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© Copyright 1999 Maclean Hunter Publishing Ltd. The following article first appeared in the April 1999
edition of BENEFITS CANADA magazine.
Disability management triumphs
Young Kon Kim represents everything an employer could ask for--loyalty, talent and a top- notch
rapport with co-workers. Managing his disability is an absolute priority.
BY CATHERINE MCMAHON
Young Kon Kim, 48, will cope for the rest of his life with a severe disability that prevents him from
working at a job he once put his heart and soul into. Paralyzed from the chest down, Kim finds it difficult
to sit in his wheelchair for more than a few hours at a time. During the morning, when the pain in his
upper body isn't too bad, he makes his way to a new job he started last September, two and a half years
after he was stricken with his paralyzing illness.
"Work is part of life," Kim says. "It's important to my life." A husband and the father of two teenage
daughters, Kim works as a computer-aided design (CAD) machine operator, designing products he used to
produce at International Custom Products (ICP) Inc. ICP is an international company that manufactures
custom cases (such as sports bags and computer cases) and other sewn products. The Toronto-based company
employs approximately 100 people. Until January 1996, Kim was a production manager and supervised 30 to 40
people.
"Being a relatively small company, we had never encountered a situation where an employee could no longer
work for us. This was a big loss," says John Newton, executive vice-president and a partner in the company.
"Mr. Kim was a kingpin in our organization. He was very capable. He was one of the best technicians in the
company and we loved working with him."
So much so, in fact, that the company was working to find another position within the organization when it
was approached by Kim and UNUM Canada, ICP's insurer. The return-to-work plan they came up with involved
Kim going back to school to be retrained as a CAD pattern maker. The employer agreed to invest in new
technology so their former production manager could get some on-the-job training. Today, Kim works mornings
from Monday to Friday designing products and providing cost estimates for new jobs.
"The situation with Young has really opened up our eyes to the possibilities of working with disabled
people," says Newton. "Young now has a new lease on life. We have been able to continue working with
someone who adds a lot of value to our organization. We've all come out winners."
THE CHOICE OF CHAMPIONS
"Integrated disability management" is what proactive employers, insurers and healthcare providers say will
help employees and companies win the complex game of helping an ill or injured employee back to work.
The concept is built on the belief that rising disability costs can be managed if disability programs
(long- and short-term disability, sick leave and workers' compensation) are managed in their entirety.
"The sooner we get people back to work, the better, regardless of whether it's an occupational or
non-occupational disability issue," says Jim Massie, vice-president of marketing at Assure Health
Management Inc., in Toronto. "Time away is time away. Unfortunately many organizations manage the processes
separately."
Returning as rapidly as possible to a normal routine--including work--is viewed by industry specialists as
an integral part of the rehabilitative process for any disability. Studies show that the longer workers
view themselves as having reduced capabilities, the less likely it is that they will ever resume their full
activities. In an integrated disability management approach, early intervention is key.
Watson Wyatt Canada's 1997 study of Canadian employers' disability management practices, called Staying
at Work, showed that strengthening return-to-work results is the number one goal of disability
management programs. Kim's story proves the benefits of a successful return-to-work, for both the
organization and the employee.
Disability claims are expected to grow as the population ages. According to the Watson Wyatt survey,
average direct costs for disability totalled close to 6% of payroll in 1997.
Indirect costs, however, can be much greater. Factors such as the cost of temporary workers, reduced
productivity, dissatisfied customers and overtime pay were cited in the survey as adding to the harmful
effect of disability on modern workplaces. Survey respondents using integrated disability management
practices, however, estimated average yearly savings of 16%.
Trends in disability are also shaping the way employers must approach their solutions. Increasing numbers
of claims for stress, chronic fatigue syndrome, repetitive strain injury and fibromyalgia are changing the
face of disability management. Traditional claims-management and rehabilitation practices aren't enough
anymore.
Jean-Marc MacKenzie, senior vice-president of corporate and legal affairs at Medcan Health Management Inc.,
in Toronto, says the line between managing a disability and managing an employment issue has become
blurred. "A back injury is a health issue," he says, "but if stress in the workplace is the root cause,
it's an employment issue. Today's disability managers use a hybrid of medical and employment intervention
to deal with the more prevalent psycho-social issues of today."
Progressive employers like the Canadian Imperial Bank of Commerce (CIBC) and The Canadian Press National
Newswire Service are moulding their disability management programs to fit into this new environment by
adopting best practices and integrating disability management approaches. Here are their stories.
UNDERSTANDING THE PROBLEM
Rising healthcare costs and employee discontent with the way the company was handling disability leave were
two significant reasons why CIBC recently re-engineered its disability management practices. "Employees who
were away felt cut-off from the organization," explains Gretchen Van Riesen, director of pension and
benefits policy. "Their concerns and our increasing premiums were symptoms of a bigger problem. Before we
could fix the symptoms we had to understand the problem."
After executing an internal audit, coming up with a set of disability management principles and researching
best practices, CIBC launched a new program in February 1998. The program focuses on creating
return-to-work plans for employees who are recovering from an illness or injury. The plans include modified
work duties, a graduated return from part-time to full-time work or taking on another job or role within
the organization.
Called "Working Together," the process supports and emphasizes relationships between employees and
managers, explains Van Riesen. "Our research tells us that the most significant impact of an employee's
satisfaction on the job is the relationship they have with their manager."
The program puts employees and managers face-to-face as soon as possible after the onset of disability.
With an independent facilitator present during the meeting, the employee and the manager map out a
return-to-work plan. "The process creates a common vision," says Van Riesen. "Each participant can see the
other give something."
A MODEL SOLUTION
Called a "behavioural model" of disability management, this give and take process breaks new ground in
defining disability and the approaches a company and an individual can take to manage the complex process
of returning to work.
In contrast, the "medical model"--the more traditional approach--asserts that an employee can come back to
work only when a doctor says so, and there is little communication between the organization and the
disabled employee to facilitate that decision.
"The doctor's certificate has become far less relevant in our new approach," says Van Riesen. "We're not
concerned with an employee's medical problem. That's a private issue. But we will ask the employee what he
or she can do within their capabilities." The company strives to recognize an employee's limitations and do
what it can to accommodate his or her needs. "Moving employees out of the paradigm of 'I can't work' is the
fastest way to getting someone back full-time," she says.
PUTTING THEORY INTO PRACTISE
To implement the program effectively, the bank uses an internal on-line absence management system. Managers
use the system to report absences and track time off. The bank's health services department receives an
alert six days after any non-work-related accident or illness, and immediately after a work-related
accident.
After a six-day absence, CIBC's health services department calls both the manager and the employee to
determine when and if a meeting should take place.
Facilitated by an independent third-party provider, meetings focus on an employee's abilities--not their
disabilities--and continue throughout the return-to-work process, until the employee fully recovers and
returns to their regular hours and duties.
"We wanted the independence an external facilitator provides," says Van Riesen. "The partnership we have
with our providers is integral to the program's success."
Educating the bank's 35,000 employees was also a key consideration in rolling out the new program. It was
an exercise in "cultural change," according to Van Riesen. The company created a full-blown communications
package brimming with brochures and videos to explain the program to managers, employees and healthcare
providers.
Results so far reveal that the program has improved employee satisfaction with the bank's disability
practices. Eighty-five per cent of employees who participated in a pilot of the program last year said the
new process was "good' or "excellent" in terms of meeting their needs.
PROOF IN NUMBERS
When it comes to costly disability initiatives, measurable results are key to convincing higher-ups of
success. CIBC has reduced costs by almost 30%. Most of the savings were due to a decline in the average
number of days disabled employees were absent. During last year's pilot study, the average number of days
lost due to disability went down to 41.5 days from 59.9 days. According to Van Riesen, the average employee
now returns to work after 23 days.
Under the old disability management system, the bank would have just started investigating the situation on
day 23. "It's a win-win situation," says Van Riesen. "The employee benefits because people are healthier if
they are at work. The organization benefits because productivity improves and disability costs go down."
THE AGE OF RSI
Repetitive strain injury (RSI) is an illnesses of our high-tech age that is a potential tragedy for both
workers and employers. Debilitating for workers and difficult to diagnose and treat, it is a contributing
factor to the trend toward rising disability costs.
Canadian Press employs journalists who work around the clock on back-to-back shifts in front of computers.
The company's 350 employees face a considerable amount of stress in the workplace. A jump in the number of
disabilities attributed to RSI--which contributed to a 50% increase in insurance premiums--sparked a more
proactive disability management program. It started with a six- person health and safety committee,
composed of union members and management, whose mandate was to dissect the RSI problem and generate
solutions.
One of the solutions was proposed by Canadian Press' insurer, Canada Life. In conjunction with Assure
Health, they suggested that the company adopt an integrated approach that would involve the services of an
on-site occupational health specialist. "We wanted our employees to have a resource within the company to
help them deal with their sick-leave issues," says Kathryn Mainguy, staff benefits manager. "But we didn't
want to be perceived as harassing employees."
Initially, the specialist was brought in to perform ergonomic assessments and conduct independent medical
exams. But almost three years later, the services range from bereavement counseling to wellness seminars.
A positive reception in the company's Toronto bureau, where the program was first implemented, has also led
to the introduction of similar services in its Montreal location. The specialist in Toronto has also
travelled to Canadian Press' Ottawa location and sites in Western Canada. "We will continue to expand the
program," says Mainguy.
Like many successful initiatives, Canadian Press' program involved a shift in corporate culture. "Our new
culture is much more open about discussing and sharing health and employment issues," says Mainguy.
"There's trust in the system now because when people need help, we provide it."
In one case, Canadian Press provided homecare services for an employee's dying spouse. In another, it
enabled an employee to work part-time hours while he was going through a difficult time at home. In both
examples, "disability" wasn't even an issue.
"Many people go through many stresses in life," says Mainguy, "and sometimes they need time away. We want
to show employees we value them."
The company's runaway insurance premiums have stopped since they initiated the program and certain claims
have been avoided entirely by providing flexible work options.
SECRETS OF SUCCESS
Have you noticed the common thread running through these two initiatives? For starters, both the Canadian
Press and CIBC make it easy for supervisors to report absences and manage return-to-work issues. They both
value a philosophy of making sure employees get the care they need to perform their jobs and resume crucial
personal and family activities. Both are also committed to the concept of modifying an employee's job
functions or work surroundings during a transitional return-to-work period.
Most importantly, these companies focus on establishing relationships at work that encourage employees to
return to the job and resume a productive life as soon as possible.
Catherine McMahon is a communications consultant living in Oakville, Ont.
*** ***
Good things in small packages
Successful disability management in small companies presents special challenges. Here are a few pointers.
By Jim Corrigan
When the disruption of disability strikes, the need to manage it is often greater--and more neglected--in
the small business than it is in larger organizations. If you're responsible for the disability plan for a
small group, you can't assume that the insurer will cover the full liability of both employee and employer.
You need to look carefully at plan design. Consider the following:
1. Does your plan reflect a co-operative approach for addressing an injured employee's desire to be
productively employed? If not, look for tools to make it happen.
2. Are there processes to support early intervention, case management, rehabilitation and return-to-work
programs to help an employee get back on the job?
Derek Gleed, a disability plan specialist with PPI Financial Group in Toronto, points out that once an
employee is away from the job more than 90 days it's likely that the employer has lost a valuable employee
permanently--something that can particularly hurt the smaller organization. This is why early intervention
techniques--not commonly available to small businesses--are critical.
Your disability plan design shouldn't keep an employee off work unnecessarily. It should work with people
who want to get back to work. Make sure it provides a residual benefit that is guaranteed in the benefits
contract. With traditional long-term disability (LTD) plans, employees must be totally disabled to receive
benefits. An individual who is only partially disabled won't qualify. In a proactively managed LTD
environment, the focus of such traditional approaches seems to miss the mark of encouraging health,
well-being and a return to productivity.
Although an employee may not be able to work full-time, a part-time return may be in everyone's interest.
The employee can earn a reduced income along with a proportionately adjusted "residual" benefit. Such an
arrangement contributes to the employee's sense of worth while reducing the cost of claims paid out.
For the small employer committed to finding the right disability plan the rewards of responding at the time
of a disability can be significant.
Jim Corrigan is president, Corrigan Insurance & Benefits Planning in Whitby, Ont.
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