Disability Management – Advantages of Early Intervention

Posted by:

As an employer, manager or HR representative, it is often tempting to give an employee as much space as they need when they are off work for an injury or illness.  They need time to recover before returning to work, right?

Statistics show that the length of a person’s workplace absence due to illness or injury increases the longer they are off.  For example, the chance a disability will continue for at least 5 more years when the disability has already continued for one year is 38.5%, for someone age 32, and it increases to 49.2% when the disability has already continued for two years.

Early intervention in the claims management process is key in reducing lost time for work and non-work related injuries and illnesses.  This early and on-going contact can assist in identifying and resolving barriers to a successful return to work.  In the early stages of a disability claim, the manager or HR Representative should be in regular contact with the disabled employee, providing them with the information required to apply for disability insurance or Worker’s Compensation.   The employee should be advised of how their disability plan works and should know if their employer will support solutions like a gradual return to work schedule or modified duties, until they are able to resume their regular duties.

As the employer representative, it is important to focus on the capabilities and restrictions of the individual who is off work, so that a return- to- work plan that accommodates their capabilities can be created. Once detailed medical information is received by the insurer or by your office (if you administer short-term claims in house), a decision can be made on the level of intervention needed.  If an employee is diagnosed with a serious illness and will be off work for a lengthy period (for example, a heart attack, stroke, or cancer), regular communication should be maintained but can be less frequent.  If the disability is more subjective and will likely be of short duration, regular and frequent communication is needed.

It is also worthwhile to explain to the employee the definition of disability and how that definition applies with respect to your plan (i.e. do you have an ‘own occupation’, ‘any occupation’ definition or something else).  Claims that are more subjective in nature can be difficult to adjudicate and can result in the employee failing to meet the definition of ‘Total Disability’ under your plan provisions.

Early intervention accomplishes three important things: firstly, it allows you to maintain contact with the disabled employee and ensures you are kept in the loop on their status; secondly, it gives you an opportunity to provide solutions and alternatives that will allow the employee to return to work earlier, and finally, it signals to the disabled employee that you care about their condition and that their claim will continue to be actively managed.

If you have a short-term disability program administered through an insurance company, ensure that early intervention is a part of the insurer’s claims strategy.  If you administer short-term disability in-house, you have a few options with respect to early intervention.  You can intervene early through your human resources team, occupational health team, or the employee’s manager, or you can leverage your long-term disability insurance provider to assist with difficult claims on a fee for service basis.

Does your benefits consultant offer Plan Member Advocacy?  If they do have this advanced service offering, you can leverage your consultant to assist in early intervention on your behalf.  Using your insurer or consultant to work with your disabled employee as an independent third party is advantageous as it keeps you at arm’s length and reduces potential for human rights conflicts or violations of confidentiality.

Ultimately, the most successful return to work plans involve employers (and employees) who communicate well and have the most flexibility in developing workplace accommodations that meet the needs of all involved parties.