DISABILITY MANAGEMENT: ISSUES AND ANSWERS
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Part I – Workplace Disability: Issues
None of us is immune to events that can instantly and permanently change our individual worlds. In the blink of an eye, any one of us might suffer significant changes in our health, through illness or injury, that could require the protections of the Americans with Disabilities Act (ADA) and/or assistance from our employer.
However, the productivity maintenance safety nets have holes in them and the work injury systems in our country are broken. Neither employee nor employer is well served by the workers’ compensation laws in most jurisdictions, and disability programs generally provide more disincentives to return to work than stepping stones for regaining one’s productivity and integrity following disabling injury and/or illness.
Part I of this Compendium will explore the complexities of the workers’ compensation system and other disability programs; the ways in which the ADA can serve as a solution to a broken paradigm; and how risk managers, human resource personnel, and employers in general might restructure their individual programs for preventing and managing disability.
Chapter 1: In The Blink Of An Eye: What Business Leaders Still Do Not Understand About the ADA
With a suddenness that mocks the blink of an eye, biomechanical forces can crush the cervical vertebrae of an auto accident victim and cause a driver or passenger permanent paralysis. A blood vessel in your head can burst in the blink of an eye and leave you hemiplegic, unable to use your dominant hand ever again. In the blink of an eye, a normal cell can become malignant. None of us is immune to events that can permanently change our individual worlds in ways that we cannot imagine or see, all in the blink of an eye.
Chapter 2: Injured Worker Helplessness and Workers’ Compensation
To explain why some injured workers fail to return to work, we need to understand the motivational and behavioral deficits that are present. Rehabilitation professionals and risk managers often point to poor medical intervention, attorney involvement, lack of meaningful work, and high wage replacement as factors that mitigate against returning to work. These may be valid reasons, but there are other explanations that deserve consideration.
Chapter 3: What Could Be Wrong With Workers’ Compensation Reform?
Although state governments have been working at reforming their own workers’ compensation systems, no attempt has been made to address the complexities of uncontrollability and non-contingent reward. This article defines these concepts and the critical role they play in the system.
Chapter 4: The Americans With Disabilities Act and Workers’ Compensation
When the ADA became the law of the land in 1990, it provided employers with the greatest instrument they have to begin controlling the ruinous costs of unmanaged workplace disability. This article discusses the basic concepts of Title I of the ADA and explores its significance for employers in their struggle to maintain viability.
Chapter 5: The ADA and Conflict Resolution
One of the most frequent causes of disruption in the workplace, and one of the most consequential factors leading to injury in the workplace, is conflict between individuals. This article explores the potential for conflict resolution as a work environment practice and the ways in which employers can significantly reduce workplace injury by sponsoring conflict resolution procedures.
Chapter 6: Increasing Company Profits Through The ADA
It is quite clear that the pool of “qualified” workers available to employers is dwindling. In this article, a case is made for a proactive approach by employers to search out qualified individuals among Americans with disabilities. The authors reference two important articles that deal with this issue.
Chapter 7: Disability Management and the Disability-Prone Employee
A significant factor in returning disabled workers to productivity is their attitude toward both their disability and their work. In this article, we explore the question of whether some employees have a predisposition toward disability and, if so, what employers can do about it. The authors draw on the seminal research of two insightful physicians who studied this phenomenon, R. C. Behan and A. H. Hirschfeld.
Chapter 8: A New Lexicon for Industrial Rehabilitation and Disability Management
Language is the building block for most social paradigms and nearly all efforts to facilitate organizational change. Employers and rehabilitation professionals often fail in returning injured employees to productivity because of antiquated ways of thinking and behaving. This article introduces relatively new language and revisits older concepts that help rehabilitation professionals and employers better understand lost time and return to work following occupationally significant injury or illness.
Part II – Proactive Disability Management: Answers
This section of the Compendium provides a conceptual framework and plenty of guidance on how employers can proactively manage workplace disability. American employers pay far too much for workplace disability because key organizational decision-makers either do not comprehend the difference between disability and impairment or did not act on the distinction. Disability is both preventable and manageable in the workplace. Safety first, safety last, but managed disability in between.
Chapter 9: The Difference Between Disability and Impairment: A Distinction Worth Making
Impairment and disability are significant terms in the workers’ compensation system, and the distinction between their definitions is critical to an employer’s understanding of the system. This article develops the distinction in meaning and how that distinction bears on the system.
Chapter 10: Analyzing and Describing Jobs: Useful Procedures in the Rehabilitation of Injured Workers
The ADA introduced new concepts to employers in terms of working with individuals with disabilities. Two of the most significant concepts are the essential functions of a job and reasonable accommodation for a job. In this article, essential functions and the process that determines them—job analysis—are discussed as the single most important step employers must take in their efforts to develop and maintain an effective approach to disability management in the workplace.
Chapter 11: 10 Tips for Disability Management Programs
In this article, corporate risk managers are offered ten tips for improving organizational approaches to managing disability. Comprehensive disability management is often a function of how well the organization coordinates existing human capital strategies. The list provided in this article consists of primary indicators that signal the need to design and implement active DMPs.
Chapter 12: On the Road to Controlling Workers’ Compensation: Traveling Beyond Compliance to Collaboration
Numerous jurisdictions have reformed their workers’ compensation laws in recent years. These reforms have seduced employers into a false sense of security by mandating, or at least encouraging, employer compliance with new legislation—compliance that promises reduction in costs and future exposure. But compliance alone falls short of true reform. Organizations must find ways to collaborate, not only with outside consultants and vendors, but also with internal personnel and departments. Achieving workers’ compensation cost reduction requires collaboration, not simply compliance.
Chapter 13: Making Disability Management Accountable
Disability management initiatives will need to consider measuring cost-effectiveness in order to be accountable. This article delineates how disability management can impact organizational costs and provides numerous ideas for constructing cost monitoring systems while determining the overall accountability of the DMP.
Chapter 14: Devising Cost-Effective, Reasonable Accommodation Strategies for a Satisfied, Non-Litigious Workplace
Organizations have the opportunity to accommodate qualified individuals with disabilities and still maintain productivity and job satisfaction. This article provides an overview of the job accommodation process and how organizations can avoid costly litigation by proactively managing workplace disability with job accommodation strategies that serve both employer and employee.
Chapter 15: The Future of Disability Management: A Case for Disability Management Programs in the Workplace
Well-managed companies will continue their human resource initiatives through the design, implementation and evaluation of DMPs. This article describes the basic components of a DMP and looks at the future of corporate disability management.
Part III. Forensically Measuring and Explaining Disability
The following section of the Compendium will serve as a primer to anyone interested in better understanding how forensic experts evaluate occupational disability and how psychosocial dynamics influence an explanation of vocational disability in personal injury matters. Even the most thoughtfully constructed, carefully implemented, and scrupulously operated DMP will not be foolproof. In some situations, employer-employee differences regarding lost time, retention, or separation will require court intervention and legal resolution. However, as with all aspects of disability prevention and management, organizational leaders and union representatives would benefit from understanding the dynamics of vocational disability and how it is measured and explained in court cases.
Chapter 16: Forensic Vocational Assessments
Forensic vocational evaluation requires a considerable number of technical processes, including standardized vocational testing. This article reflects on the experiences of one vocational expert who has practiced for over 25 years and offered expert testimony in both state and federal courts. Companies that become involved in workers’ compensation and personal injury litigation would be wise to become familiar with how vocational losses are measured and explained in court systems.
Chapter 17: Explaining Acquired Occupational Disability
The authors of this article have concluded that acquired disability following trauma must be “explained.” Unless an expert is fully informed of the multitude of pre- and post-injury medical and psychosocial dynamics that surround an individual’s claim of occupational disability, the expert may not be in a position to make absolute judgments regarding residual employability, pre- and post-injury work capacity, or the causal attribution of vocational disability. Thorough and accurate history-taking is necessary when assessing pre-injury work longevity, determining residual employability, and causally ascribing occupational disability to a particular event. Acquiring a complete and reliable history through various sources places the expert in a better position to offer a professionally certain opinion.
Part IV. A Final Word: Toward Organizational Health
As a final word, we offer an analogy between the person with dysfunctional behavior and the organization with nonproductive policies or no policies at all regarding managing disability. Work organizations can change just as the neurotic individual must change in order to become more productive. Change is not easy, and effective change can be realized with effort. But first one may ask, “How many psychologists does it take to screw in a light bulb?” It depends on the light bulb.
Chapter 18: Toward Organizational Health
The analogy offered in this article is that work organizations are similar to human organisms in many ways. Primarily both grow and develop in more or less healthy ways. For human beings to remain functional and productive, they must utilize their brains to cope with personal pain and establish purposeful change to remain vital. Organizations are like that. This article encourages the heads of organizations to recognize purposeful change through disability management programming. As with the human being, the responsibility for organizational change is internal and begins at the head.
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