UNDERSTANDING DISABILITY

MANAGEMENT

WHY ARE WE HERE?

WHAT IS DISABILITY

Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a

problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or

action; while a participation restriction is a problem experienced by an individual in involvement in life situations.

Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she

lives. Overcoming the difficulties faced by people with disabilities requires interventions to remove environmental and

social barriers.

FACTS

FACTS

v  Full-time employees in the public sector (more likely unionized or female) lost more work time (12.9 days) in 2011 for personal reasons than their private-sector counterparts (8.2 days).

v  Full-time workers who belonged to unions or were covered by collective agreements missed more work days on average in 2011 for personal reasons than their non-unionized counterparts (13.2 versus 7.5) .

v  Workers with permanent jobs (more likely to be unionized) lost more work days (9.6) than those whose jobs were not permanent (7.0).

v  Days lost tended to rise with workplace size, increasing from a low of 7.5 in workplaces with less than 20 employees (firms more likely to have low union rates) to 11.1 in workplaces with more than 500 employees (firms likely to have high union rates).

FACTS

v  Days lost tended to rise with job tenure, with almost all of the differences arising from illness and disability. Employees with tenure of up to 1 year lost 6.2 days, while those with over 14 years lost 11.7 days (the latter group was also likely older).

v  As workers age, they tend to miss more days of work. This is influenced by illness and disability, not personal/family reasons.

v  Those aged 20 to 24 missed on average 5.9 days, compared with 10.3 days for those aged 45 to 54 and 13.2 days for those aged 55 to 64.21

v  The incidence of physical chronic disease increases with age, which contributes to increased illness and disability among this group.

FACTS

v Absenteeism is more than a human resources issue. It costs the Canadian economy billions of dollars each year. Unless organizations start proactively addressing absenteeism—beginning with better tracking of the number of absences and reasons for absences—this number will most likely increase as the workforce ages. By looking at absence patterns and identifying the causes of absences, organizations can put in place programs and policies to reduce absenteeism.

WCB

EXPERIENCE RATING ASSESSMENT 3 year window

Time Loss and Health Care costs

Discount or Surcharge off of the base rate

Industry classification

CLASSIFICATION Rate varies by industry classification

Rate group classifications are set by similarity of risk and overall activities of business

Industry rates are designed to equally distribute cost

Rates are quoted as an amount per $100 of payroll

Various rate groups based under one business with differing business activities.

HOW IT WORKS Summary of three years of experience with a one year lag i.e. Sept 2016 – 2014,2013, 2012

Each year is active and is reviewed for the full three years

Current year is weighted most heavily

CLASSIFICATION 2016 - Classification Unit 753004: Local Government and Related Operations Description of classification unit:  CU 753004

Sector: Public Sector

Subsector: Public Administration

Rate group: HS

Industry group: HS06

Base rate 2016: $2.03 per $100 of assessable payroll, to a maximum wage per worker of $80,600

Previous Rates: 2015 2014

$2.00 (maximum wage per worker: $78,600) $1.67 (maximum wage per worker: $77,900)

THE NUMBERS

2016 2015 2014 2013

$2.03 $2.00 $1.52 $1.42

$263,900 $260,000 $197,600 $184,600

v Group of approximately 200 EE v average salary - $65,000/year v Payroll $13M Here’s how the increases have impacted them:

Difference in base rate has cost the organization $79,300.

THE NUMBERS Introduce a slight surcharge of 10%:

2016 2015 2014 2013

$2.23 $2.20 $1.75 $1.62

$289,900 $286,000 $227,500 $210,600

THE NUMBERS Introduce a slight discount of 10%:

2016 2015 2014 2013

$1.83 $1.80 $1.37 $1.28

$237,900 $234,000 $178,100 $166,400

TOP CHALLENGES?

BILL 14 MENTAL HEALTH CLAIMS A worker is entitled to compensation for a mental disorder that does not result from an injury for which the worker was otherwise compensated;

v  Is a reaction to one or more traumatic events arising out of and in the course of the workers’ employment

v  Is predominantly caused by a significant work related stressor, including bullying or harassment, or a cumulative series of significant work related stressors, arising out of and in the course of the worker’s employment

v  Is diagnosed by a psychiatrist or psychologist as a mental or physical condition that is described in the DSM

v  Is not caused by a decision of the worker’s employer relating to the worker’s employment, including a decision to change the work to be performed or the working conditions to discipline the worker or to terminate the worker’s employment.

BILL 14 CLAIMS THE ACCLAIM SOLUTION

v Assessments available immediately v Network of psychologists and specialists available to

conduct assessments for an employee making a claim

v Acclaim receives the referral v Psychologist conducts assessment, and results sent to

case manager at Acclaim v Objective information to WorkSafe BC and case

management completed by Acclaim v Treatment plan implemented accordingly including

immediate RTW

WHAT AM I ALLOWED TO DO?

Involve the union?

Contact the employee?

Ongoing communication with the employee?

Create work to accommodate?

Question validity?

Touch base with the physician?

Review medical evidence?

WHAT AM I ALLOWED TO DO? There is an abundance of Canadian data available on the main reasons behind short- and long-term disability claims. However, it can be difficult to pinpoint the causes of casual or intermittent absences because the majority of employers do not track this type of information. There are also privacy laws in Canada that prevent employers from probing too deeply into the reasons for an employee’s absence.

WHAT HAVE YOU BEEN DOING?

EFFECTIVE DISABILITY

MANAGEMENT

NIDMAR v  Internationally recognized organization committed to

reducing the human, social and economic costs of disability.

v Follows an international standard practice established by the International Disability Management Standards Council (IDMSC) for measuring and implementing disability management programs and practices.

v Supported by Human Resources and Skills Development Canada (HRSDC) and the Workplace Safety & Insurance Board (WSIB).

COMMON STEPS IN THE DESIGN OF A SUCCESSFUL

WORKPLACE DISABILITY MANAGEMENT

IDENTIFYING KEY STAKEHOLDERS

IN THE DISABILITY MANAGEMENT

PROCESS

ESTABLISHING DISABILITY MANAGEMENT POLICIES,

PROCEDURES & PROGRAMS

DEVELOPING A COMMUNICATION

PLAN

DEVELOPING RETURN TO WORK

STRATEGIES

DETERMINING ACCOMMODATION

& TRANSITIONAL JOB OPTIONS

MANAGING OR OUTSOURCING

DISABILITY CLAIMS?

MONITORING & EVALUATING THE

PROGRAM

MONITORING & EVALUATING INDIVIDUAL

ACCOMMODATION & RTW PLANS

UNDERSTANDING THE COSTS

AUDIT FOR COST RELIEF?

TO OUTSOURCE OR NOT?

WHY WORK WITH A THIRD PARTY? 1.  Elimination of perceived conflict of interest between

management of performance and management of disability

2.  Independent review of justification of absence and duration. Verification of adequacy of information.

3.  Assessment of whether additional information should be requested.

4.  Determination of whether work place accommodations are required

5.  Development of suitable Return to Work program 6.  Access to multi-disciplinary professionals and

assessments

BENEFITS OF A THIRD PARTY? ü  Employee privacy protected with respect to medical

issues

ü No potential to mix medical issues with performance issues

ü  Professionals with knowledge to understand medical issues

ü  Professionals with an understanding of the physical demands of different roles and medical limitations of the unique situation

ü  Team dedicated to disability management (not balancing other responsibilities)

SELECTING A THIRD PARTY ü  Provider follows ‘Best Practices’

ü  Proper certification (e.g. NIDMAR)

ü  Staff with a wide range of specialties (e.g. Kinesiologists, Nurses, Registered Social Workers, Psychologists)

ü  Strong processes/policies/ measurement

ü  Focus on abilities vs. disabilities

ü  Knowledge of RTW vs. Restrictions

ü  Regular communication

ü  On-site intervention availability

PROVIDER

CHOOSING THE RIGHT PROVIDER

SERVICES

Attendance Management

Occupational Health & Safety

Workers’ Compensation Services

Independent Medical Evaluations

Short and Long Term Disability Management

Wellness Programs

WORKSAFE BC

Medical management of the claim continues with the goal of a return to regular duties

In LT cases, medical management of the absence is initiated with the goal of implementing a RTW Plan. Meeting with the Board may be required

EE reports workplace injury. Internal accident reporting procedures are followed

HR/Manager submits Acclaim ABSENCE NOTIFICATION FORM & sends to Acclaim with the Accident report & offer of Mod. Duties

File information is reviewed by the AMC. EE is contacted with 24 hours by Acclaim

Functional abilities information is received. Suitable modified work is reviewed with HR/Manager

Once the EE returns to full regular duties case management ends & the claim is closed

If interventions are required - business plans will be developed and presented

CM begins, EE contacted weekly, status updates provided to HR/Manager

Acclaim assesses limitations and opportunities to RTW with EE, treating practitioner and MGR

HR/Manager submits Acclaim ABSENCE NOTIFICATION FORM via email, fax or web submission

EE is contacted within 24 hours by Acclaim

Acclaim ensures that the employee has forms to submit to their doctor and timelines

Once medical information is received, Acclaim notifies EE and HR/Manager. Within 24 hours decision communicated to EE and HR.

6-8 weeks prior to LTD date, if appropriate LTD information sent to EE and notice to LTD provider.

If interventions are required - business plans will be developed and presented

SHORT TERM DISABILITY PROCESS

TOOLS

PROCESS

Onsite Clinical Psychiatrist/Psychologist

Psycho Social Screening

Identify & confirm mental health issue

Emotional & Psychological Questionnaire

Existing EAP Provider

Ensure appropriate treatment & plan is in place

Ongoing file review with clinical psychologist

Recommend intervention to assist in moving files forward (IME, community resources, EAP)

Monitor & communicate trends related to mental health claims

Pharmaceutical Consultation

MENTAL HEALTH CLAIMS

Motivational Interviewing

EMPLOYER

Potentially large exposure

Rating issues – potential for significant risk here

Many steps involved – accident investigation, claim initiation, claim management, RTW strategies…COMMUNICATION

EMPLOYEE

Appropriate diagnosis

Timely access to care and treatment

Understanding of complex system and support through navigation process

AND ANSWERS QUESTIONS

Thank you!