Many employees falsely believe that a disability means they can no longer engage in meaningful work, as their condition is now a defining aspect of their life that renders employment all but impossible.

Disability case managers see that perception as one of their biggest challenges. Without goals, disability can result in a substantial and sustained decline in life satisfaction. Employees often lose the will to work and may convince themselves that they’re no longer capable of being in the workforce.

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An absent employee is also the loss of a person the business had hired as a good fit for the role. The time away will often leave a noticeable gap, one that might require temporary workers or an increased work burden. The financial burden on the employer also increases in line with the duration of the absence. Because of that, many employers offer short-term disability. To work to their full potential, the best programs use hands-on case management. Disability case managers engage employees in a goal-orientated treatment and recovery plan and return them to work in a timely manner. They measure success by reducing the time the disability guidelines predict the employee should be away.

Employers also have a legal responsibility to return an injured employee to work. In Canada, labour and human rights statutes protect injured workers from dismissal based on disability. Some provinces, such as New Brunswick, Quebec and Ontario, have specific conditions to prevent that from happening. In Ontario, all larger employers must make reasonable accommodations to re-employ injured workers. They have an obligation to attempt the return to work within two years of an illness or injury.

The shift to long-term disability

An employee with an illness, injury or disability receives a lot of attention during the short-term disability period. The reasons are clear. A very high percentage of employees will return to their job within that time frame. That’s especially true if the employer offers modified work opportunities.

Not all employees will return to work during the period of short-term disability. Traditional benefits plans include a process for the transition to long-term disability, usually at around 17 or 26 weeks. After the transition, the amount of contact and level of communication with the employee often decreases. The change can have a negative psychological impact.

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The shift in focus to the long term shouldn’t mean losing viable opportunities to return to work. The person who didn’t return to work during the short-term disability period may have had a surgery that requires a longer recovery time. The employee may also have a more severe, but not permanent, illness or injury. It doesn’t always mean the employee has completely exited from the labour market. If the attitude is that long-term and permanent disability are one and the same, then the prospects for a return to work decrease.

Unfortunately, many diseases and conditions, consistent with current medical knowledge, are, in fact, total and permanent disabilities. They can include very severe injuries (such as paralysis), progressive diseases (such as cancer) and mental-health disorders (such as those following a brain injury). There are often limited treatment options and little hope of recovery.

The case for medium-term disability

The concern is that, in many other cases, the psychological gap between short- and long-term disability is too great as the change in benefits signals a false permanency.

As a result, there’s a strong case for introducing a medium-term disability benefit as an active and engaged recovery management program that fits between the short- and long-term versions.

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The introduction of a medium-term disability program can provide a path for strong case management up to the all-important two-year mark. In most disability cases, for the first two years, employees may be unable to perform their own job. The change of definition at the two-year mark is a harder barrier to pass. Employees must prove they’re unable to perform any occupation. It’s usually a recognition of total disability. The intention of medium-term disability is to reduce the number of cases reaching the two-year mark.

Intervention during the medium term of a disability could remove many false perceptions. It may also have physical and psychological benefits for the employee. Like short-term disability, there would be the continuing focus on recovery, treatment and return-to-work goals. A medium-term disability program should also be financially attractive for the employer.

As the concept is very recent, the innovations in medium-term disability draw on traditional disability management practices. They include engaged intervention and return-to-work planning. The program then develops strategies to manage the increased severity of a condition that couldn’t be resolved during the period of short-term disability.

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The medium-term income benefit would:

  • Ensure continuity of income;
  • Give employees an incentive to work through retraining, for example, to enhance work-related skills and capacities; and
  • Prevent workers from falling into dependency on social assistance.

Medium-term disability would also guarantee that the employer and case managers have a chance to exhaust all reasonable efforts at return to work.

In an integrated model, a case manager would manage both short- and medium-term disability. Together, those involved would continue to work towards the goal of the earliest possible return to work and function. The employee doesn’t drop out of the system, as with the traditional switch to long-term disability. Strategies used during short-term disability can carry over to a progressive medium-term strategy for recovery and return to work.

The process of medium-term disability

The case manager should qualify an employee for entry into a medium-term disability program based on evidence that the person has some potential to return to work.

Once the employee begins the program, the process focuses on:

  • Vocational rehabilitation and hands-on support for return to work;
  • Regular reviews of work ability; and
  • A supportive environment.

Supporting the employee includes keeping a strong link to the workplace. The emphasis is on health, social and vocational rehabilitation and regular assessments.

Read: How to create a culture that welcomes employees back from disability leave

The most important benefit of medium-term disability, then, is ensuring the employee doesn’t fall out of the workplace by losing communication and connection to the employer. Unfortunately, that’s what often happens during the traditional long-term disability period. So with increasing rates of disability and an aging workforce, the time is right to introduce a new solution into disability management programs.

Liz Scott is the principal of Organizational Solutions Inc.

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Copyright © 2021 Transcontinental Media G.P. This article first appeared in Benefits Canada.

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