specific conditions to prevent this happening. In Ontario, all larger
employers must make reasonable accommodations to re-employ
injured workers. They are obligated to attempt this return to work
within two years of a work-related injury. Re-employment should
be to their former (or a comparable) job if the worker is medically
capable, or to the first suitable job available, if they are not.
Disability management programs work on the principle of
looking after and engaging the employee. What is good for the
employee will ultimately benefit the company. Research also says
that employers that increase or improve disability management
and accommodation activities slow the departure of individuals
with disabilities from their workforces.
THE OPPORTUNITIES IN MEDIUM-
TERM DISABILITY
Traditional benefit plans include a process for the transition from
STD to LTD, usually at around 17 or 26 weeks. After the transi-tion,
the amount of contact often decreases. The change can also
have a detrimental psychological impact on the employee.
The shift in focus, from short- to long-term, should not mean
losing viable opportunities to return the employee to work. The
person that does not return to work in the STD period may have
had a surgery that requires a longer recovery time. They may also
have a more severe, but not permanent, illness or injury. It should
not mean that the employee is completely removed from the la-bour
market.
An employee with an illness, injury or disability receives a lot
of attention during the STD period. A very high percentage of
these employees will return to their job within this timeframe, es-pecially
if the employer offers modified work opportunities. In
a well-managed STD program, the employee experiences high
touch communication and guidance. They should also have active
help finding the right treatments, support through recovery and
receive a return-to-work plan.
Unfortunately, there often isn’t the same level of communication
and help once the employee moves to LTD. There can be good rea-son
for this. Many diseases and disabilities, consistent with current
medical knowledge, are permanent. These can include very severe
injuries (such as paralysis), progressive diseases (such as cancer,
multiple sclerosis, ALS, etc.) or serious mental health disorders or
brain trauma. Treatment options are often limited and there is lit-tle
hope of recovery.
If an employer wants to self-insure LTD, they take on a lot of
risk and liability. The employer is accountable for the employee
until retirement age or death. However, a self-insured approach
can reduce the need for large reserves and give the employer the
ability to focus on rehabilitation. They can continue to work to
return the employee back to the workplace and it can be a good re-turn
on investment.
There is a strong case to introduce a medium-term disability
(MTD) benefit. MTD is an active and engaged recovery manage-ment
program that fits between STD and LTD.
The introduction of a MTD program can provide a path for
strong case management up to the two-year change of definition.
In most disability cases, for the first two years, the employee may
be unable to perform their own job. The change of definition at the
two-year mark is a harder barrier to pass. The employee must be
considered unable to perform any occupation. It is usually consid-ered
to be “total” disability. The intention of a MTD program is to
reduce the number of long-term permanent disability cases reach-ing
this mark.
THE STRENGTH OF ACTIVE MEDIUM-TERM
DISABILITY MANAGEMENT
Intervention in the medium term of a disability could remove
many false perceptions. In many cases, it may also have physi-cal
and psychological benefits for the employee. Like STD, there
would be the continuing focus on recovery, treatment and return-to-
work goals.
An MTD program should be financially attractive for the em-ployer.
The employer is able to continue the STD’s strong focus on
returning to work. Something as simple as changing the terminol-ogy
– removing the word “long” – shows the continuing positive
focus of the employee and employer towards return to work goals.
As the concept is very recent, the innovations in MTD would
initially draw on traditional disability management practices.
These include engaged intervention and return-to-work planning.
The MTD program would then develop strategies to manage the
increased severity of a disability that could not be resolved during
the STD period. The ultimate aim is to maximize the intervention
time without labelling an individual as totally and permanently
disabled.
The medium-term income benefit would:
■■ Ensure continuity of income
■■ Give employees an incentive to work – e.g., retraining to
enhance work related skills and capacities
■■ Prevent workers from falling into dependency on
social assistance
MTD would also guarantee that the employer and case man-agers
have the opportunity to exhaust all reasonable efforts at
returning to work.
In an integrated model, a case manager would manage both
STD and MTD. This ensures familiarity, knowledge, experience
and empathetic care on each claim. Even as the MTD peri-od
approaches, the employee should already have a familiar and
comfortable relationship with their case manager. The employee
should understand that the case manager has their best interest
at heart. Together, they will continue to work towards the goal of
the earliest possible return to work and function. The employee
does not drop out of the system like the traditional switch to LTD.
MEDIUM-TERM DISABILITY AND MENTAL HEALTH
In the past few decades, mental health problems have increasingly
contributed to sickness absence and LTD. Studies show that LTD
in general, including those due to mental health conditions, causes
a lower socio-economic status, reduced quality of life and higher
mortality rates. The unemployed are less likely to be in a healthy
state compared to the employed.
Disability as a result of a mental health disorder can also lead to
less essential motivational resources and goal-directed behaviour.
In other words, someone who has experienced a lot of help and
benefits
36 ❚ JUNE 2017 ❚ HR PROFESSIONAL