Workability in Michigan - Distortion and Abuse Reduction
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Transcript of Workability in Michigan - Distortion and Abuse Reduction
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7/31/2019 Workability in Michigan - Distortion and Abuse Reduction
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Workability In Michigan
Distortion and Abuse
Reduction in theStay At Work/Return To Work
Process
Revision: March 29, 2012
Author: WIM Workability In Michigan Distortion and Abuse Subgroup
Preventing Needless Work Disability byHelping People Stay Employed
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Workability In Michigan
What is WIM Workability in Michigan?
Advocacy group with a wide variety ofstakeholders.
Grass-roots approach to transform:
Disability benefits
Workers compensation systems and the
outcomes they produce.
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ACOEM GUIDELINES
American College of Occupational andEnvironmental Medicine (ACOEM)
Preventing Needless Work Disability by
Helping People Stay Employed
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Workability In Michigan
Recommendation 1
Adopt a Disability Prevention Model
1. Increase awareness of how rarely disability ismedically required
2. Urgency is required because prolonged time awayfrom work is harmful
NOTE: After 12 weeks off, an employee has only a50% chance of ever returning to work.
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Recommendation 2
Address Behavioral and CircumstantialRealities That Create and Prolong WorkDisability
3. Acknowledging and dealing with normal humanreactions
4. Investigating and addressing social and workplacerealities
5. Finding a better way to effectively address
psychiatric conditions6. Reducing distortion of the medical treatment
process by hidden financial agendas
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Recommendation 3
Acknowledge the Contribution ofMotivation on Outcomes and Make changesto Improve Incentive Alignment
7. Paying physicians for disability prevention work toincrease their professional commitment
8. Supporting appropriate patient advocacy by gettingtreating physicians out of a loyalties bind
9. Increasing real-time availability of on-the-jobrecovery, transitional work programs, andpermanent job modifications
10. Being rigorous, yet fair in order to reduce minorabuses and cynicisms
11. Devising better strategies to deal with bad-faithbehaviors
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Recommendation 4
Invest in System and InfrastructureImprovements12. Educating physicians on Why and How to play a
role in preventing disability13. Disseminating medical evidence regarding recovery
benefits of staying at work and being active14. Simplifying/standardizing information exchange
methods between Employers/payers and medicaloffices
15. Improving/standardizing methods and tools that
provide data for Stay-at-work and Return to-workdecision-making
16. Increasing the study of and knowledge about Stay-at-work and Return-to-work
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Distortion and Abuse Prevention
6. Reduce distortion of the medical treatmentprocess by hidden financial agendas;
7. Pay/reward physicians for DisabilityPrevention Work to increase ProfessionalCommitment; and
10. Be rigorous, yet fair in order to reduceminor abuses and cynicism.
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Workability In Michigan
Top 4 Abuses and Distortions
1. There is limited or no financial, productivity or other benefitto a manager or supervisor to participate in the Stay-at-Work/Return-to-Work process;
2. Physicians are often not paid or rewarded for their
participation in Stay-at-Work/Return-to-Work managementprocess;
3. The reimbursement/liabilities gaps between work-relatedand non-work-related benefits results in abuses to achieve
the most beneficial option; and
4. Treatment providers are chosen to manipulate the desiredoutcome.
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#1: There is limited or no financial, productivity orother benefit to a manager or supervisor toparticipate in the Stay-at-Work/Return-to-Work
process.
TYPICAL ABUSES AND DISTORTIONS:
Restricted workers are more burden than value in thework place.
Restrictions increase the burden on the employer
Managing disabilities requires extra time
Disability management is not reflected in departmentperformance assessment.
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#1: There is limited or no financial, productivity orother benefit to a manager or supervisor toparticipate in the Stay-at-Work/Return-to-Work
process.
REALITIES:
Supervisors/Managers lack RTW/SAW education. Duration of the absence changes motivations &
behaviors
Focusing only on financial and productivity demands
may not improve disability management. Disability management can often be inconsistent with
organizational culture
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#1: There is limited or no financial, productivity orother benefit to a manager or supervisor toparticipate in the Stay-at-Work/Return-to-Work
process.
RECOMMENDATIONS:
Educate managers and supervisors in SAW/RTW Establish measurable standards of performance
Hold managers & supervisors accountable formeasureable quality disability management.
Provide appropriate integrated programs to supportmanagers
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#2: Physicians are often not paid or rewarded fortheir participation in Stay-at-Work/Return-to-Workmanagement process
TYPICAL ABUSES AND DISTORTIONS:
Extra or fair compensation is not provided
Lack of a perceived value for participating
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#2: Physicians are often not paid or rewarded fortheir participation in Stay-at-Work/Return-to-Work
management process
REALITIES:
We should be compensating and rewardingPhysicians for efforts
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#2: Physicians are often not paid or rewarded fortheir participation in Stay-at-Work/Return-to-Work
management process
RECOMMENDATIONS:
Remember to say Thank You
Reward Physicians with repeat business
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#3: The reimbursement/ liabilities gaps betweenwork-related and non-work-related benefits results
in abuses to achieve the most beneficial option
TYPICAL ABUSES AND DISTORTIONS:
Workers Compensation versus disability plans
Benefit Durations Social Security Disability Insurance Impacts Medical Reimbursements
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#3: The reimbursement/ liabilities gaps betweenwork-related and non-work-related benefits results
in abuses to achieve the most beneficial option
REALITIES:
Workers compensation is statutory
Solutions are limited
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#3: The reimbursement/ liabilities gaps betweenwork-related and non-work-related benefits results
in abuses to achieve the most beneficial option
RECOMMENDATIONS:
Discourage plans that provide 100% pay while off
work
Consider Employee Funded Buy-Ups
Narrow gap between disability pay and WC
Manage time-off on non-work related disability topay for increased benefit
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Workability In Michigan
#4: Treatment providers are chosen to manipulatedesired outcomes
TYPICAL ABUSES AND DISTORTIONS:
Employees choose providers who conform to their
needs and wants; and
Employers choose providers who conform to theirneeds and wants.
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#4: Treatment providers are chosen to manipulatedesired outcomes
REALITIES:
There are treatment providers:
Who will keep employees off of work when notmedically necessary; and
Who will provide medical opinions that enablesystem manipulation.
There are also treatment providers: Who are reputable, skilled, and objective.
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#4: Treatment providers are chosen to manipulatedesired outcomes
RECOMMENDATIONS:
Identify and only select treatment providers who
are reputable, skilled, and objective; and
Educate employees.
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THANK YOU!
For more information or to get involved:
www.workabilityim.org
http://www.workabilityim.org/http://www.workabilityim.org/