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The changing face of disability management; siloed no more, the new thinking requires a multidisciplinary approach and pays attention to the employee, not how a case is handled.

At H.E. Butt Grocery Co., which operates more than 300 retail stores in Texas and Mexico, disability management brings together what had been two separate parts of the company: benefits and risk management.

With distinct yet complementary perspectives, the two departments take into account employee health and wellness, reducing costs, improving productivity and promoting safety.

"Previously, our departments were completely siloed, but in the past two years, we have worked together to deliver a more coordinated program and partner-centric (employee-centric) model," says Tammy Schoenert, a benefits manager for the San Antonio, Texas-based company. "All areas, both internal and external, work very closely now."

Disability management today is multifaceted and multidisciplinary in response to employer demands. Instead of focusing solely on workers' compensation cases or offering return-to-work services to injured employees, disability management is becoming integrated with other benefits and programs such as wellness, prevention, safety and group health.

As a result, there has been a gradual but significant change in the professional backgrounds of those Who practice disability management. Disability management is not limited to those with vocational rehabilitation or occupational nursing backgrounds, according to research by the Certification of Disability Management Specialists Commission.

Disability managers may come from human resources, benefits or other backgrounds. They may work as consultants or for third-party providers and may be dealing with personnel working in finance and safety departments.


The changing face of disability management reflects a shift in employer thinking that requires a multidisciplinary approach. Instead of focusing only on how a ease is handled--whether it's related to workers' comp, short-term disability, or the Family and Medical Leave Act--the emphasis is being placed on the individual. Companies are looking at their employees and what specific programs and offerings will help bring them back to work.

Beverly Johnson, who heads corporate workers' comp for Cummins Inc., a Columbus, Ind.-based manufacturer of truck engines and related technologies, says her department must look beyond work-related injuries and illnesses.

"I have to take into account the other disability disciplines--short-term disability, long-term disability, FMLA and also salary continuation," she says. "All of those play a part because, ultimately, it is our plants that bear the costs of all those benefits programs."

Tracking disability and workers' comp cases serves the purpose of knowing how a claim is being handled. The company must know how a claim was paid in order to get credit for its indemnity payments.

Separate from this administrative aspect, there is also the wellness and prevention piece. Preinjury and post-injury management and return-to-work initiatives help reduce the incidence of occupational and nonoccupational injuries.

"You need to look at all programs, even though you have statutory law on workers' comp and the benefits that companies provide usually reside in separate departments," Johnson says. "Still, you have to look at them as a whole. If companies design their benefits contracts separately, they won't get the benefit of all the costs that they're paying."

The multidisciplinary nature of disability management is a change whose time has come. Just as employee health and wellness issues are multifaceted, so too must be the programs that address them.

One emerging area is behavioral health, as employees are more forthcoming about seeking treatment for depression. In addition, depression is a common secondary medical condition when someone becomes seriously ill or injured or faces the onset of a chronic condition. "You cannot have a successful disability management program unless you are delivering the appropriate care and resources for all the other pieces," says Schoenert.

Responding to employee absences due to illnesses and injuries--both job-related and nonoccupational--requires approaches that tap into the expertise of professionals from various disciplines.

In the past, these professionals might have communicated little, let alone collaborated. Today, however, benefits design and delivery brings together people who may be, or working with, disability managers.

Disability management is multidisciplinary, and requires specific skills and expertise. If companies have selected external providers to consult on disability management issues or to provide services to their employees, be sure that these professionals are competent.

Choosing qualified individuals is a key to success. Unless someone is skilled at disability case management, there is the risk of a missed opportunity to implement a return-to-work plan to help an ill or injured worker come back to the job before the worker is 100 percent.

Unless a disability manager is experienced in analyzing the causes of employee absence, wellness and prevention programs may not meet the needs of a company's employee population.

Regardless of their professional backgrounds, disability managers must be knowledgeable about three key areas: disability case management, disability prevention and workplace intervention, and program development, management and evaluation.


Collecting and analyzing absence data is the first step to building an integrated approach to disability management. This type of analysis is critical if companies are to design and implement programs targeted to their specific employee populations.

By looking at employee absences, whether job-related or not, companies can identify the causes. With the major causes identified, the right tools and strategies can be implemented to address employees' needs.

Companies that do not gather data from all possible sources--health-care dollars, pharmacy spending, short-term and long-term disability, workers' comp claims and unscheduled absences--are likely to miss out on opportunities to improve and promote employee health and productivity.

"These employers will also miss out on the value of a healthy culture," says Johnson. "A healthy organization also has better recruitment and employee retention. It's a total value."

One type of data necessary for the successful implementation of an integrated disability management model is data collected through a health risk assessment survey. Many large and midsize employers are utilizing these surveys to identify health risks.

The goal is to use the results to educate employees on how to address health issues and take action and implement behavior changes to minimize future health risks. Survey input, in addition to existing claims data, can help identify trends and where to target wellness and disease management initiatives.

"HRAs are the core technology for employers going forward as companies are realizing the importance of the health and productivity of the work force," says Dee W. Edington, director of the University of Michigan's Health Management Research Center. "The alternative, of course, is to do nothing; just wait and pay for disease care. That doesn't work any more. Now companies want to get people healthy and help them maintain their health."

A multidisciplinary team to design and deliver the right benefits and programs for a company's work force is considered a best-practice approach to disability management. By bringing together human resources, risk management, benefits and disability management, companies can gain greater leverage to improve and promote employee health and wellness.

"The key is partnering and working together," says Schoenert of H.E. Butt. "You can't have one area trying to develop and deliver successful programs without working with the other areas. Everyone has great ideas to contribute, and being involved in the design process helps ensure buy-in and commitment from the beginning."

PAMELA CAGGIANELLI is chairwoman of the Certification of Disability Management Specialists Commission and manager of corporate health for Bausch & Lomb Inc.

RENEE MATTALIANO is chairwoman-elect of the commission and an absence management consultant at Zurich North America. They can be reached at
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Author:Caggianelli, Pamela; Mattaliano, Renee
Publication:Risk & Insurance
Date:Mar 1, 2007
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