Week 12 - Disability Management and Return to Work

Question 1

Disability Management in the real world

Answer 1

• A professional team’s success can hinge on its injury list.
• Sidney Crosby suffered two on-ice hits to the head in 2011.
• Sidney’s initial return to competitive play wasnot sustained; however, he was able to return following proper disability management.

Question 2

Purpose of Disability Management

Answer 2

• prevent workplace injuries and illnesses
• facilitate successful return to work for injured employees
  –> not the same as worker’s comp function as an insurance program
  –> focus: how to manage work-related disability during recovery and during resumption of work activities

Question 3

Three Motives for Disability Management

Answer 3

financial motives, moral and social motives, legal motives

Question 4

Financial Motives

Answer 4

• 317 million workplace accidents occur worldwide per year
• workplace disability costs about 4% of global GDP
• Canada cost: direct costs 9.7 billion, indirect 19 billion
• disability management can help to reduce costs associated with injury and illness

Question 5

Employer Benefits for proper disability management

Answer 5

• minimizing the costs of disability
• a quicker return to previous productivity levels
• reduced work delays
• improved employee morale
• retaining skilled employes
• improvement in the company’s reputation and image
• reduced training costs
• may help reduce insurance costs
• avoiding litigation

Question 6

Moral and Social Motives

Answer 6

• doing what is right
• many people do want to return to work and resume their lives
• emotional and health costs are higher when not working (higher rates of depression, social exclusion)
• work is a source of meaning, identity and social support

Question 7

Legal Motives: duty to accommodate

Answer 7

• HAVE to accommodate workers who are attempting to return to work following an injury or illness
• change job tasks (no heavy lifting, administrative-focused work)

Question 8

Undue Hardship

Answer 8

• Component of human rights legislation that means employers must accommodate the needs of a disabled worker unless the necessary modifications would lead to health and safety difficulties or present unsustainable economic or
  efficiency costs
• There is no precise legal definition – will be different in every organizational context
• E.g., the specialized equipment needed for
  accommodation would bankrupt the company

Question 9

Employee Responsibilities

Answer 9

• inform when accommodation is needed and when it is no longer needed
• need to cooperate in finding suitable accommodation (may require flexibility)

Question 10

Employer Responsibilities and Challenges

Answer 10

• ensure the workplace is inclusive
• inform employees of their rights
• hard to determine what accommodations are appropriate
• hard to know what’s undue hardship (case by case)

Question 11

Re-employment obligations

Answer 11

• based on worker’s compensation acts so it differs provincially, not everyone “needs” to be rehired

In Ontario
* the worker has been “unable to work” as a result of the work-related
injury/disease
* the worker was continuously employed with the injury employer for at least
one year before the date of injury, and
* the injury employer regularly employs 20 or more workers.

Question 12

Federal / Provincial Acts protecting those with disabilities

Answer 12

• Currently, no federal act protects those with disabilities
  but can be protected from discrimination (Charter of
  Rights and Freedoms)
• Provincial legislation / – Ontario: Accessibility for
  Ontarians Disability Act (AODA)
  – Law that sets out a process for developing and enforcing safety standards
  – Began in 2005, still not fully implemented…
  – Ontario had pledged to be fully accessible by Jan 1, 2025
• Critics: Still nowhere near “fully” accessible
• Lack of enforceability built into the Act

Question 13

Disability Management definition

Answer 13

Proactive employer practices to
prevent or reduce workplace disability,
intervene early to reduce risk of injury,
and provide coordinated management and rehabilitation functions to promote workers’ recovery and safe and
timely return to work.

Question 14

Systems Approach

Answer 14

an approach to disability management that emphasizes the work and organizational context, not on individual employees

Question 15

Primary Values for Disability Management Programs

Answer 15

• safe and productive employment for individuals, including those with disabilities
• reduced incidence and impact of workplace injury and illness

Question 16

Indicators of Program Success

Answer 16

• decreased rates of incidents and illness
• shorter duration of work disability
• reduced associated costs (e.g., wage replacement)
• sustained return to work
• improved quality of life

Question 17

People-focused Climate

Answer 17

• values human resources and supports safety initiatives
• employees have a voice in the program
• all employees should be educated on relevant policies
• injured employees should feel welcomed
• injuured employees should be given an active role in their own rehab and accomodation decisions (empowerment)

Question 18

Prevention Focus

Answer 18

• start by: examining employer’s safety records (common injuries? jobs/work sites that report frequently?)
• efforts to reduce the incidence of illness/injury
• prevention efforts that reduce the incidence of illness/injury result in cost savings for organizations
  e.g., offering massage therapy as occupational benefit - can result in fewer sustained injuries

Question 19

Early Intervention

Answer 19

• reduce risks for injury/illness
• looks for patterns in absence data and intervene
• make contact with injured workers 1-2 weeks within when incident occurred
• express care for well-being NOT for blame/return to work pressure
• findings: increased perceptions of fairness which led to greater organizational commitment, better mental health outcomes

Question 20

Role of Supervisors

Answer 20

• play important roles in prevention and return to work. they need to be trained in all aspects of the programming
• be inclusive, supportive, involved and patient with reutn ro work
• work with return-to-work coordinator to implement job changes, bring others up to speed if these changes affect
  them
• Important for coworkers to not feel resentful if modification
  negatively impacts their own workload

Question 21

Return to Work (RTW) Case Management

Answer 21

• co-ordinated services for ill and injured employees
• goal: to enhance injured worker’s quality of life and reduce costs associated with care
• return-to-work coordinator: help to bridge the injured, supervisor and relevant medical professionals

Question 22

Integrated Claims Management/Monitoring

Answer 22

• when injured and must leave work, must submit a claim to benefits program
• facilitates insurance claims process and streamlines claims process/rtw experience for employees
• keeps database of relevant information
  e.g. PepsiCo’s Absence Management Program

Question 23

A Case Study at PepsiCo Canada

Answer 23

• One of Canada’s Top 100 Employers
• Single leave management system for all types of leaves
• Employees can access links to a centralized system that
  incorporates referrals to additional employee supports
  (e.g., EAP)
  – Reduced paperwork and reporting
• Successful program—employees feel supported and
  understand why absences matter

Question 24

Return-to-work coordinator

Answer 24

person who is responsible for return-to-work case management

Question 25

Return-to-work planning

Answer 25

– Collaboratively developed, plan that identifies an injured or ill worker’s return-to-work goals – Should outline timeline targets, actions required by the employer and employee, and health care needs. – Individualized plans that have specific timelines are the most effective

Question 26

Workplace Accommodation

Answer 26

– Modifications to the arrangement of work that promote early and safe return to work for injured, ill, or disabled workers – Vital aspect of RTW planning – Among the most cost-saving strategies in disability management

Question 27

Light-duty work ## Footnote type of workplace accommodation

Answer 27

* Workplace accommodation where workers return to a job that is less demanding than their previous job

Question 28

Gradual work exposure (or work hardening) ## Footnote types of workplace accommodation

Answer 28

A type of light-duty accommodation where job demands slowly increase until the workers are performing the full requirement of their pre-injury jobs

Question 29

Work trials ## Footnote workplace accommodation

Answer 29

* A form of accommodation where workers return to work on a trial basis

Question 30

Supported and sheltered work ## Footnote type of workplace accommodation

Answer 30

* Modified work arrangements designed to help those with permanent disabilities who have either not been successful in competitive work environments or require substantial support to return to work. *** Supported: **Helped in their regular environment * **Sheltered** Perform their job in special worksites

Question 31

Physical Demands Analysis (PDA)

Answer 31

– Want to match the worker’s current and future capabilities with the demands in their job – Standardized evaluation of the physical and cognitive demands of a job completed by a person familiar with the job – Involve identifying the types of activities involved in the job as well as the frequency and intensity for the activity – Can be used preventatively (identify risks) but also post-incident (help to determine if the person can medically come back)

Question 32

Functional Ability Assessment

Answer 32

- or functional capability evaluation - a standardized assessment of an injured or ill worker's ability to perform job tasks that is completed by a member of the health care team treating the injured worker - Both PDA and FAA can help identify the types of job modifications and accommodations that would lead to a safe and early return to work for an injured worker

Question 33

Stakeholders in Disability Management

Answer 33

- injured or ill workers - employers - unions - health care providers - insurance providers - governments - disability management contractors

Question 34

Barriers to RTW

Answer 34

- slowdowns in the process (e.g., paperwork delays) - psychosocial factors (e.g., stress, mental health) - low quality jobs: hose with high demands, job stress and/or a lack of control - fear of stigma

Question 35

Fear of Stigma

Answer 35

afraid of discrimination, being ignored, that others/supervisors/coworkers are resentful of their job modifications

Question 36

Disability-related absence often has three stages

Answer 36

- acute (1-30 days) - subacute (31-90 days) - chronic (91+ days)

Question 37

Barriers to RTW

Answer 37

- long absences can be a barrier to a successful RTW - private insurers estimate average length of a chronic disability is nearly three years - when early and safe return is possible, facilitating early return is important for all stakeholders

Question 38

Labour market re-entry programs

Answer 38

- can help an individual who cannot return to the original workplace. - During the labour market re-entry process, the injured, ill, or disabled worker’s capabilities, experience, and training are reviewed. * Additional skills training may be provided to help the worker find employment that provides earnings comparable to those in the previous job.