Article 1: Human Resource Management of Disability Proneness

Article 2: Making Disability Management Accountable

Article 3: Give Feedback, Not Criticism

Article 4: What Skills Does a Young Person Need for a Rewarding Career?

Article 5: Workplace Injury & the Breach of the Social Contract

Human Resource Management of Disability Proneness

By Jasen Walker and Fred Heffner

"Without work, all life goes rotten, but when work is soulless, life stifles and dies." – Albert Camus

Particular employees in specific circumstances can be prone to develop disabling disease or injury. Disability proneness exists in every work population. Human Resources can prevent and manage disability proneness.

Several years ago, Human Resource professionals were introduced to the concept of "Integrated Disability Management." The adjective "integrated" draws attention to the fact that disability management can be most effective when it controls absence and prevents disability subsequent to both non-occupational events, such as short-term disability (STD) and the Family and Medical Leave Act (FMLA), and occupational accidents (i.e., workers’ compensation). In an integrated disability management (IDM) protocol, the company-provided employees’ benefits program is closely coordinated with the organization’s disability management and human capital strategies in an effort to reduce costs. It is important that insurance benefits integration be established. A Disability Management Program that does not make this significant connection between non-occupational and occupational insurance benefits is something less than state-of-the-art.

However, it is crucially important to emphasize that true "integration" of disability management programming involves not only benefits activation when necessary but, more importantly, coordination and linkage of the company’s human capital strategies that intend to not only prevent lost time but enhance productivity and attract new talent. Years ago, Risk Management sought cost control purely on the basis of fiduciary concerns and oversight. Managing risk with effective human capital strategies (i.e., Employee Assistance Programs and Return to Work Programs) took a backseat to properly investing insurance money and controlling benefits costs with aggressive claims handling and legal challenges.

Although the intended objective of an "integrated" program is return on investment, the critical outcomes of the "disability management" program are maintenance of productive workers and the reduction of lost time. Of these two sought-after results, controlling benefits costs and reduction in lost time, the latter is significantly more important. In fact, the reduction in lost time produces cost savings and addresses a critical issue facing most employers today: retaining qualified employees and attracting new employees. IDM works best when employee benefits plans are coordinated and human capital strategies are both proactive and effective in keeping valued employees productive.

To the point, effective IDM involves an equal emphasis on benefits plan coordination and continuous provision of disability prevention and management strategies such as good hiring practices, health and wellness, carefully crafted succession plans, employee assistance, conflict management and mediation, job accommodation when necessary, and effective transition-to-work programs.

Recognizing issues that cause lost productivity and absenteeism in the workplace and appreciating how effective disability management can reduce both financial and human loss in work organizations is enhanced with the HR professional’s understanding of the concept of "disability proneness." For the purposes of evaluating and upgrading existing Disability Management Programs, this "White Paper" provides HR professionals with responsibilities in disability management with information on the antecedents and consequences of disability proneness, a key target in state-of-the-art integrated disability management programming.

Background

Based on anecdotes in the literature and our own observations at CEC Associates, Inc., in more than 4,000 injury cases, we introduced the concept of "disability proneness" in February 2000. In this White Paper, we discuss the concept of disability proneness, its antecedents, its consequences, and how it might be proactively managed by the work organization that wishes to reduce absenteeism, curb disability costs, and increase general productivity.

Retrospectively, we have learned from our experiences of evaluating injured and ill workers for the purposes of either disability assessment or rehabilitation that an employee’s personality difficulties coupled with a troubled life situation can produce an "unacceptable disability," a phenomenon that was identified 40 years ago by two occupational health physicians (Behan and Hirschfeld, 1966). An "unacceptable disability" may be defined as a vocational maladjustment with or without lost time that is difficult to explain from a medical perspective and is nearly always tension-producing for both the employer and employee. Unacceptable disability often reveals itself in an employee’s lack of productivity, increased unhappiness, and interpersonal conflicts manifested in the workplace.

When unacceptable disability is followed by an accident or diagnosable illness, the so-called "explanatory event" (e.g., a work-related slip-and-fall accident), unacceptable disability can be transformed into an acceptable disability for the employee. With resultant lost work time sanctioned by the benefits system and paid for by the employer, the pre-accident occupational maladjustment is no longer the focus of concern. Instead, the accident or explanatory event, not necessarily the beginning but the tangible evidence of disability, serves to justify lost time and absenteeism.

Behan and Hirschfeld concluded that particular employees, under certain stressful conditions, could manifest "disability without disease." From hundreds of case studies, these physicians concluded that unacceptable disability required an accident or explanatory event in order to be acceptable, even though the occupational dysfunction (disability) began well before the identification of an injury (disease). Behan and Hirschfeld first identified "disability proneness," although they never used that term.

For many years, Behan and Hirschfeld, as well as others (i.e., Weinstein, 1979), proposed that unresolved anger, particularly among men who struggled with verbally expressing their frustrations, was an identifiable precursor to the so-called explanatory event(s) (occupational injury or disease) that made lost time tangible and acceptable. Four decades after the Behan/Hirschfeld proposal, Daniel Vinson and his research colleagues (2006, Annals of Family Medicine) found that higher levels of anger increase the risk of injury, especially among men. Our experiences have led us to believe that ignored or poorly handled anger, frustration, resentment, unrecognized depression in the individual employee, and interpersonal conflict often sabotage work/business productivity. These human experiences frequently manifest as disability proneness that actually seeks an accident or injury to justify and explain inevitable lost time, or what most professionals think of as vocational disability.

It has become evident in our thousands of case histories that disability proneness is a significant concept in lost work time and it not only reduces organizational productivity, but also drives disability costs. More importantly, we have come to believe that disability proneness can be recognized by front-line supervisors, co-workers, employee assistance personnel, occupational health professionals, and nearly any well-oriented company employee committed to proactive disability management. In addition, we conclude that disability proneness can be a target of human capital strategies and workplace interventions, such as employee assistance and managerial mediation programs in a comprehensive, integrated disability management program. In pursuit of this conclusion, we begin with the complex emotion of anger, and look, in turn, at depression, substance abuse, employee helplessness, and other work dysfunctions that can result in disability proneness. We close the paper with an understanding of how key organizational personnel, led by an HR professional, can assist individual employees and organizations to recognize and proactively manage the antecedents and causes of disability proneness.

Anger in the Workplace

Anger in the workplace is a problem. There is evidence that workplace anger is common. Nearly 25% of respondents to a 1996 Gallup survey said they were "generally at least somewhat angry at work." Anger is a strong emotion that is often misdirected. Workplace anger is commonplace enough that we sometimes conceive of the significantly frustrated employee as potentially "going postal." According to the National Institute for Occupational Safety and Health (NIOSH), the Bureau of Justice Statistics (BJS) reported that an average of 1.7 million people were victims of violent crime while working or on duty in the United States each year from 1993 through 1999. An estimated 1.3 million (75%) of these incidents were simple assaults while an additional 19% were aggravated assaults.

While estimating over 111,000 violent incidents annually, NIOSH introduced a 1993 study showing that workplace violence costs $4.2 billion each year. Although anger does not always result in workplace violence, it serves as a form of control over others or it lingers as a personal preoccupation—anger that causes employees to be tense and at risk for accident and injury. Furthermore, workplace bullying, a form of chronic anger, is a significant problem that has led to proposals for federal legislation to prevent it.

After analyzing data from more than 2,500 injured patients, Vinson found that anger was significantly associated with increased injury risk among men and women combined. Of course, it is difficult for the purpose of doing research to define anger, but it is evident in retrospective analyses that employee tension buildup and anger are frequently antecedents to, if not causes of, workplace injury.

The Effects of Depression

Another very common human experience often described as "anger turned inward" that can be linked to workplace dysfunction and disability proneness is depression. According to the National Institute of Mental Health, "in any given 1-year period, 9.5% of the population, or about 20.9 million American adults, suffer from a depressive illness." The economic cost of depression is estimated to be in the tens of billions of dollars (1993). Left untreated, depression is as costly as heart disease or AIDS to the U.S. economy, costing over $43.7 billion in absenteeism from work with over 200 million days lost from work each year. Depression can also be shown to directly contribute to lost productivity, while at the same time increasing treatment costs (1993). Depression ranks among the top three workplace problems for Employee Assistance professionals, following only family crises and stress (1996).

The Behan and Hirschfeld formulations of more than 40 years ago (1966) and Weinstein’s subsequent construct (1979) hold true today: in the buildup stage of the disability process, before an explanatory event (such as a workplace accident or depression, which can be observed as increased irritability, increased blaming, and decreased productivity) becomes the seed for "unacceptable disability." Employee depression need not go unrecognized and untreated. Competent and sensitive supervisors, leaders of health and wellness programs, and active employee assistance intervention can interrupt the disability process precipitated by depression.

Substance Abuse

The vast majority of drug users are employed. Unfortunately, when they come to work, they do not leave their substance abuse and related problems at the workplace door. According to the U.S. Department of Labor, of the 16.7 million illicit drug users aged 18 or older in 2003, 12.4 million (74.3%) were employed either full or part time.

Research indicates that between 10 and 20% of the nation’s workers who die on the job test positive for alcohol or other drugs. In fact, industries with the highest rates of drug use are the same as those at a high risk for occupational injury, such as construction, mining, and manufacturing. The National Institute on Drug Abuse has estimated that employed drug abusers cost their employers about twice as much in medical and workers’ compensation claims as their drug-free coworkers.

The term "self-medicate" can be defined as the process by which some individuals may abuse substances while attempting to relieve other problems such as depression, anxiety, pain, sleeplessness, or other symptoms of illness. Therefore, substance abuse can be a symptom of an underlying problem, and individuals experiencing job stress (from promotion, demotion, failure, reduced seniority or status, or other changes) and/or family tension may be inclined to self-medicate.

Employees self-medicate with prescribed medications, illicit drugs, and/or alcohol. Substance abuse is an international problem, and it most certainly finds its way into the workplace. Historically, Occupational Assistant Programs (OAPs) have focused on substance abuse, and with their evolution, OAPs have evolved into more comprehensive Employee Assistance Programs (EAPs) with "broader brush" concerns and targets.

Employee (and Injured Worker) Helplessness

After years of research, Martin Seligman, a psychologist at the University of Pennsylvania, discovered that when an individual believes he or she has no control over life’s events, he is likely to develop helplessness, to give up, and to experience depression. The helplessness may become chronic and refractory (hard/impossible to manage) depending on what Seligman terms as the individual’s attributional style. Attributional style is how one generally perceives and explains life events.

Building on the Seligman model, in 1992, we described the debilitating effects of injured worker helplessness and the importance of work organizations endeavoring to keep injured employees productive and in control of their work lives as opposed to separating them through the so-called benefits system, e.g., workers’ compensation. We have shown that "benefits" programs designed to aid injured or sick employees actually engender helplessness in them. Productive meaningful work is more therapeutic than the receipt of disability benefits.

Since formulating his theory of Learned Helplessness, Seligman, also a best-selling author, has realized the more beneficial aspects of focusing on learning optimism. Human capital workplace strategies and proactive Disability Management Program administrators would be wise to integrate (there is that word again) Seligman’s concepts of Positive Psychology with their disability management philosophies.

It becomes very evident that work organizations and workplace relationships can create situations that set the stage for an employee to learn helplessness. Moreover, for particular individuals who tend to believe that personal control and job outcomes are beyond them, the lost time system becomes fertile ground for "injured worker helplessness." Depending on the workplace dynamics and the individual’s attributional style, the employee can learn helplessness that will, in turn, make him or her vulnerable to injury or illness. Once the lost time process begins, the workers’ compensation or disability systems only add fuel to the process of learning helplessness.

The lesson here—keep people productive in meaningful work in which they perceive control over outcomes! Resist releasing them into the lost time system where they have little control and making them recipients of "benefits." Not incidentally, research has also shown that "non-contingent reward" or benefits programs can produce a phenomenon known as "learned laziness" (Walker, 1992).

Work Dysfunction

Rodney Lowman (1993) defines work dysfunction as a psychological condition in which there exists a significant impairment in the capacity to work caused either by the personal characteristics of the employee or by an interaction between those characteristics and working conditions. Organizations vary in the extent they create or ameliorate stress. Jobs can be badly designed; supervisors can be ogres or behave very aggressively in an attempt to meet their own needs. Co-workers can be petty, vindictive, and antagonistic. Work conditions, particularly those characterized by high levels of responsibility with limited opportunities for control, can have demonstrable effects on an individual employee’s health and well-being. On the other hand, dysfunctional workers themselves may not be aware of, or accept responsibility for, the extent to which their own shortcomings and personal characteristics may contribute to problems on the job. Work dysfunction is often a precursor to disability proneness. Integrated disability management programs can be instrumental in identifying work dysfunction and truly assisting individuals who may manifest it through poor work performance, interpersonal conflict, or absenteeism.

Workplace Conflict

People do not always get along in the workplace and workplace conflict is inevitable. And, while it is costly, it is also reducible. According to Daniel Dana, a management consultant, over 65% of performance problems result from strained relationships between employees—not from deficits in the individual employee’s skill or motivation. Value differences, racial and gender prejudices, personal needs and emotional issues, perspective, role conflicts, and power struggles are but a few of the reasons that interpersonal conflict is common in the workplace and why these issues become a major focus of attention for managers. Most organizations spend little time training people how to communicate, cooperate, and solve interpersonal conflict. Yet, a classic study found in the Academy of Management Journal (1966) determined that 25% of the typical manager’s time is spent responding to conflict, and that figure rises to 30% for first-line supervisors.

Ignoring interpersonal conflict at work has even greater consequences. Some results of unresolved conflict in the workplace are injury and accidents, lost productivity, increased client complaints, absenteeism, sabotage, increased use of sick leave, and "presenteeism." Presenteeism, as opposed to absenteeism, is the phenomenon of lost productivity of employees who have a high intent to turnover but who do not leave the organization. This situation is sometimes referred to as "retire on the job."

What Corporate Strategies Can Prevent and Interrupt the Dynamics of Disability Proneness?

There are a number of human capital strategies to deal with disability proneness that have been deemed essential to exemplary and truly integrated Disability Management Programs. To be "truly integrated," these strategies must not become corporate silos operating independently in a bureaucratic fashion. Most of these programs can be effectively operated by a disability management team, led perhaps by a Human Resource professional, and integrated not only with each other, but into the very fabric of the workplace.

1. Safety/Wellness programs

For mid- to large-sized companies, the essential correctives to injury proneness are aggressive and continuing Safety and Wellness programs. (For smaller companies, understanding the basics of what these formal programs include is the minimum, essential ingredient.) Ergonomics, smoking cessation, relaxation/meditation methods, stress management techniques, nutrition classes, and other such prevention strategies are made a regular part of the operational process. In Pennsylvania, for one, employers get a 5% discount on their workers’ compensation premiums if they implement safety programs. If the work organization maintained a philosophy that all accidents could be prevented, and successfully acted on that philosophy, no one would be injured.

2. Communication Skills training for all supervisory and front-line management personnel

Whether a supervisor is attempting to teach a concept or intervening in a dispute, how well that supervisor interpersonally communicates is key to continuing productivity and morale. The most vital element in effective management and supervision—communication—must be learned. Unfortunately, most of us are "taught" communication styles from our first supervisors, our parents, and more often than not, these are ineffective in the workplace.

In The Assertive Manager, Elaine Zuker writes, "Communication is the cornerstone of business. Managers use many different channels to communicate with others, and [they] spend between 50% and 90% of their day in communication of one-kind or another. Communication is a set of skills you learn."

Most communication between front-line supervisors and subordinates is verbal. Listening and sending messages are more complex than we realize. Listening is an art that takes some of us many years to learn. When another’s behavior is unacceptable to us, the messages that we send them to change their behavior can be destructive rather than constructive to the relationship. Of course, no one wants to be told that their behavior is unacceptable. Learning to listen is tough, and learning to confront appropriately is probably even more difficult. Instead of acquiring and consciously learning listening and confrontation skills, most of us who engage in interpersonal communication at work follow our idiosyncratic styles of relating to others, and whether we want to admit it or not, we probably communicate like our parents communicated with us.

3. Employee Assistance Programs

The EAP is a basic process designed to assist management to identify and resolve an individual worker’s problem that interferes with work. EAPs are most effective when they can identify and address problems before they manifest themselves as such. Effective EAPs provide "24/7" access (including telephone access). The functions of an effective EAP in chronological order are supervisory training, assessment, consultation, referral, and crises management. The stages of how these functions develop are awareness of the problem, predicting consequences, identifying causes, and applying corrective resources. The more effective EAPs are "broad brush" and recognize that personal problems that interfere with work behaviors are highly variable and not limited to substance abuse alone.

Since prevention and early intervention are the objectives, EAPs must be constructed with the philosophy that supervisors are on the front line. Supervisors must receive specialized training in how to recognize potential problems and when, where, and how to refer the worker to the EAP component for services. Training supervisors in small companies is as important as training them in larger companies: the difference is in the referral source. Referral sources for small companies are frequently community-based resources. Safety/Wellness and EAP coordinators are responsible for designing the supervisor training, initiating it, and conducting follow-up training in regularly scheduled intervals.

In fact, because many of the causative factors in EAP cases are family-related (including domestic violence), model EAP services are available to family members as well. That is, the family may be a cause of the problem and will have to be treated along with the employee. In any event and in all cases, the familial unit will be affected by the employee’s dysfunction and will have to be brought into the referral/treatment process to optimize outcomes.

The objectives for Safety/Wellness programs and EAPs for employers include:

The specific services of the EAP include:

The overriding interest for employers in operating Safety/Wellness programs and EAPs is to put prevention and early intervention policies in place. While the value of the services that flow from such policies may, on first blush, appear to benefit the employee most, the greater value accrues to the employer.

4. Managerial Mediation Training

Since anger plays such a significant role in workplace injuries, the single most productive preventative is managerial mediation. Generally, strife in the work site is between co-workers or between an employee and his or her supervisor. Since this condition is a commonplace event, there has been, for more than a decade, a strategy to deal with it. The strategy is called Managerial Mediation Training.

The specialized methods and materials of mediation in the workplace are those that were developed in conflicts outside of this environment. There are now mediation (conflict resolution) services available through most court systems, counselors specializing in marital/divorce conflicts, and even in nation-to-nation conflicts: President Carter (Nobel Peace recipient in 2002) brought in mediation specialists when he worked on the Middle East conflict.

These methods of mediation have long since been adapted to workplace disagreements and are called "Managerial Mediation Training" (Dana, 1990). Workplace supervisors are trained in the specialized methods of mediation and are required to bring the methods to those conflict situations that, if left unaddressed, would likely escalate. The process is designed to bring "mutual acceptance" to the disputants in the conflict.

Unmanaged employee conflict is arguably the largest reducible cost in organizations today. It is estimated that over 65% of work performance problems result from strained relations between employees—not from deficits in an individual’s skills or motivation.

Federal legislation, notably the Family Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA), requires disputants under the direction of the EEOC and the Department of Justice to engage in mediation before they will sanction litigation.

Lastly, we recommend that various members of an organization develop a team approach to Integrated Disability Management. When delivered in an integrated fashion and managed by an interdisciplinary team that is led by a Human Resource Professional, these human capital strategies can be the core of a proactive, integrated Disability Management Program. True integration of disability management requires primarily the delivery of human resource programs and secondarily activation of lost time benefits programs.

Summary

The purposes of this White Paper are to describe the various workplace dynamics and human situations that can result in disability proneness and to address the basic elements and methods of effective disability management. More importantly, we emphasize the importance of integrating effective disability management not only in terms of benefits, but also primarily through collaboration of human capital strategies. In this paper, we examine the genesis of disability proneness and posit strategies to prevent causes of disability proneness and ameliorate, if not eliminate, the process—one that begins prior to lost time, injury, or illness. It is hoped that an understanding of disability proneness and a greater appreciation of how truly integrated disability management can prevent and interrupt the process of becoming disabled will assist HR professionals in helping design, implement, evaluate, and upgrade Disability Management Programs.

We propose that work organizations, preferably under the supervision of a Human Resources administrator, organize and integrate the various personnel programs that can collectively combat the antecedents and potential causes of disability proneness. By assisting employees at risk with the right services in a timely fashion, disability can be prevented. Integration of disability management is as much an effective combination of employee help programs as it is an integration of benefits programs and insurance plans. With an emphasis on prevention of disability rather than benefit payment for lost time, Integrated Disability Management programs can reduce costs by having a significant effect on keeping members of a work organization healthy and productive.

References:

1. Walker, Jasen. "Disability Management and the Disability Prone Employee." Pennsylvania Self-Insurers Association Newsletter, 1990.

2. Walker, Jasen. ""Injured Worker Helplessness: Critical Relationships and Systems Level Approaches for Intervention." Journal of Occupational Rehabilitation, Vol. 2, No.4, December 1992.

3. Behan, Robert C. and Hirschfeld, M.R. "Disability without disease or injury." Archives of Environmental Health, Volume 12, May 1966.

4. Vinson, Daniel and Arelli, Vineesha. "State anger and the risk of injury: a case-control and case-crossover study." Annals of Family Medicine. 4:63-68. 2006.

5. Weinstein, M.R. "The concept of the disability process." Psychosomatics, 1978, 19, pp. 94-97.

6. National Institute for Occupational Safety and Health. www.cdc.gov/niosh/homepage.html.

7. National Institute of Mental Health. www.nimh.nih.gov.

8. "Fact sheet: alcohol and other drugs in the workplace." National Council on Alcoholism and Drug Dependence. www.ncadd.org/facts/workplac.html.

9. Seligman, Martin. "Learned helplessness." www.noogenesis.com/malama/discouragement/helplessness.html.

10. Lowman, Rodney L. "Counseling and psychotherapy of work dysfunction." American Psychological Association, Wash. D.C. 1993.

11. Dana, Daniel. "Talk it out! 4 steps to managing people problems in your organization. Human Resources Development Press, Inc. 1990.

12. Academy of Management Journal (1966). www.aom.pace.edu/amjnew.

13. Zuker, Elaine. The Assertive Manager: Positive Skills at Work for You. AMACOM, 1989.

Making Disability Management Accountable

by Fred Heffner, Ed.D., and Jasen M. Walker, Ed.D., CRC, CCM

Disability management initiatives will need to consider measuring cost-effectiveness. This article delineates how disability management can impact organizational costs and provides numerous ideas on how to construct cost monitoring systems while determining the overall accountability of the Disability Management Program.

INTRODUCTION

Disability in the workplace is expensive. The Census Bureau predicted that the total medical, income replacement, and productivity-level related costs of workplace disability would top $340 billion in 2000. That year, The Mercer Human Resource Consulting Group reported absenteeism costs were 14.3% of payroll. The US Department of Labor reveals that companies lose 2.8 million workdays each year because of employee illnesses and injuries. Disability management consultants cite studies that indicate of the 500,000 newly disabled workers each year who remain out on disability five months or more, only half will ever return to work. Workplace disability is expensive, but no planned interventions or solutions to preventing and managing lost time will be acceptable to business leaders unless the proposed programs offer more than anecdotal results to justify continuing support.

THE FULL COST OF DISABILITY

According to research models employed by Rutgers, the State University of New Jersey, in conjunction with UNUM and the Washington Business Group on Health, a framework for conceptualizing losses and expenditures has yielded information on what employers generally spend and how they spend it on workplace disability. For nearly 20 years now, it has been well documented that the full cost of workplace disability is composed of Direct Costs + Indirect Costs + Disability Management Costs.¹

Direct Costs are thought of as benefits for medical absence (sick leave), short-term disability, long-term disability, disability pension, workers’ compensation, the disability component of Social Security taxes, and miscellaneous accident insurance.

Indirect Costs are expenses that occur when an employer is absent due to a disability. These costs of disability, which are in addition to the more straightforward direct costs, include: 1) the added expense of using replacement workers; and 2) lower productivity typically resulting from initial use of replacement workers, lack of replacement, or disabled worker before after absence.

Disability Management includes a variety of activities and programs intended to prevent disabilities from occurring and/or to minimize the impact on employers and employees. Included in these costs are resources used for claims management, return-to-work programs, wellness programs, employee assistance plans, medical clinics, and safety programs. As noted, using this type of framework, The Mercer Human Resource Consulting Group has reported that absenteeism costs were 14.3% of payroll in 2000, and it was predicted that these costs would steadily climb.

Disability management expenditures have historically represented approximately 1/8 of total disability costs on average. Every organization is unique and commitments to disability management vary tremendously. However, Disability Management Programs (DMPs) have been utilized increasingly over the past decade by businesses seeking to control the cost of workplace disability. The Washington Business Group on Health, in collaboration with human resources consulting firm Watson Wyatt Worldwide, has surveyed large employers since 1996 regarding their DMP activities and concerns. The most recent survey results indicate that 43% of large corporations have implemented some form of integrated DMP, up from 23% in 1996. As the workforce ages, the incidence of disability among the employed population is expected to rise thereby challenging employers to maintain proactive disability management initiatives, programs that recognize the importance of prevention and the necessity to accommodate the needs of a very skilled, but aging workforce.

MEASURING THE "RETURN" FOR EMPLOYERS WITH DMPS

There are three distinct ways employers can achieve significant gains from operating quality DMPs:

·         Return-on-Investment (ROI)

·         Productivity increases

·         Improved employee relations

Each of these outcomes carries significant potential for employers. To determine whether their DMPs are cost effective, employers must accumulate and analyze relevant data. This can be accomplished by having an external audit or by facilitating interdepartmental cooperation through a committee designed to gather and analyze costs before and after a planned DMP development. The most fundamental and critical function of a quality DMP is to gather and accumulate data relevant to the programs. These data include, at minimum:

Direct Costs:

·         Benefits for medical absence

·         Short Term disability

·         Long Term disability

·         Disability pension

·         Workers’ Compensation

·         Number of absences (by department)

Departmental personnel can help a DMP planning committee by tracking and reporting the number of days lost for all employees secondary to injury or illness, the total number of claims per year, the average number of lost time days per employee, and the average length in claim duration, among other things. [A worksheet which might be used as a template for accruing data is given in Appendix A.]

Indirect Costs:

While the greatest value of a quality DMP derives from the Direct Cost savings, there are substantial Indirect Costs savings as well. The primary Indirect Cost savings are:

·         Expense of replacement workers.

·         Productivity differentials associated with using replacement workers.

Additional Indirect Cost savings that are not as easily assessed include:

·         Reducing the number and severity of accidents and illness as a results of disability management education through safety and wellness programs and other efforts to educate employees.

·         Reducing the number of employees seeking legal representation and litigation.

·         Increasing in-house efficiencies achieved by Human Resources and supervisory staff in dealing with accidents/illnesses immediately, comprehensively, and with heightened expertise.

·         Reducing lost-time duration through the aggressive application of transition-to-work programming.

·         Enhancing the loyalty and dedication of employee as they come to appreciate the interest of management in their welfare.

·         Decreasing the potential for non-compliance to federal, state, and local laws.

The resultant values of a quality DMP may be couched in positive terms as well. A quality program should:

·         Increase productivity.

·         Create a safer workplace.

·         Provide for fairer and higher quality heath care and treatment for employees.

·         And above all, ensure healthy and committed employees.

DISABILITY MANAGEMENT RATIONALE

Disability management brings together human resource managers, occupational health and safety personnel, employee assistance program coordinators, rehabilitation case managers, departmental supervisors, and union representatives in a collaborative effort to maintain employee health and productivity while ensuring legal compliance with government mandates such as the Americans with Disabilities Act and the Family and Medical Leave Act. When appropriate, internal legal experts or "house counsel" may be involved in disability management issues that confront a governing team. Interdepartmental cooperation can be time consuming and expensive, and in addition to the costs of these previously stand-alone human capital programs, a disability management team can absorb time and costs. However, coordination, and when appropriate, integration of human capital strategies, is necessary to reduce costs associated with injury, illness, and absenteeism. The cost of constructing and maintaining a proactive DMP will need to be part of the organizational rationale or justification for moving the program forward year after year.

RETURN ON INVESTMENT

Having baseline data for Direct, Indirect, and Disability Management Costs at the start of proactive disability management allows an organization to make comparisons with similar data following intervention and further allows the organization to make decisions regarding ineffective and/or unnecessary strategies implemented during a comprehensive disability management protocol. For example, organizations utilizing contract rehabilitation case managers

Employers are becoming increasingly dissatisfied with anecdotal results to justify their support of DMPs and are more and more insistent on verifiable measures (the so-called "metrics") for these programs. There are no national benchmarks or standards for evaluating DMPs. Individual employers need to develop and rely on their own evidence-based practices. It should be noted that Human Resource professionals are not necessarily supportive of return-to-work commitments and disability management programming. Top level management will need to recognize this reality and work through any internal resistance operationalizing disability management. Another caveat is that older workers will have higher incidences of chronic illness, but these realities are offset by the experiences and loyalties these workers bring to the organization.

Each of the costs/benefit domains identified above carries significant potential for employers. To determine whether their DMPs are cost effective, employers must accumulate and analyze relevant data. The most fundamental and critical function of a quality DMP is to gather and accumulate data relevant to the programs. These data include, at minimum:

Monetary Costs:                                                                                                        

^{Productivity Gains:}

^{Employee Relations Improvements:}

In addition to these kernel measures, there are factors that might be classified as accruing to Administrative efficacies. These measures would include:

·         Claim and benefits analysis (timeliness, accuracy)

·         Program administration costs

SETTING DISABILITY MANAGEMENT OBJECTIVES

Employers desirous of gaining control of their DMPs for the purpose of realizing significant cost savings should start by deciding what they hope to gain from their program. The Weyerhaeuser Corporation, a long-time exemplary of such programs, implemented their program with the following objectives:

·         A significant decrease in the number of employees injured on the job.

·         An increase in return-to-work rate and fewer lost days.

·         An improvement in the quality of services provided to injured workers.

·         A reduction in workers’ compensation costs.2

It is important to note that Weyerhaeuser and other exemplary programs felt that they were not well served by "third party administrators" and subsequently brought all of their disability management planning and administration in-house. Employers seeking full, and quality, control of their DMPs will be well served by emulating the Weyerhaeuser model in respect to third party services.

When they decided twenty years ago that gaining control of their DMPs was an important thing to do, several companies like Weyerhaeuser made public the results they achieved by implanting carefully crafted DMPs into their operational procedures. Some selected outcomes (dating from their inceptions) of implementing in-house DMPs include:

      A. The Weyerhaeuser Company:

1. Reduced its workers’ compensation claim rate from 24 per 1000 employees in 1985 to 15 per 100 employees in 1989.

2. Reduced its lost-work-day rate from 102 per 100 employees in 1985 to 53 per 100 employees in 1985.3

B. The Walbro Corporation:

1. In 1985, invested $100,000 in a revised DMP and returned the investment in 10 months.

2. Reduced its workers’ compensation cost by more than 55 percent the first year of the revised program.

      C. The Will-Burt Company:

1. Reduced its workers’ compensation costs from $200,000 in 1985 to $9,000 in 1990

2. Medical costs declined from $1,961 per employee in 1985 to $1,993 in 1990, even though the medical cost index increased by 83% during this time period.

1. In 1993, the Philadelphia self-administered workers’ compensation program of the ThyssenKrupp Budd Company was renovated using the ideas presented in this compendium.
2. Stephen J. Fireoved, Esquire, led the DMP over the next 10 years using an interdisciplinary team approach as recommended by CEC Associates.
3. 90% of participants (injured workers) in that program transitioned to full duty with no ongoing restrictions, and that particular location of the Budd Company essentially functioned without the support of a third-party administrator.⁴

CURRENT STATISTICS

For employers who want more extensive data on disability management, CEC Associates, Inc., has found that the three most prolific sources of the costs factors in disability management programming are:

While the format by which they report on disability costs for employees varies as their Web sites upgrade from time to time, there is a wealth of information on costs available on these three sites. The National Business Group has an affiliation with Wyatt Watson which does regular employer surveys, and Liberty Mutual also conducts employer surveys and reports their results. Currently, the Liberty Mutual Web site has a "Lost Productivity Calculator" that can be useful in ascertaining costs.

References

¹ UNUM Life Insurance Company of America, "The Full Cost of Workplace Disability Study," 1989, 1992, and 1996.

²Akabas, Sheila H., Gates, Lauren B., and Galvin, Donald E. Disability Management: A Complete System to Reduce Costs, Increase Productivity, Meet Employee Needs, and Ensure Legal Compliance. AMACON (A Division of American Management Association). New York, 1992.

³Akabas, Sheila H., Gates, Lauren B., and Galvin, Donald E. "How Weyerhaeuser Improved Its Workers’ Compensation Program." Disability Management Sourcebook. Washington Business Group on Health, 1989.

⁴Fireoved, Stephen J. "Development and Implementation of a Successful Disability Management and Return To Work Program." Presented to the Philadelphia, Pennsylvania Association of Occupational Health Nurses, November 9, 2004.

APPENDIX A: Quantifying the Cost of Employee Disability

The following units can serve as a guide for employers to establish base-line data in respect to the cost of employee disability. The recommendation is that data be gather on each of the units and then accumulated for management review. (Employers may choose to add additional cost factors. Data may be –should be-- divided by such factors as salaried employees, hourly employees, specific department employees, etc.)

APPENDIX B: The Questions Senior Management Should Be Asking to Determine the Accountability of Their Disability Management Program (DMP)

Are the costs of creating and operating a DMP justifiable? In light of escalating lost-time costs and declining productivity, the questions senior management should be asking about their Absentee/DMP include:

1.      Do we measure the productivity of our workforce?

2.      How do we measure this productivity? What are the formalized or documented procedures we have for gathering this data?

3.      What are the specific data we should be accumulating to have a meaningful baseline to serve as the basis for sound management decisions?

4.      Are there standardized metrics available as benchmarks? If so, where can we find them?

5.      Are we interested in employee satisfaction as a significant business factor?

6.      Do our annual lost time costs affect our business results?

7.      Do we distinguish between the costs ascribable to return-to-work situations and our overall health care costs? If not, are there viable business reasons for not doings so?

8.      How do our absenteeism results and the attendant costs thereof compare with similar-sized companies?

9.      Do we recognize and address the similarities and differences among our short-term disability, long-term disability, workers’ compensation, and Family and Medical Leave Act statistics?

10.  Do we gather and analyze data on claim adjudication costs and timeliness of resolution?

^{APPENDIX C: How Effective Are Disability Management Programs (DMPs)?}

Determining the effectiveness of a DMP rests on the inclusion of basic components. Of these, the single most important determinant is the presence and sincerity of the top management commitment to disability management. Next, a DMP may be deemed to be effective if it addresses all (or at least most) of the following aspects of workplace disability. A DMP that lacks significant components from the following may be deemed to fall short of effectiveness.

The program has documented procedures and methods that are regularly applied to:

1.      measure on an ongoing basis the fiscal return (bottom line) from the DMP;

2.      demonstrate the specific responsibilities of the supervisor/Human Resources professional to their employees in respect to present or potential disabilities;

3.      demonstrate the specific relationships between medical providers and occupational rehabilitation providers;

4.      assign responsibility and accountability to individuals for the program outcomes;

5.      integrate and resolve the frequently competing interests of health care benefits, insurance issues, workers’ compensation, health and safety education, labor/management issues, and (when relevant) third-party providers;

6.      evaluate and address deficiencies in staff competencies to conduct an effective DMP; and

7.      address the issue of the organization’s leadership to understand the impact of the economy and labor market on the practice of rehabilitation and return-to-work programming.

Other critical issues in respect to determining program effectiveness include the understanding and application of:

1.      Transition-to-Work methods and materials

2.      The need for competency of staff in basic skills such as problem solving, communicating, writing, and identifying and qualifying the use of appropriate assessment tools.

Give Feedback, Not Criticism

By Jasen M. Walker, Ed.D, C.R.C.

Interpersonal communications are the keystone of all relationships, both at home and at work. Communications are especially critical in small businesses where fewer people are more closely linked.

At work, we may all find ourselves in the position of sending message to others: the boss, managers, and colleagues alike. These messages are frequently negative in that we are trying to convey the unacceptability of a certain behavior. Frequently, we send such messages in the form of criticism, or "put-downs," because most of us have learned to use criticism as a tool to modify (or attempt to modify) another’s behavior.

Criticism, however, generally produces resistance to change and, as a result, defeats the very purpose for which it is intended. In other words, criticism is seldom constructive. In fact, "constructive criticism" is truly rare: it might, indeed, be thought of as a contradiction in terms. Let’s look first at some thoughts about criticism. I will then suggest some methods for increasing constructive communications – not criticism – in the workplace.

The "I" Message

Dr. Thomas Gordon, in his books Leadership Effectiveness Training and Teacher Effectiveness Training, tells us that critical messages are heavily loaded with negative judgments. They chip away at the recipient’s self-esteem, damage the relationship, and cause defensive responses in the receiver of fault-finding messages.

The person who is being criticized tends to focus attention on how to make such defensive responses. The result is that the behavioral alternatives we would like that person to consider are quickly lost in this defensiveness. An employee, for example, hearing your critical message, will inevitably think: "There’s something wrong with me (or you), otherwise you wouldn’t be causing me this problem."

Gordon goes on to suggest that critical messages are also often dishonest because of the manner in which we "code" them. We criticize because another person’s behavior causes us a problem. However, we do not report that we have a problem. Instead, Gordon points out, we send a "you" message: "You are always the one who is late for meetings. You are so irresponsible."

Gordon advises that we must "own" the fact that we have a problem with this person’s tardiness and send an "I" message: "When you are late for meetings, I become annoyed and anxious because I do not want to start the meeting without you, and yet, the others who are on time should not be delayed or inconvenienced. This conflict annoys me and wastes my time."

As you can see, verbal criticism, such as labeling, name-calling, or judging, is generally at the core of "you" messages. This is dishonest communication because the sender of the message is shifting the ownership of the problem to the receiver. In fact, it is the sender who owns the problem that results from the other’s behavior. In your position as a boss, it is to your benefit to find ways of sending "I" messages.

Gossamer Threads

Dr. Sidney Simon, a humanistic educator, has said that our relationships are held together with "gossamer threads." Each of us is connected to those who are important to us with a light, delicate, yet resilient fiber. Real gossamer threads, of course, are film-like webs that can support significantly more weight than the spider that weaves them.

In our relationships, criticism moves quickly along the web as a wave of shocks and vibrations. What’s more, the shock wave is returned to the sender of critical messages, who often feels guilty and less worthy. Resentment flows along the threads from receivers to senders of put-down messages. Eventually, with enough criticism, the threads that tie us together can be irreparably damaged. With enough criticism, the connecting webs are broken and communications ceases.

In the workplace, you are an important person to your employees. They look to you for appreciation and support. They hope to be recognized for a job well done. When criticism is given, the gossamer threads that hold together work relationships are stressed and damaged. Employees feel mistrust, resentment, and alienation, and there is little reason to wonder why worker motivation and on-the-job morale might suffer.

The Value of Feedback

It is apparent that all of us would benefit from re-thinking and re-conceptualizing the nature and purpose of criticism. First, of course, we must accept that learning, task-orientation, and productivity will inevitably require communication about the quality and/or quantity of work performed. To keep productivity and worker motivation high, however, you must avoid the traditional pitfalls of criticism that intend to advise, instruct, correct, and provide solutions. Instead, when employee behavior is unacceptable, you would do well to reconsider criticism in terms of feedback.

Feedback differentiates between put-down messages and those that help employees better understand how their unacceptable behavior is designed to do three things:

·         Let the employee know the specific behavior that is unacceptable.

·         State how the unacceptable behavior tangibly interferes with getting the job done.

·         Express how you feel, both about the unacceptable behavior and the inability to get the work done.

Remember the previous example of an "I" message? Such messages do not have to be perfect; no matter how carefully constructed, they, too, will cause an emotional reaction in the receiver, and you must be prepared to listen carefully to the other’s response. Nevertheless, "I" messages are effective because they let the receiver know you are willing to assume your responsibility in the relationship.

When it is necessary to give feedback about another’s behavior, try to do it immediately, if at all possible. When you store up negative feedback and your associated feelings, the situation is likely to erupt at a later time, thus risking more damage to the relationship. However, you would also do well to sensitize yourself to the other’s readiness to receive feedback. No one needs a feedback session when he is having a bad day.

Some How-Tos

Let me suggest some methods for increasing constructive communications in the workplace.

1.      Establish and adhere to criteria for giving negative feedback.

Focus on specific behavior in a non-blameful manner. Do not attach personality traits or use judgmental terms such as "irresponsible," "thoughtless," "stupid," etc.

"Own" the problem by stating how the behavior affects you; avoid sending the other person a "you" message. Instead, begin with "I" and state specifically and descriptively what you observe in the other person’s behavior.

Be around to pick up the pieces. That is, be willing to listen actively to the response your message will no doubt elicit from the recipient of your feedback.

Finally, if the other person has heard this feedback several times before, then this should tell you the relationship is either too poor to foster helpful change or the other person derives some gratification in continuing to behave the way you find unacceptable. If the latter is the case, and it likely is, sit down and discuss your individual needs. In other words, problem-solve.

2.      Process feedback with a third party before delivering it.

Before delivering negative feedback, check it out by discussing it with a third party. It is not necessary to divulge the name of the person with whom you have a problem. Do not use this review as a chance to gossip. Such discussions with a neutral party will usually help you sort out the problem and deliver a better message.

3.      Have a third party present.

With the permission of the receiver, have a third party present. The receiver may wish to choose the third party, but agree that this person should remain neutral. A third person serves to keep the message sender careful in the manner in which he or she communicates feedback.

4.      Schedule validation time.

On a weekly basis, roam around your office and find someone doing things correctly. Tell them about it.

5.      Utilize validation envelopes.

Have everyone in your business tack an envelope with their name on it to the wall of an accessible spot –the break room, for example. Let all your employees know they are encouraged to slip notes into the envelopes of individuals who have done something they appreciate. Validation envelopes allow everyone to communicate recognition, appreciation, and/or gratitude for the day-to-day acts of productivity and kindness that might otherwise seem taken for granted. Moreover, they allow statements of appreciation to be shared in all directions, not just from the top down.

6.      Know the difference between validation and praise.

      Validation is sincere statement of appreciation for an act of another. Praise, on the other hand, is given to manipulate others and reinforce behavior. It is designed by the sender to control outcomes. Pure validation has no purpose other than to express gratitude and appreciation.

      You may get resistance to these ideas at first, but gently encourage their use. You will be surprised at what happens when you continue to deliver carefully constructed feedback, appreciate and validate rather than praise, and establish mechanisms by which both feedback and validation can be sent and received.

Dr. Jasen Walker holds graduate degrees in counseling and educational psychology, and has been a small business owner for 25 years. His firm, Corporate Education and Consultation Associates, Inc., in Valley Forge, PA, provides services geared toward making the workplace more productive through the human element.

What skills does a young person need for a rewarding career?

^{By Jasen Walker, Ed.D., C.R.C., C.C.M., and Fred Heffner, Ed.D.}

Background:

In this article, we focus on those traits and skills that individuals in the present economy must develop in order to fashion a rewarding career. We reference the findings of several sources and add information gained from our own experiences in evaluating thousands of individuals who have been both successful and unsuccessful in the world of work. The article starts by identifying behaviors that we believe young people need to manifest to develop a successful career, and we conclude that the assumption made by several human development theorists, especially Lapan (2004), is correct: Young people should develop an approach to the present and future that is "proactive, resilient, and functionally adaptive."

We begin by recognizing work dysfunction as the opposite of vocational success. Lowman (1993) defines work dysfunction as "psychological conditions in which there is significant impairment in the capacity to work caused either by characteristics of the person or by interaction between personal characteristics and working conditions." Lowman is careful to point out that unemployment would not be classified as a work dysfunction because the condition is the result of an outside force. However, the condition of the worker who is terminated because of depression or some other personal difficulty (e.g., unmanaged anxiety and resultant error-proneness) would be considered a work dysfunction.

We believe that future work dysfunction, occupational pathology, and the more ubiquitous job dissatisfaction can be prevented to a large extent by adopting and promoting youth educational experiences that emphasize "flow" (Csikszentmihalyi, 1990), "positive psychology" (Seligman, 2000), and "emotional intelligence" (Goleman, 1995). Moreover, we believe that genuine happiness through work is a realistic goal, not simply fantasy. We advocate that career assessment performed during the infant stages of vocational development can be part of the total educational experience necessary for any individual who upon entering adulthood wishes to enjoy true success, optimal experience, and what Kushner (2001) termed "a life that matters."

From our 25 years of conducting vocational evaluations and career assessments of nearly every kind of worker in the Western economies, two issues have come to our attention. First, many people, even after years of experience in a job or in several different jobs, have surprisingly little understanding of their occupational strengths and weaknesses. Second, most people possess even less appreciation of what employers expect from them as workers in terms of their attitudes and behaviors. These "blind spots" in worker perception nearly always lead to some level of work dysfunction or job dissatisfaction.

But it is not only being dysfunctional at work that leads to employee dissatisfaction. Finding meaning in work, realizing a higher purpose from it, and making a contribution to society through a chosen vocation, as opposed to seeking only financial gain, leads to job satisfaction for both employee and employer. Realizing job satisfaction and occupational success through matching an employee’s strengths with an employer’s expectations is the primary goal of careful career assessment and planned vocational development. Twenty-five years of experience in vocationally evaluating both satisfied and troubled workers leads us to believe that many individuals have not had the earlier opportunity to properly target a suitable career.

Ultimately, prospective employees who wish to pursue rewarding careers understand themselves and employment requirements generally, and careful career assessment helps create the platform for developing a set of skills essential to living "proactive, resilient, and functionally adaptive" work lives. Although many people "fall into jobs," we believe from our experiences in evaluating thousands of individuals in and out of work that the road to rewarding careers can be created and need not be left to chance.

Why do career assessments?

To answer this question, we cite the work of two researchers:

      ·         Dr. Amy Wrzesniewski of New York University

·         Dr. Edwin Locke of the University of Maryland

Wrzesniewski found that individuals experience work in one of three distinct ways:

1.      As a job: the individual is primarily concerned with the financial rewards of work.

2.      As a career: the individual is focused on advancing within the occupational structure.

3.      As a calling: the individual works not for financial gain or career advancement, but for the sense of fulfillment that work brings.

Locke’s research shows consistently that mental challenge – assuming that one is willing to respond to the challenge – is a critical determinant of job satisfaction.                           .

If one is only interested in work as a "job," there is no need for a career assessment. Individuals who declare themselves satisfied with this level should be shown the charts of yearly and lifetime incomes by educational level (see Appendices A and B). After examining these charts, the individual must either be satisfied with this classification (i.e., "job") or must be provided with motivating education. Wrzesniewski provides "paths" to finding positive meaning in work that could be used at this level.

Individuals who identify themselves with either of Wrzesniewski’s two other ways need to be provided an opportunity for a career assessment as the optimum way to achieve the career/calling. The career assessment will generally result in reaching career entry without lost time as the result of inappropriate detours and at the minimum cost to get there.

Locke’s finding that the basis of job satisfaction is a commitment to a mental challenge to achieve it is another lead into career assessment. The commitment to undertake the mental challenge leads again directly to the need to start with a career assessment.

But mental challenge alone is insufficient for the realization of job satisfaction. Most well-planned vocational evaluations include aptitude and abilities testing designed to assess what mental tasks individuals can manage and further approach in terms of current and future work. Job satisfaction also involves the match of the worker’s temperament, or personality traits, with those environmental factors present in the job and workplace. Very consistently, for example, we have found that individuals who manifest warmth, compassion, and a sense of humanity prefer to work in settings that offer and/or demand nurturing and altruistic interactions with others. Those who lack warmth often feel more comfortable and successful dealing with inanimate objects. However, most people have little insight into their personality dynamics and work temperament, and if they do, they frequently misinterpret what particular jobs might offer in terms of satisfying personal tendencies or needs.

Comprehensive career assessments account for an individual’s mental abilities, interests, and personal traits and attempt to match those variables with work that challenges and/or satisfies the individual on multiple levels. Again, unfortunately, most high school seniors know what they might be "interested" in doing, but few have the benefit of knowing themselves and the world of work sufficiently to begin with good career decisions. As a result, most graduates find jobs; many stumble into careers, and some find satisfying careers; but few realize their callings.

How do high school seniors usually decide on post-secondary direction?

There are clearly identifiable directions that seniors take in their post-secondary lives. Those directions include:

1.      Inertia: Students do nothing about their lives after high school. They simply determine one day after graduation to apply for a job, usually entry level at minimum wage (or enroll in some educational/training program) and thereby set their futures.

2.      Peer emulation: Students are influenced to follow selected peers. This might be either entry into education/training or simply into employment. When the chosen direction is into college or technical training, these students are generally in pursuit of an inappropriate career. If they enroll in college, they frequently do not choose majors until they are required to do so after the first year of matriculation. (It should be noted that a deferred choice of major can be a productive strategy since it provides more time and exposure to what may be an appropriate career.)

3.      Personal choice: Individual choices made on personal experiences. Students become wedded to some direction for personal reasons, as opposed to peer pressure, and doggedly pursue that direction.

4.      Quality career assessment: Students who avail themselves of career assessment opportunities have distinct advantages over those who do not.

5.      Teacher/Counselor recommendations: Students follow the recommendations of a teacher or guidance counselor. These recommendations should be comprehensive assessments that include results of aptitude tests and measures of temperament, but frequently they include only interest inventories (preferences) and an over-reliance on classroom performance records. (The recommendations of parents are less often accepted by a son or daughter as a matter of rebellion against anything suggested by parents.)

In terms of counselor recommendations, a new issue is emerging. With armed services recruiters visiting schools and aggressively recruiting, there is significant concern within the guidance counseling profession that counselors remain neutral in terms of advising students on enlistment.

One of the ironies of this issue is that military recruiters have one of the better career assessment tools available anywhere. The measure is called the Armed Services Vocational Aptitude Battery (ASVAB). The ASVAB is the most widely used multiple aptitude test battery in the world. It is designed to predict future academic and occupational success. Students who take the battery are not required to enlist in the military. When a student opts to take the battery, the counselor receives a copy of the results. In sum, students who take the ASVAB receive their scores in terms of their occupational and military proclivities. All high school students who choose not to take the ASVAB are disadvantaged in respect to knowledge about their vocational futures, unless they have the opportunity to take part in some other career assessment.

The issue of aggressive recruitment is not specifically germane to the present concern about career assessment, but the idea of advising students to follow any post-secondary career that is not derived from a valid career assessment is risky, if not pernicious. It remains ironic that students who do not take the ASVAB tend to be disadvantaged in comparison to those who do because they do not receive the same comprehensive aptitude battery to help with career assessment.

What are the advantages of Career Assessment?

^{Research shows that:}

What can be done to assist high school students to maximize their career direction?

The primary objective of career assessment is to prepare for life after basic education is achieved. CEC Associates’ experience with clients in a vocational rehabilitation setting is that workplace injuries equate to low self-esteem and lack of motivation. A too-frequent characteristic present in those who are in vocational rehabilitation is that they are heavily invested in the "money economy" as opposed to the "satisfaction economy," as postulated by Seligman in Authentic Happiness. ("Our economy is rapidly changing from a money economy to a satisfaction economy.") The issue as described by, especially, Seligman and Wrzesniewski is moving from a "job" to a more meaningful work-life experience. Wrzesniewski defines the "job" as a reality where:

    "The nature of work itself may hold little interest, pleasure, or fulfillment. Since the primary concern is the wage, if there is a decrease in pay or if a higher paying job opens up, they [the job holders] are quick to drop the job and move on."

Career assessment should not be equated with the desire to achieve upward mobility. To establish a basis for the world of work, young adults should be encouraged to take an active role in a developmental process that can lead to a maximized level of satisfaction. Students should be given an opportunity to:

·         Invest effort in career exploration to preclude making expensive curriculum or school changes later. Changing a major or trade is extremely costly.

·         Examine the potential outcomes of a quality career assessment in terms of opportunities, avoiding frustration, and saving time and money.

·         Determine what to major in before examining the range of schools that can provide that major most effectively/efficiently.

·         Appreciate one’s skills, abilities, interests, and self as a basis for making informed decisions.

·         Understand that job/career choices should be based on preference and suitability.

·         Realize that job availability after college or trade school may be a primary consideration in the developmental process.

Career Assessment: Lapan’s theories of career development across K through 16 years:

Richard Lapan of the University of Missouri-Columbus has developed a rationale (sometimes called an agentic approach) for the career assessment that evolves like this:

1.      Young people should develop an approach to the present and future that is:

·         proactive

·         resilient

·         functionally adaptive

2.    This approach requires young people to be able to:

·         interact with a clear sense of purpose and direction

·         orient themselves to valued opportunities and choices

·         act in agentic and empowered ways

·         exhibit a mature commitment to a self-defined direction

·         be hopeful, motivated, and optimistic about the present and their future

·         persevere and overcome obstacles

·         be creative and curious

·         balance an ability to be entrepreneurial with the need to care for others and the environment

3.      Six primary constructs that promote either growth or constriction in choosing a future career include:

·         positive expectations, including self-efficacy beliefs and attributions

·         identity development through the interrelated processes of career exploration and goal formation

·         an enhanced understanding of oneself, the world of work, and how best to fit or match this self-understanding to occupational possibilities

·         the pursuit of one’s intrinsic interests and preferences

·         the ability to achieve academically and become a self-regulated, lifelong learner

·         the use in one’s everyday interactions with others of a range of complex social skills and work-readiness behaviors

The essential piece in the transition from high school to post-secondary education/ training is the application of positive psychology principles to the process. Seligman’s concept of positive psychology has grown from theories that emphasize positive prevention and optimism as opposed to negative thinking and a focus on pathology and dysfunction. The career assessment is predicated on a positive embrace of the future and is a crucial component of it.

Survey of recent college graduates as new employees

CEC employs college graduates as Vocational Evaluation professionals. In a survey of these young professionals, CEC found that:

·         The most frequently given reason for what the employees wanted if they were to consider themselves in a "rewarding career" was the opportunity to "learn more and upgrade their skills."

·         Next to the "learning" opportunity as a prime contributor to a "rewarding career" was the opportunity to "advance and grow."

·         As for desirable "traits" one needs to have a "rewarding career," the respondents cited "hard work/determination" as the most important.

·         A "positive attitude" and "motivation/willingness to learn" were tied, after the "hard work/determination" trait, as the next most important traits to have as per survey results.

Differences between young professionals pursuing "careers" and workers in "jobs"

Simply citing the difference between the perceptions and beliefs of workers in "jobs" and those who pursue "careers," and preferably "callings," is not meaningful. What is important to note is that individuals who persist in terms of their preparation for a career identify worker traits and behaviors that are too often anathema to those who enter vocational rehabilitation because they have been occupationally dysfunctional prior to the onset of a job-ending injury or event. Too often, those dysfunctional workers fit into Wrzesniewski’s "job" classification. We propose that a career assessment performed effectively and in a timely manner can increase the number of workers finding "careers" and "callings" and thereby reduce the number of people who fall into the "jobs" classification.

As with any single or short-term intervention, comprehensive career assessment is not a panacea, but it can serve as a road map, a much-needed guide to increasing the likelihood of optimal life experience through future work. Without such a road map, young people run the risk of becoming lost by simply "falling into something," only to realize later that they are truly unhappy in their work. Occupational inertia, the tendency to be stuck in a job, can be devastating to both the individual and to the economy that thrives on hard work, commitment, dedication, innovation, and creativity. When there is so little time and so much of it is spent at work, job satisfaction and happiness through work need not be left to chance.

It should also be pointed out that the young professionals we surveyed see themselves primarily as pursuing a "career," not a "calling." However, that aspect of Wrzesniewski’s research is not relevant to the career assessment issue. Career assessment is an important step in ultimately gaining a "career" and perhaps discovering a "calling."

In reality, most professional vocational rehabilitation counselors see themselves as having to go back to that time in the reluctant client’s maturation process and now induce the career assessment that was not previously available to the often troubled worker. "Rehabilitation evaluations," the primary process used by vocational rehabilitation counselors, are in essence "career assessments." Perhaps it would be wise for parents, teachers, counselors, and educators in general to recognize the power of pro-activity and prevention in the career development process. Habilitation, the process of making one capable, is much less costly than rehabilitation.

Conclusion:

Career assessment is an important step to gaining a career. Our experience in vocational evaluation and rehabilitation has led us to believe that productive and satisfied workers have been privy to a developmental process that includes, to a considerable degree, elements of "positive psychology" and "flow" and that they have experienced in an appropriate education, one that includes careful career planning. Timely and competent career assessment is a critical tool in the development and future well-being of the adolescent. In vocational rehabilitation of troubled workers, that tool, the vocational evaluation, is often the corrective for the absence of a timely career assessment.

Workplace Injury and the Breach of the Social Contract

By Jasen Walker, Ed.D., C.R.C., C.C.M. and Fred Heffner, Ed.D.

"Betrayal, the only truth that sticks." - Arthur Miller

Recovery from workplace injury is often refractory and beyond explanation from the known medical models of physiology and tissue healing. Psychosocial phenomena such as injured worker helplessness, secondary gain, and co-malingering have frequently been posited as reasons for employees not returning to work following what medical observers would consider "normal" recovery time from diagnosable injuries. In this article, we explore the hypothesis that a breach of the assumed "social contract" between employer and employee can produce delayed or aborted return to work following occupational accident and injury.

After more than 27 years of conducting detailed interviews of injured workers and providing them with occupational rehabilitation services, it is our observation that Arthur Miller’s view of "betrayal" as the only truth that sticks has substantial merit in the life of the recalcitrant Workers’ Compensation claimant. We have come to believe that the injury itself frequently becomes a secondary issue to the unwillingness and resentment found in an adversarial employer-employee relationship, one that develops following a work-related accident, and sometimes even before that event.

Social contract theory is based on the assumption that individuals live in a state of nature in which group maintenance is difficult. Social contract theory is underscored by the assumption that the individual is either "good" or "evil." That is, social contracts are necessary in order for the group to survive because without the social contract, the individual would be left to his or her own devices and ruled by his or her own nature. It follows that this would be detrimental to interdependent members of a group. Social contract theory is not without controversy, but for the most part, Western culture has inculcated its members with the necessity of the social contract.

The social contracts that we have identified in terms of employee-employer relations include the expectations:

·         of equality and fairness in the hiring process;

·         of a safe working environment;

·         that work injury will not result in separation;

·         that return to work and/or vocational rehabilitation will follow maximum medical improvement; and

·         that without return to work and/or vocational rehabilitation, work injury benefits will continue.

Frequently, injured workers tell us that they have been victims of broken social contracts, perceived and unspoken covenants with their individual employers. To varying degrees, these workers’ compensation claimants expressed resentment, anger, bitterness, and quite regularly, a sense of betrayal. They lament that the system, and more specifically their employers, has let them down. They declare that they have been abandoned and often refer to themselves as "damaged goods." Sometimes they describe disbelief that the same employer who relied on them for years for faithful service would send private investigators to their neighborhoods to make inquiries about their activities following an accident or injury. With time out of work, these disgruntled ex-employees see themselves as "unemployable," and more than a few manifest signs of "injured worker helplessness." Others see themselves as "honorably disabled," and they seem to wear their occupational injuries as badges of honor, statements that another authority figure in their lives has overstepped his/her bounds and mistreated them. Ultimately, most permanently displaced injured workers find betrayal to be "the only truth that sticks." The prognosis for any type of occupational rehabilitation in these situations becomes poor.

We have come to believe that proactive disability management programs, recognized by well-managed companies as essential to the health and well-being of the company, are invaluable strategies in recognizing and validating the value of social contracts. Disability management programs can not only validate the social contracts most employees adopt, but can maintain the critical trust levels needed to keep the company productive. Let us review these often unspoken agreements.

The Expectation of Equality and Fairness in the Hiring Process

Discriminatory acts on the bases of age, national origin, race, religion, sex, and disability have been deemed illegal by the U.S. federal government. Nearly every worker is familiar with the concept of discriminatory employment practices, and they expect equality and fairness in the practices of hiring, compensation, transfer, promotion, and firing.

When company practices fail to protect individual employees (or particular sub-groups of employees), members of the work population in general resent the lack of protection. Moreover, employees fear and generally reject a company’s philosophy of disparate treatment in the hiring, pay, and return to work of individuals with a history of injury or illness. Recently, we interviewed an African-American longshoreman who declared that he was disabled from returning to work in any capacity except in work for which he was deemed ineligible because it was traditionally assigned to a group completely unrepresented by people of color. The job was in the "white gang," according to his statements.

Although vocational rehabilitation is also available and applicable to professionals and other high-level job classifications, many individuals in vocational rehabilitation worked in unskilled or semi-skilled positions with relatively limited educational requirements. For this cohort, the fairness of the hiring process is especially crucial. Add to this the reality that even if the hiring practices are fair, they also have to be perceived to be so by the applicant. Factors employers need to consider as they review their hiring procedures for effectiveness and compliance include the following. The applicant:

·         has available to him/her, in understandable language, full information on what the job entails;

·         is accorded all of the protections explicitly outlined in the Americans with Disabilities Act (ADA);

·         is encouraged, even prodded, to ask questions and be assertive about what is happening in the hiring process;

·         understands, when pre-employment tests are used, why the tests are given and how the testing process will unfold;

·         is guaranteed that the process is standardized and objective;

·         feels that he/she is fully respected by the HR professional who is responsible for hiring; and

·         is ensured that the information being gathered is truly and specifically only for the purpose of hiring.

Each of these minimum requirements of the hiring process is, at face value, easily acceded to and given assurances for by the HR staff. But the scrupulous adherence to the letter of each is another matter.

Two other significant issues are that the applicants perceive that the hiring process is racially and ethnically fair (that is, there is no test bias) and that there is "procedural fairness." In terms of procedural fairness, the measure is that it is "not what you do, but how you do it." The greater the applicant’s perception that the outcome of the hiring process can be favorable, the fairer the process will be.

Obviously, the issue of fairness becomes even more important to the individual who has been displaced from employment by illness or injury. Most workers’ compensation claimants, having carried out unskilled and semi-skilled jobs prior to being injured and displaced, have little experience in finding alternative employment without fair hiring opportunities. As a result, 70 percent of all workers’ compensation costs are driven by the 30 percent of injured workers who have encountered prejudice regarding their injuries and post-accident unemployment.

The Expectations of a Safe Environment

Over the many years of our vocational rehabilitation practice, the comment "I don’t want to go back to that place; it isn’t safe," is a common injured-worker declaration. In some instances, the statement may have a basis in truth; in others it certainly does not. Still, the failure to protect workers is the most serious mistake management can possibly make.

And the mistake goes beyond the delivery of protection. It is also a mistake to let employees or future employees perceive that they are not safe in a particular environment. Employers have an obligation to satisfy the expectations of their employees and to design and aggressively apply safety and loss prevention programs.

Safety is an interactive and communicative process. Workers need to be educated in how to access information about the work environment and how to better understand and exercise their rights under the Occupational Safety and Health Administration (OSHA). They must be given specific information on how to complain and file a danger report. Further, employees must be encouraged to participate in the environmental dialogue. Many employees see themselves as disfavored, dissuaded from raising criticism, or discouraged from having their viewpoints heard.

The specific issue here, however, is not that employers create and conduct safety measures, but that they become cognizant of an additional responsibility to make employees aware of the extensive safety measures in place. Employers need to create and nurture a safety culture. Employees have to be empowered to ask questions about safety and even challenge existing practices. They need to be engaged in the process to the extent that there can never be a time when they can say that the environment was toxic to their health and safety or that they will not return to work on the basis of that contention.

There is, in today’s workplace, a reality beyond actual safety and wellness. Employers agree when they go into business to a social contract that says their employees will have an expectation that they will be in a safe environment when they are at work. The employers need to assure that safety is no accident and, indeed, happens with intent.

Minimum steps employers can take to address safety and the concerns for safety that employees may have include:

·         creating, documenting, and disseminating the company’s commitment to safety;

·         developing and activating accountability measures;

·         involving employees in the formulation, conduction, and day-to-day practice of safety/ wellness programs;

·         identifying and addressing hazardous conditions;

·         investigating and documenting causes of accidents;

·         training staff in safety methodologies and materials; and

·         evaluating the effectiveness of the safety policies.

In some states, including Pennsylvania for example, employers get a discount on their Workers’ Compensation premiums if they plan and put into practice certified safety and wellness committees.

There are other matters that need to be considered with respect to the social contract for a safe workplace:

1.      Employees need to be fully informed of their rights under the ADA, especially their right to have job accommodations and to have job descriptions that are based on the "essential functions" of the job.

2.      One respected study carried out in Sweden showed that women are at a greater risk of not being involved in work environment issues than men.

The Expectation that Work Injury Will Not Result in Separation 

Until recently (within the last five years), having a workplace injury was frequently an opportunity for the employer to separate an unwanted worker from the payroll. The reality was that most injured workers turned out to be, by the employer’s thinking, undesirable. In recent years, this trend has slowed. However, while it is still the method of choice in too many cases, there are now limiting factors at work:

1.      Federal and state legislation make it more difficulty to do so. The principal pieces of legislation in respect to this are the ADA and various Workers’ Compensation laws.

2.      The departments of labor at both the federal and state levels are vigorous advocates for return-to-work programs.

3.      Employers, both small and large, are struggling to fill their job needs from an ever-decreasing pool of qualified applicants.

At this point, legislation and the case law refining the legislation make it more difficult to arbitrarily outsource employees. At the federal level, the Equal Employment Opportunity Commission (EEOC) is charged by the U.S. Department of Labor to set guidelines for the ADA and to vigorously support employees in litigation when they believe employers are in error. State departments of labor now also promulgate proactive approaches to return to work.

The Pennsylvania Department of Labor and Industry, for example, has decided that such programs can:

·         reduce the financial burden on employers, workers, and families of workers;

·         reduce the negative effects on workers by reducing the length of time off work;

·         allow unions to continue to protect the employment rights of their members;

·         allow the healthcare provider to develop more specialized treatment plans; and

·         provide support for the primary care provider in the return to work.

It is important to note that these labor agencies have, over time, waffled between favoring employers and, as presently, favoring employees.

Through aggressive and high-quality vocational rehabilitation services, employers have come to see that a return-to-work attitude carries benefits for both the employer and the employee. The historic method of returning employees to work was called "light duty." Typically, the employee was paid to just sit around until he/she was able to go back to work. The current methodology is "transition to work," where the employee is placed in real work, but controlled through incremental stages of duration and strenuousness.

Workers should have a realistic expectation that if they are injured at work, they will have the support of their employers in rehabilitating and returning to productivity.

The Expectation that Return to Work and/or Vocational Rehabilitation Will Follow Maximum Medical Improvement

Exemplary disability management programs include minimally essential measures. Among these are:

·         immediate and sustained intervention by the employer in the treatment plan;

·         application of the resources of a competent and unbiased Case Management service; and

·         placement of the injured worker into a Transition-to-Work program.

Following employee injury or illness, Case Management (CM) activities can be initiated immediately. Conducted by in-house rehabilitation professionals or by contracted case managers, CM can facilitate return-to-work objectives – outcomes beneficial to both employer and employee. Employees may delegate case management and return-to-work services, but this does not mean they can, thereby, abdicate their responsibilities for employee management.

Employers who provide extraordinary assistance to highly-valued employees need to come to understand that they have a comparable responsibility for all workers. If there are employees who likely will not receive the full support of the employer in the event of a workplace injury, the appropriate time to deal with that issue is prior to the critical event. When the employer does not intervene in the case of unacceptable employee behavior before an accident, the employer is renewing the social contract, and the employee is right to expect a return to work.

In other words, employee maintenance works best when it is seamless from date of hire to date of return to work as well as followed-up with a transition-to-work program. On the other hand, if an employee is nonproductive and dysfunctional, that issue should be appropriately managed before an accident and not after a lost-time injury.

The Expectation that if Vocational Rehabilitation Is Not Successful, the Work Injury Benefits Will Continue

While employee rights in the U.S. need not be as extensive as they are in some social welfare societies in Europe, American employers do have an obligation to provide long-term support to employees who sustained major injuries at work. Most Workers’ Compensation laws are built on "no-fault" concepts to "make the injured worker whole." Workers’ Compensation was originally considered "social legislation," and it naturally follows that employees would perceive "being made whole" as a social contract.

Losing the ability to care for one’s self can happen to anyone at any time. Addressing the issue of disability some years ago, George Will, a columnist for The Washington Post, told an audience that while he would never experience gender or racial discrimination, he could be injured on his way home that night and thereafter experience disability discrimination. Disability discrimination can happen to anyone, and disability management programs should build on this reality.

All employees have a right to believe that if they are catastrophically injured in the commission of a work assignment, they will have recourse to the benefits that provide for them for the remainder of their lives. By employing workers, employers are creating a social contract to assist employees in these circumstances.

When this contract is neglected or broken by either the employer or its insurance carrier, the injured worker experiences a sense of betrayal as he or she does when any of the aforementioned contracts are breached.

The Meaning of Betrayal

Betrayal is a personal experience that represents disappointment, letdown, loss, and pain. Those who are betrayed no longer trust the offender. Betrayal is an intentional or unintentional breach of trust or the perception of a breach of trust. Workplace injury followed by the injured worker’s sense of betrayal is like "pouring salt into the wound" and that experience makes it difficult for injured employees to gather and maintain the necessary motivation for occupational recovery.

Most work organizations are dependent on trust to survive. Without trust, organizations would be chaotic. Trust is the glue that seals the social contract. However, as Tennessee Williams wrote in Camino Real, "We have to distrust each other. It’s our only defense against betrayal." Perhaps the only more noxious experience than intractable pain is betrayal. Betrayal destroys the essential fabric of the relationships that keep organizations operating and people engaged in cooperative commerce.

Organizations would do well to advocate for their injured workers as well as understand and maintain the social contracts, spoken or unspoken, that most employees naturally adopt when joining a company. Organizational leaders must delegate but never abdicate their responsibilities to the workers they lead, whether in health or sickness.

It has been our experience that wellness advocacy in the workplace and well-designed disability management programs can significantly reduce the incidence of social contract breach and the consequential injured worker perception and belief that he/she is helplessness to do anything about that betrayal of trust. By proactively maintaining safe workplaces and managing illness and injury when it occurs, employers can maintain trust --- the human adhesive that holds work relationships together and the lubricant that facilitates employee performance.

References:

1. Csikszentmihalyi, M. (1990). Flow, The Psychology of Optimal Experience. Harper & Row, New York, NY.
2. Goleman, D. (1995). Emotional Intelligence. Bantam Books, New York, NY.
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5. Locke, E. (2000). The Prime Movers: Traits of the Great Wealth Creators. AMACOM.
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Appendices:

A.     Does a Post-Secondary Education Pay?

Educational Attainment                                   Annual Income           

No H.S. Diploma                                             $25,953

H.S. Diploma                                                   $34,518

Some College and/or Vocational/Technical       $41,526

Bachelor’s Degree                                           $63,41

*Source: The U.S. Department of Commerce, 2003

B.     Worklife Earnings

            Educational Attainment                      Earnings (in millions of $)

            Professional Degree                                      $4.40

            Doctorate                                                     $3.40

            Master’s Degree                                           $2.50

            Bachelor’s Degree                                        $2.10

            Associate Degree                                         $1.60

            H.S. Diploma                                               $1.20

            Less than H.S. Diploma                                $1.00

*Source: U.S. Census Bureau