In the past, employers have been hesitant to consider the psychological component of injury/disability cases fearing it would add a stress claim to the physical claim. However, recent research has demonstrated that behavioral health concerns that go unaddressed cost organizations far more than proactive interventions to manage them. One key area on which most employers are now focusing is the development of innovative Return to Work (RTW) programs that integrate behavioral health considerations into their overall risk management strategies.

Employee attitudes and behavioral health concerns often negatively impact their recovery from physical injuries resulting in protracted disability leaves. At least 64% of individuals with physical illnesses or with extended LTD claims experience psychological concerns that cause a delay in physical health improvement. (Source: Work Loss Data Institute)

Following are practical tips to reduce leave time and mitigate organizational risk:

Implement Return to Work Coaching

PAS’ specially trained work coaches are available to reach out to employees on disability, address any behavioral and life management concerns that may impede their recovery progress and guide them through the process of attaining the resilience and positive motivation needed for a successful return to work.

Providing this support during times of worry, anger, or fear and helping employees feel more confident in talking with their doctors, co-workers and supervisors about their situation has proven to be highly effective:

In a recent Disability Management Employers Coalition (DMEC) study, respondents reported that incorporating reach out calls to injured workers and providing Return To Work coaching was one of the most effective strategies to get employees back to work more quickly and reduce claims cost.

Provide training for supervisors on relational skills and how to effectively extend support.

Employee dissatisfaction with their supervisor is a key contributor to high workers’ compensation and disability losses. Once a leave is taken, claimants may interpret the return to work process as “hurry up and get better—we don’t care how you are feeling about getting back to work—you are costing us a lot of money.” This is entirely antithetical to what injured employees want to hear which is “we feel for you, we really want to take care of you.” It is important for employees to feel supported by their supervisor during the absence and upon return. Without positive communication between the employee and the workplace, the chances of a successful return to work drops 50% if the injured worker is not back within 90 days.

Establish a RTW Coordinator

A RTW Coordinator will guide employees, supervisors, and treatment providers through the RTW and transitional work processes. Without coordination, progress can dissolve through mistrust, miscommunication, inadequate accommodations and re-injury. Focus on compassionate customer service to claimants. Communicate regularly regarding claims status and pay them promptly to avoid creating employee concern that may drive them toward taking an adversarial posture.

The RTW Coordinator should also remain alert to address any psycho-social “red flags” that may emerge that could substantially cause a delay in the employee’s recovery path:

Complaints about dissatisfaction with their job or supervisor;

Increased stress at home or work;

Possible substance abuse, panic attacks or depression;

Symptom magnification or claims of chronic pain;

Non-compliance with treatment recommendations or expression of undue pessimism or hopelessness;

Anxiety about returning to work.

One DEMC member organization, Southern California Edison, reported that 100% of those who participated in return to work coaching came back from disability leave and stayed on the job compared to 70% of those without coaches.

A 10 year study conducted by Johns Hopkins School of Medicine found that integrating services that addressed individual workers’ psychological, as well as physical needs, resulted in a 73% decrease in lost-time rate and a 44% decrease in medical costs per $100 of payroll.

In addition to Return to Work Coaching, there are many practical workplace initiatives that have proven successful to reduce prolonged disability leaves:

Create a positive organizational culture

In the “need-press” theory of psychology, employees have expectations they anticipate to be met by the workplace (needs), while employers place expectations on the employee to produce (press). In order to prevent problems, need-press must be balanced. Help employees feel like partners, educate supervisors about behavioral components of disability and lost time, promote safety and wellness to reduce risks. Engender a people-oriented climate so that:

Employees are involved in planning and decision making;

Workers trust the organization;

Communication is open, employees feel free to voice concerns and make suggestions;

Working relationships are cooperative;

Workers are motivated to stay with the company for a long time.

Implement a planned process of work reengagement.

Early in the leave, it is important to initiate reach out efforts to help the employee stay connected to the workplace. Transitions back to work should be tailored to the employee and the job in concert with the needs of management and the recommendations of the physician.

During treatment and especially when contemplating return to work, it is typical for employees to experience significant depression and anxiety that may disrupt optimal cognitive processes resulting in:

Slowed thinking;

Poor judgment;

High distractibility;

Impaired social interaction;

Low frustration tolerance;

Increased irritability.

Supervisors need to consider the employee’s psychological as well as the physical components of return to work. Reintegration with co-workers prior to the actual return can helps the entire work group be better prepared. EAP support during the return to work process further increases the likelihood of a long-term positive outcome.

Communicate to supervisors the importance of routinely referring troubled employees to the EAP as a risk management strategy

Presenteeism is often a precursor to a lost time event. Emerging personal, health or family problems may present over time in the form of reduced productivity. Without EAP support, presenteeism may progress to disability and workers compensation claims down the road.

To learn more about PAS Return to Work Coaching, contact us at 1.800.356.0845 or email us at [email protected].

This article is not intended to be construed as legal advice, but is provided as an overview of good business practices.

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