individual’s return

to work you may want to consider the following

accommodations.

• Reduce physical exertion and workplace stress

• Schedule regular rest breaks

• Provide a flexible work schedule and/or option to

work from home

• Modify work schedule to gradually achieve full-time

hours and/or duties

• Implement ergonomic workstation design

13

Maintaining concentration

Please reference: Manulife’s Workplace Solutions

for Mental Health website for return to work guides

(http://groupbenefits.manulife.com/canada/GB_V2.nsf/

public/mh_employer)

• Reduce distractions in the work area

• Relocate to a quieter area (while being careful not

to isolate)

• Allow for use of white noise or environmental

sound machines

• Increase natural lighting or provide full spectrum

lighting

• Reduce clutter in the employee’s work environment

• Plan for uninterrupted work time

• Divide large assignments into smaller tasks and steps

• Restructure job to include only essential functions

• Modify the way instructions or feedback are given

(e.g., written instructions)

Stress management difficulties

• Refer to employee assistance programs

• Allow modified daily schedule with frequent breaks

• Provide a self-paced workload

• Modify supervisory approach (e.g., additional praise

and weekly meetings)

• Provide a less stressful job (e.g., decreased

accountability, social interaction)

14

7 key strategies to a successful return to work(RTW)

By Colleen Bradbury

Returning an ill or injured employee to work is an

important and sometimes complex process. However,

with timely actions and an appropriate support system

the Return to Work (RTW) process can progress smoothly

for all parties involved.

It is critical for workers to know that they are valued

members of a workforce. Paying attention to the

psychosocial needs (support, self esteem and mood) is

crucial, perhaps even more so than the physical aspect in

some cases. RTW plans are most successful when applied

through proper planning, evaluation and commitment to

success. With the proactive support outlined here, you

can arrange a RTW program that meets both your

business requirements and your employees’ needs.

1. Be informed and communicate – Early in the onset

of a medical absence from work the employee should

be properly informed of the organization’s disability

plan and the benefit application process. Reducing

any additional stress should be the focus at onset as it

may otherwise interfere with the recovery process.

2. Monitor and stay connected – Monitor the care of

the employee through Manulife Financial, as well as

any problems with benefits, treatment, and family, etc.

If issues arise, work to resolve them quickly to avoid

any additional stress or barriers to RTW. Remain in

regular contact with the employee. Doing so will

reinforce to your employees that they are valued.

This can be achieved appropriately by having co-

workers, union members or other organizational

representatives connect with the worker.

3. Begin the process of planning RTW early –

It doesn’t have to be perfect, but through early planning

of a RTW framework you can be better prepared to

consider accommodation. Working with your Case

Manager and your employee will help you understand

the barriers that may be present, while considering your

workflow designs, staffing needs, collective agreements,

and business demands. Advance preparation in the early

stages can open the way for a problem-free RTW when

the employee is cleared to do so.

4. Set the stage – Prior to the RTW effective date,

communicate with your management team, the co-

workers, any potential clients, and your employee to

ensure that they feel ready and welcome to return.

Confidentiality constraints may affect the detail of

information shared, but you can clear the way for a

more successful RTW by communicating the needs

and guidelines of the plan ahead of time. Frequently,

a meeting with your employee, direct manager,

rehabilitation specialist, and HR representative may be

recommended to plan a successful RTW.

5. Implement the plan – The RTW is best designed

when it returns the employee to his or her pre-

disability position through a progression of either

work time or work duties (depending on the nature

and extent of any functional restrictions). Most RTW

plans are no longer than six weeks, and in many

instances are shorter.

6. Address issues as they arise – It is normal for your

employee to encounter some difficulties as the RTW

plan progresses. It is a best practice to address these

issues as they arise (at the worksite if at all possible)

and modify the RTW plan rather than send your

employee home.

7. Monitor and evaluate – Regular contact with

the employee, direct manager, and Manulife Financial

will ensure greater success as you take an active role

in the process. Consider asking the participants

for feedback when the RTW plan is complete.

Doing so will only benefit future planning and lead

to greater success.

Workplace solutions formental health

Peter Varela is currently the Director of DisabilityPractices at Manulife Financial. Through his 15years experience in group disability and 20 yearsexperience in the industry, Peter has assumedvarious leadership roles within operations and litigation.

Mental health is one of the dominant issues in the

workplace affecting the lives of millions of Canadians

and their families. Mental illness costs the Canadian

economy more than $51 billion a year in lost

productivity, direct medical costs, and reductions in

health-related quality of life.

In response to the growing concerns about mental

health in the workplace and its affect on absenteeism

and disability, Manulife has created a practical, outcome-

focused approach to mental health that provides

resources for you and your employees called Workplace

solutions for mental health.

Workplace solutions for mental healthManulife provides just-in-time tools as part of our

case management and return to work process. Case

Managers deliver these tools to front line managers,

human resources and other employer representatives

when they need it most. In addition, Case Managers

will also provide tools and resources to help employees

better understand and deal with mental health issues.

The tools are available through Manulife’s website:

http://groupbenefits.manulife.com/canada/GB_V2.nsf/public/mh_intro

The following link takes you to Return to Work –

Manager’s Guide. This is an example of one of the

interactive tools available for you to watch when you

have an employee returning to work. This tool will help

you better understand your role in making an employee’s

return successful:

http://events.snwebcastcenter.com/manulife/GBMentalHealth/RTW_Manager_course/

WellConnected® is offered through Manulife Financial (The Manufacturers Life Insurance Company).

Group Benefits products are offered through Manulife Financial (The Manufacturers Life Insurance Company).© 2009 The Manufacturers Life Insurance Company. All rights reserved.

Manulife Financial and the block design are registered services marks and trademarks ofThe Manufacturers Life Insurance Company and are used by it and its affiliates includingManulife Financial Corporation.

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