|
|
Business
and Health® Archive
Jan. 20, 2003
Benchmarking:
What Works in Disability Management
You don't need
to reinvent the wheel to get better results at lower costs. Instead, find out
what your peers are doing.
Disability management is already recognized
as a common sense way to reduce lost time after injury or illness, increase
productivity and improve operational performance. In other words, companies
seek to decrease the amount of time ill and injured employees are off work
— and the consequent costs — while preserving the earning power
of the employee.
Essential components of disability management
include interventions at the onset of injury or illness, job accommodations
to promote retention and productivity, and preventive steps to reduce further
lost time and minimize the impact of disability. More recently
"evidence-based outcomes" have provided corporate managers with
clear choices in best practice standards.
The direct link between integrated disability
management and workplace productivity was highlighted in the report,
"Staying @ Work: Integrated Disability Management Around the World
2000/2001," by Watson Wyatt Worldwide. "Integrated disability management
maximizes employee contributions to the success of the company and reduces
cost associated with employee absenteeism," the report stated.
What we know about
return-to-work programs
When illness or injury keeps workers off the
job, the costs to employers escalate in a number of significant ways: lost
productivity, increased worker compensation costs and potentially expensive
litigation. Returning the worker to the job in a safe and timely manner is in
the best interest of all concerned. Many large employers use early
return-to-work (RTW) programs, under which ill or injured workers are
transitioned back into the workplace, often with modified duties,
accommodations or temporary light-duty assignments elsewhere in the company.
The benefits are not lost on the Ohio Bureau
of Worker's Compensation, which offers incentives to companies that develop
RTW programs that include outcome-based practices. "Our experience has
shown us that there are key steps that both large and small companies can
take to develop effective return to work programs," said Donald Shrey,
MD, president of Advanced Transition, Inc., who has helped over 50 companies
in Ohio develop RTW programs. Those necessary components include:
"clearly defined and documented procedures that describe the program in
detail, identification of key individuals who are responsible for early
contact and involvement with the injured worker, and a program that has
timelines and identified goals that relate to productive work."
As disability management continues to evolve,
there are abundant opportunities for companies to learn from each other's
best practices. As in the past, mid-sized and smaller companies can adapt the
successful strategies and programs of large firms. "In my experience,
many small companies or organizations just deal with problems as they present
themselves, and don't necessarily have a plan for potential issues that might
arise," observed An Brunelle, a consultant with Disability Management
Specialists in Glendale, Calif. "By benchmarking large companies, which
are usually more experienced in disability management issues, smaller firms
could discover insights to being more proactive," added Brunelle, who is
also a Commissioner with the Certification of Disability Management
Specialists Commission (CDMSC).
Integrated disability
management practices
Larger companies, too, likely will benefit
from benchmarking the best practices of trail-blazing firms as they move to
the next phase: integrated disability management (IDM), which seeks to
coordinate and centralize health- and disability-related coverage and
benefits.
IDM may begin with simple steps, such as
broadening eligibility for the RTW program to include non-occupational
illness or injury. Further, an integrated approach may establish a single
point of contact for all health- and disability-related absences, regardless
of how and where they occur. On a more sophisticated level, there is seamless
integration of worksite practices, health and disability benefits, and
preventive programs such as safety and wellness. The goal is to limit
employer costs, improve services to employees, promote workplace productivity
and minimize absenteeism.
When it comes to benchmarking, however, how
can companies begin the process? Sometimes it's as easy as asking the right
questions. Janna Calkins, a California-based certified disability management
specialist and consultant, told of a West Coast industrial firm with 5,000
employees that benchmarked 15 other firms when it began its RTW program
several years ago. "We looked at how these other companies had set up
their return-to-work programs," she recalled. "It was very helpful
to know the way companies created their programs or to be told about the
stumbling blocks that they encountered."
In time its comprehensive disability
management program, which received support from upper management, resulted in
a reduction of more than 1,000 lost work days at a savings of more than $1
million in lost-time costs. In subsequent years, the proportion of lost time
cases fell from 1.45 to 0.35 per 1,000 employees, while lost workdays fell to
7.54 from 26.15 per 1,000 employees, Calkins noted.
A best practice
approach to disability management
To start the benchmarking process, companies
should begin with published information on the particular issues and trends
that other companies have faced. The Occupational Safety and Health
Administration (OSHA) offers in-depth information on operational and
administrative guidelines in developing ergonomic programs and responding to
workplace injuries on its web site. Consulting firms such as Watson Wyatt
also publish studies on disability management, absence management and related
topics. Further, the Workers Compensation Research Institute has cost-benefit
information and outcome data concerning a variety of disability management
and other workplace issues. The general public has access to abstracts, while
full texts are available to members. (See Resource Links at the end of this article.)
Professional journals may be a source of
company-specific information, particularly in articles written by managers at
large companies. While large companies readily share mission statements and
some general information about disability management, many of them consider
the details about how their programs function to be proprietary information.
"There is some very useful information about there in the public domain,
including positive results that companies have realized from their
programs," Lui added. "However, some of the information may be
anecdotal."
Trade associations can be helpful, as both a
potential source of studies and information on workplace issues, and also to
provide a forum to "network" with other companies. Through a trade
association, for example, you may be able to develop a relationship and
exchange information with peer companies. Consultants may also be helpful,
particularly for mid-size and small firms. They are usually knowledgeable
about practices and approaches that have been adopted by a variety of firms
and can tailor programs to the needs of smaller employers.
Once you have contacted a company regarding
its disability management program, some of the questions that should be
raised include:
- Are disability management programs provided by a
third-party provider or managed in-house?
- Are the programs overseen by certified
disability management specialists who have the work experience and
educational background to handle the variety of issues that may arise
in workplace disability?
- Is there a formal RTW program, and if so, how is
it organized and managed? What is the average time that employees spend
in the program?
- If an employee is assigned to a temporary
assignment elsewhere in the company under RTW, who pays the salary
cost? The employees "home" department, the department he/she
is assigned to, or is there a separate fund?
- Has the company adopted any integrated
disability management practices, such as allowing all ill and injured
workers to qualify for RTW?
- Is there joint labor and management involvement
in the development and monitoring of disability management approaches?
How are other stakeholders integrated into the program?
- Does the company offer employee assistance
programs (EAP) to provide help and/or resources to workers with
personal, family or medical problems? Can EAPs be integrated into
wellness, prevention and similar programs to decrease absenteeism?
- Does the company track the cost and benefits of
its disability management programs? If so, how?
- Do their insurance carriers offer benefits such
as reduced premiums or other incentives for having RTW programs that
decrease overall disability claims?
Keep in mind, however, that companies cannot
simply adopt another firm's model or program. Each company has its own
culture, union and employee issues, medical management, and workplace needs,
which make it unique. There is no "band-aid" approach that can be
applied from company to company. "There are a lot of pieces that have to
be put together for each specific company," Lui added. "You can't
think that one piece will solve your whole problem."
The predominant thinking at many companies,
unfortunately, is that disability management should be handled either by the
human resources department or by the risk-management department, and never
the twain shall meet. If a company outsources to a third party for disability
management services, the assumption may be that it's best left in the hands
of the "experts." The problem, however, is that "knowledge
silos" are created within the human resources department or at the
insurance brokers, which work against consolidating or integrating disability
management.
One of the downfalls of these silos is the
inherent lack of communication between the human resources or risk manager,
which may be handling disability claims, with behavioral managers in charge
of the EAP program. With an integrated team approach, companies can spot
recurring incidents among certain employees who, for example, have multiple
work-related injuries or illnesses over a period of time, or who are frequently
absent. When communication improves among these parties, referrals can be
made to help the employee deal with a health or personal issue.
Collaboration between
employers and workers
Active participation of both employees and
employers is a significant factor in the success of disability management
programs. "Joint labor/management involvement is essential in the
development of a transitional work program, whether the workplace is
unionized or not," Shrey finds. Breaking down knowledge silos and
creating a team that acts for the greater understanding of the importance of
disability management are vital for the success of future programs. For
example, companies that have a unionized workforce may seek to have labor
representatives involved in discussions of how an ill or injured worker can
be accommodated or placed on temporary assignment. Further, when employees
feel that they are part of the disability management solution, programs and
participants become even more proactive.
After the RTW program was implemented at the
West Coast industrial firm, Calkins said employees took it upon themselves to
notify the company when they were scheduled to have surgery and to request
placement in the program.
The significance of collaboration in managing
disability at the workplace is best evidenced through a recent global
initiative. A multifaceted approach, bringing together employers, labor
representatives and government officials, was taken on the international
level, with the drafting of the "Code of Practices on Managing
Disability in the Workplace," under the auspices of the International
Labour Organization, which is part of the United Nations. The objective of
the Code, which was formally adopted in late 2001 and is being reviewed by
several large U.S.
firms, is to provide "practical guidance on the management of disability
issues in the workplace." (See Sidebar.)
For companies that adopt the Code of
Practice, the emphasis will shift from merely complying with legal standards
such as the federal Americans with Disabilities Act (ADA) to a more proactive
approach of integrated disability management that seeks to benefit both
employer and employee. Further, by analyzing and adopting best practices in
disability management, companies can be better assured of meeting the
requirements of state disability laws, which are in some cases more stringent
than ADA. California's disability laws, for example, far exceed
the ADA
requirements, and any company with operations or employees in that state must
comply with these stringent state statutes. (See Disability Legislation: State Laws May be Tougher than
Federal ADA)
As companies move forward with their
disability management practices, it's important to see them not as a
"quick fix" or a "compliance issue," but as viable,
productivity-related programs. Luckily, smaller firms that are adopting
disability management practices or larger firms that are moving to greater
integration of disability and medical benefits don't have to go it alone. Through
benchmarking and best practices, there is a wealth of information available
on what some companies have experienced, the obstacles they've overcome, and
the benefits that they've reaped.
Norman Hursh is a
Commissioner of the Certification of Disability Management Specialists
Commission ( www.cdms.org ), the only nationally accredited certifying body for
disability management specialists. He is also Associate Professor in the
Rehabilitation Counseling Department of the Sargent
College of Health and Rehabilitation
Sciences at Boston
University. He directs
the graduate specialization in Vocational Evaluation and also in Disability
Management. Further, he is the Director of Rehabilitation Services at the
Sargent Clinic at Boston
University.
Resource
Links:
Draft Code of Practice on Managing Disability in
the Workplace
http://www.ilo.org/public/english/employment/skills/disability/draftcod.htm
Certification of Disability Management Specialists
Commission
http://www.cdms.org
The Occupational Safety and Health Administration
(OSHA)
http://www.osha.gov
Watson Wyatt Worldwide
http://www.watsonwyatt.com
Workers Compensation Research Institute
http://www.wcrinet.org
ILO Code of Practice on
Managing Disability in the Workplace is a Reality
By Norman Hursh, Commissioner
Certification of Disability Management Specialists Commission
An international code for disability
management is the first of its kind to offer guidelines and practices that
will effectively enable people with disabilities to integrate into the
workplace. The Code of Practice on Managing Disability in the Workplace
was adopted by a tripartite meeting of employer, worker and governmental
experts selected by the Governing Body of the International Labour
Organization (ILO) of the United Nations in November 2001.
For employers, the Code establishes practice
standards in disability management that will contribute to improved return to
work outcomes for workers who are injured or disabled.
As a long-time professional in the disability
management field, I believe the Code takes a significant step in addressing a
wide range of employment issues that challenge employers and people with
injuries and disabilities, including recruitment and hiring, employment and
job advancement, and job retention and return to work. The Code provides a
blueprint for action both for the small employer who wants to be proactive in
developing workplace disability management programs, and the larger company
who operates in many states and different countries.
Key points underlying the Code are:
- With the right skills, in the right job, with
supports where required, people with disabilities are capable and
reliable employees, an asset to their employers
- Managing disability issues in the workplace is in
the business interest of employers, leading to savings in terms of time
lost, insurance and health care payments, and costs of recruiting and
retaining workers
- Retaining people who acquire a disability while
working means that the employer retains experienced workers, with valued
expertise, in whom considerable investments have been made
- Effective workplace disability management
practices based on evidence, best practices and experience enable
workers with disabilities to contribute productively in the workplace
- A comprehensive disability management strategy
should include provisions for recruitment, retention, promotion, return
to work, as well as adjustments and accommodations where these are
required
- Effective disability management relies on
cooperation among employer organizations, worker organizations, and
government organizations
Norman Hursh. Benchmarking:
What Works in Disability Management. Business and Health 2003;1.
Copyright © 2003 and published by Medical Economics Company at Montvale, NJ
07645-1742. All
rights reserved.
|
|