Partnerships: the bridge from disability to ability management.

Considerable literature is devoted to disability management in business and industry. However, the concept of ability management has received less attention. Appropriate as a return-to-work follow-up service, ability management programs have the potential to increase employee satisfaction and satisfactoriness. Partnerships, an example of an ability management program for employees with disabilities, is described.

Increased health care costs, labor shortages and an aging work force have created renewed interest in disability management in business and industry (Bowe, 1984; Mitchell, 1987; Parent & Everson, 1986). Disability management typically consists of ...early identification at the workplace of disability-related problems; effective management of physical symptoms; facilitation of return-to-work; and modification of jobs, when necessary" (Tate & Habeck, 1986, p. 4). The emphasis in most disability management programs is, appropriately, on the return of workers to the jobs that they held prior to discontinuing work due to injury, disease or accident. Evidence clearly supports the assertion that the sooner this disability management process begins the more likely workers are to return to work (Matkin, 1987).

Although the initial days and weeks of the work reentry phase are critical, another stage of disability management merits considerationfollow-up after the worker has been on the job three to six months. Munrowd and Beecher (1986) identified the three month follow-up as an important part of the disability management process. They viewed the follow-up period as a time to monitor the employee's response to the job and to solve any problems experienced by the worker. But, the three to six-month follow-up also provides an opportunity for more than just disability management or problem solving. The follow-up phase of the return-to-work process is an ideal time to adopt an ability management orientation; that is, a commitment on the part of all involved-employer, employee and rehabilitation professional-to create work conditions that will enhance worker satisfaction and satisfactoriness (Dawis & Lofquist, 1984).

The purpose of this article is to describe the relationship between disability and ability management and to introduce "Partnerships," an example of an ability management strategy. Through a series of structured activities and assessments, Partnerships enables human resources and rehabilitation professionals to offer a full continuum of return-to-work services ranging from disability to ability management.

The Need for Disability Management Programs

The need for disability management programs is clearly documented in disability incidence and unemployment data. For example, the National Center for Health Statistics (DeJong, 1987) estimated that the number of adults with severe, chronic health conditions grew from 3.7 million in 1959 to 8.2 million in 1984 (an increase of 121 %). According to the National Safety Council (Work Life, 1988) and the Menninger Foundation (Hester, Decelles, & Gaddis, 1986), 569,000 workers a year become so severely disabled that they are out of work for at least five months. The majority of those workers (52%) never resume employment, and the situation only becomes more serious in the future. In the next 30 years "...the number of workers in the disability system is expected to increase by 53% ... while the work force will grow only 28%" (Hester, et al., 1986, p. 1).

Based on the 1985 census data, Bowe (1986) reported that the percentage of men with disabilities in the labor force was lower in 1985 (37.25%) than in 1980 (49.1%). Census data for 1985 (Bowe, 1986) and findings from other studies (Britt, 1988; Thurer, 1982) document the poor success rates that women with disabilities have in entering or reentering the work force; 26.3% and 25% of women with disabilities were in the labor force in 1980 and 1985 respectively.

Bowe (1986, p. 5) provided one explanation for the low work force participation of people with disabilities. "Individuals who become disabled in mid-career are more likely than ever before to take early retirement rather than to attempt to surmount the disability and return to work. Indeed, early retirement has become a common response to disability, which usually occurs in the latter years of employment." Noting that the majority of disabled persons are in the 25 to 54 age group, the President's Committee (1987) recommended that rehabilitation place a high priority on serving recent or current workers who are experiencing work disruptions due to disability. According to a Harris poll (Lou Harris & Associates, 1986), the majority of these adult workers with disabilities want to work, even though they must overcome many barriers to do so.

Previous literature has identified factors negatively influencing the return-to-work rate (Hood & Downs, 1985; Roessler, in press). Work disincentives in Social Security, employer stereotypes about disabled workers, nonexistent workplace interventions, conflicting advice from professionals and extended periods of unemployment represent some of the most serious barriers to resuming work. Fortunately incentives exist to encourage business and industry to develop effective disability management interventions for the workplace.

A Rationale for Disability Management Programs

One incentive for businesses to develop disability management programs stems from the cost of disability and health care. The combined costs of disability income payments and health care services have been estimated to be as high as $185 billion a year (Tate, Habeck, & Galvin, 1986). In disability benefits alone, government and business pay workers between $120 and $160 million a year. On an annual basis, business devotes approximately 5% of total payroll expenditures to disability costs and nearly $7 billion to sick leave benefits. The average injury sustained on the job results in expenses totaling $19,000 (Munrowd & Habeck, 1987).

Savings possible through efficient disability management programs are, therefore, of definite interest to business and industry. In a recent article, Munrowd and Beecher (1986) cited some impressive statistics in support of the cost-effectiveness of disability management programs. Disability management efforts produced savings in a Buick-Oldsmobile-Cadillac plant in terms of reduced absenteeism, lower workers' compensation costs, and reduced overall rehabilitation costs for employees requiring long-term services.

Positive experiences with disability management outcomes were reported by the Motor Wheel Corporation plant in Lansing, Michigan (O'Malley & Donaldson, 1986). In a group of 102 workers referred for rehabilitation, 48 were closed as returning to work at Motor Wheel at significant cost savings. "Returning 48 of these employees to work has reduced Motor Wheel's weekly compensation liability by $13,403 per week or $643,344 per year" (O'Malley & Donaldson, 1986, p.30).

Although cost containment factors often prompt industry to initiate disability management programs, they soon assume secondary importance as companies experience other types of positive results. For example, Tate, Habeck and Galvin (1986) reported that disability management programs enhance an industry's competitive edge by enabling it to retain well-trained and loyal workers. O'Malley and Donaldson (1986) found that the results of ongoing disability management efforts in their plant communicated clearly to management and union representatives alike the desire of workers with disabilities to be productive and self-supporting.

Disability Management Programs

Disability management programs in the workplace begin with early identification of disabled workers and of the conditions that result in worker disability. Information about workers needing assistance is often provided by sources such as the benefits and/or medical departments. Workers with disabilities are then evaluated to determine their medical, psychological, social and return-to-work needs. Direct services follow which include case management job analysis and job modification. Finally, follow-up or monitoring services are provided which address issues that emerge after job placement (Akabas, 1986; Beaudway, 1986; Munrowd & Beecher, 1986; Tate, Habeck & Galvin, 1986). For the most part, the emphasis in current return-to-work programs in industry is on the management of the disabling condition so that the person can return to the same job as quickly as possible. Less attention seems to be given to the monitoring or follow-up phase.

Important as the disability management process is, evidence suggests that the concept might profitably be expanded to include an ability management aspect as well. In a small survey of returning workers who were part of a disability management program (N=22), 33% of the group indicated a need for additional follow-up services subsequent to return to their jobs (O'Malley & Donaldson, 1986). Tate, et al. (1986) discussed the general types of help these workers may have needed. They stressed the importance of services that maintain the worker in the job and that help to prevent further deterioration in health and functional capacities. They also stressed the need for services that enable the individual to develop new skills for meeting job demands and for overcoming environmental obstacles.

Involving workers in programs to improve their job skills and job satisfaction could logically be labeled "ability management." Ability management services are particularly important during the three to six-month follow-up period after the individual has adjusted to the initial requirements of returning to work. J.0. Crites (personal communication, January 23, 1989) described a process similar to ability management in his work on career mastery. Enhanced career mastery, therefore, is an appropriate goal for an ability management program.

Career Mastery: An Approach to Ability Management

The time following return to work for the employee who has experienced a mid-career disability is a period of disequilibrium (thwarting conditions) in the worker/job fit (Crites, 1982; McMahon, 1979). In effect the worker is reentering a work establishment phase in which he/she must develop career mastery or coping techniques. For example, workers must adjust to changes in on-the-job interpersonal and supervisory relationships, daily living needs, and task performance requirements. Successful career mastery, the goal of ability management programs, is characterized by enhanced worker satisfaction and satisfactoriness, two conditions synonymous with extended worker tenure on the job (Dawis, 1987).

One should note the close relationship between ability management and other more familiar terms such as career development or human resources planning (Hall & Associates, 1986). Jackson and Vitberg (1987) defined some of the key elements of career development to include ... real efforts by managers to encourage employees to develop their unique capabilities, to focus them in ways that are specifically related to the organization's goals, and to facilitate imagination, creativity, and entrepreneurship" (p. 72). Therefore, ability management efforts represent the initial step in long-term career development planning for workers with disabilities.

Unfortunately, a recent review of the literature yielded few citations on career development interventions for workers with disabilities (Greenwood & Johnson, 1985). Finding the same dearth of literature on the career development of disabled persons, Dunn (1979) and Vandergoot, Jacobsen, and Worrall (1979) nevertheless stressed the need for follow-up services with employers and their employees with disabilities. Greenwood and Johnson (1985) called for additional research to identify the career advancement needs of people with disabilities and to demonstrate the efficacy of career development interventions.

The remainder of this article outlines a rationale and approach for a systematic ability management program for individuals who have returned to work following mid-career disabilities. Currently under development at the Arkansas Research and Training Center in Vocational Rehabilitation (Schriner & Roessler, in press), the program is entitled "Partnerships." It involves (a) employee groups conducted by a human resources professional, (b) supervisory evaluation of employee performance and preferences, and (c) career mastery planning meetings between employees and their supervisors. As a follow-up ability management service to identify the conditions thwarting career mastery, Partnerships should occur three to six months after the employee has returned to work, thereby creating the bridge from disability to ability management.

Partnerships

Designed to enhance the career mastery of employees who have become disabled, Partnerships is a multi-component program with both organizational and individual emphases. The intent of the program is to accomplish the following three objectives: (1) increase organizational productivity by enhancing the career adjustment and retention of employees with disabilities, (2) improve the organization's and the employee's career mastery planning skills and (3) strengthen the business-rehabilitation partnership for employees with disabilities.

With the help of a human resources or rehabilitation professional as a consultant, Partnerships involves both the business and its employees in examining, critiquing and implementing career adjustment and development plans. Displayed in Figure 1, the basic steps of the Partnerships' process are as follows:

1. The organization renews its commitments to disability and ability management opportunities for employees.

2. Employees examine, with the help of a rehabilitation or human resources professional, their career adjustment assets and needs and develop a personal career mastery plan.

3. Supervisors review employee performance and preferences and consider career mastery needs.

4. Participating employees and their supervisors jointly discuss career adjustment needs and collaborate in developing career mastery programs.

5. Outcomes of the plan are monitored by employee and supervisor.

The theoretical and empirical foundation for Partnerships is found in Crites' (1982) work on career adjustment and in the Minnesota Theory of Work Adjustment (Dawis, 1987; Dawis & Lofquist, 1984; McMahon, 1979). Concepts from the two theories which are central to Partnerships include thwarting conditions, integrative adjustment responses, satisfaction, satisfactoriness and tenure. Adopted from the Minnesota Theory of Work Adjustment, the fundamental principle underlying Partnerships is that job tenure is a function of employee satisfaction and satisfactoriness. In other words, an employee must meet the demands of the job (satisfactoriness) while at the same time being satisfied that personal needs are being met (satisfaction). To increase his/her satisfactoriness, a worker may need to learn new job or social skills. To increase worker satisfaction, management may need to modify demands and opportunities related to the job. Plans for enhancing both satisfaction and satisfactoriness represent the end product of the supervisor/employer collaboration in Partnerships. The role of the human resources or rehabilitation professional is to structure and encourage cooperative employee/supervisor endeavors.

Partnerships consists of two major components as depicted in Figure 1. The first is the employee assessment and consultation component led by a rehabilitation or human resources professional. The purpose of the small group activity is to help workers with disabilities understand their career mastery needs, the demands of the work place, and ways of improving satisfactoriness and satisfaction. Consisting of four two-hour sessions, the small group phase involves employees in examining the role of work in their lives, reviewing their work histories and plans, identifying their career adjustment needs and preferences and planning for career mastery.

Employee exploration of career mastery needs is facilitated by specific activities, discussion topics and assessment instruments adapted from the work of Super (1980), Crites (1982) and Janis and Mann (1977). To identify barriers that workers experience in coping with work establishment tasks, participants complete and score the Career Mastery Inventory (CMI) (J.0. Crites, personal communication, January 23, 1989) which is a revision of the Career Adjustment Development Inventory (Crites, 1982). Results of the CMI provide insights into thwarting conditions which the worker is encountering in the following areas: organizational adaptability, position performance, work attitudes and habits, co-worker relationships, advancement and career choice and plans. Having identified and analyzed thwarting conditions, participants develop integrative (coping) responses that will increase their productivity (satisfactoriness) and job satisfaction.

During this phase of Partnerships, participants also evaluate their job satisfaction in terms of the 20 work reinforcers in the Minnesota Theory, e.g., ability utilization, authority, creativity, security, social status, etc. Information from these ratings (level of current and desired job satisfaction) indicates areas in which the job might be enriched to enhance worker satisfaction (Dawis & Lofquist, 1984). Supervisory (management) responses to these needs for increased worker satisfaction are a critical part of the organization's commitment to Partnerships.

By combining insights from the Partnerships' exercises, CMI results, job satisfaction evaluations and group discussions, employees develop an initial career mastery plan with the help of the rehabilitation or human resources professional who is leading the group. These plans become the basis for discussions between employees and their supervisors regarding specific actions that both must take to increase the individual's career mastery. During career mastery planning, supervisors also consider information from performance evaluations and their own observations regarding the needs and preferences of the individual. Representing a collaborative effort by the supervisor, worker and the Partnerships leader, the career mastery plan identifies the interventions needed for the employee to develop new job skills, resolve interpersonal problems and change the reinforcer patterns of jobs. As a result, employers, supervisors, human resources personnel and employees with disabilities become allies in the ability management process.

Although originally developed with the disabled worker in mind, Partnerships is also appropriate for orienting new employees to their job roles as well. Hence, the program has the potential to integrate disabled and nondisabled workers in collaborative activities. In less then 15 hours of individual and joint planning, the organization and the employee can initiate a productivity enriching experience for all involved. Readers interested in evaluating the impact of the program in their own settings need the following materials (contact the authors at the Arkansas Research and Training Center for more information):

1. The User's Manual enables the rehabilitation or human resources professional to present the employee and organizational phases of the program.

2. The Employee's Workbook contains career mastery activities for the worker to complete during the group sessions.

3. The Organization Manual provides materials which guide supervisory personnel in their review and development of career mastery policies and procedures.

Conclusion

Employers and employees are well served by the resurgence in interest in disability management programs at the worksite. However, this article postulates that the impact of disability management programs could be enhanced with the addition of an ability management perspective. To add the ability management orientation, human resources and rehabilitation professionals need to be familiar with the Partnerships approach. By offering Partnerships at the workplace, rehabilitation professionals increase the potential for career mastery and job tenure among all participating workers. Partnerships is the bridge from disability to ability management.

Footnote

Based on a presentation made to the Employer Committee of the President's Committee on Employment of People with Disabilities. DuPont Corporation, February 10, 1989, Wilmington, Delaware. Contact the authors for more information on Partnerships at the Arkansas Research and Training Center in Vocational Rehabilitation, University of Arkansas, Fayetteville, Arkansas, 72701.

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Received:   January 1989
Revised:    June 1989
Accepted:   July 1989