july2015 screen version1rs

July 2015 Vol. 7, No. 3

Conference Issue: Strategies for Today’s WorkforceThe Effects of Extreme ProductivityDisability, Meet Mobility (the App)

annual conference

20th

san franciscoaugust 2-5 • 2015

OFFICIAL PUBLICATION OF THE DISABILITY MANAGEMENT EMPLOYER COALITION

Disability & Absence Management

contentsJuly 2015 Vol. 7, No. 3

DEPARTMENTSThe CEO’s DeskOur Collective Voice

5

Compliance Memos EEOC’s Proposed Wellness Program RuleSupreme Court Actions Related to BenefitsNew State and Local Employment Laws

7

DMEC NewsAttendance Blossoms at Compliance ConferenceLeadership Series Returns to Call Center Roots

32

FEATURESTHEME: Disability & Absence Management

Published by DMEC, Inc.

Editor Peter Mead, [email protected] For all Advertising & Editorial questions

Layout & ProductionMark Jaquette

Editorial Review Panel Skip SimondsLinda J. Croushore, MEd, CRC, LPCSuzanne Suva, SPHR, CPDM, CBP, CCMPOntaria Read, CPDMSteven M. Genduso, MA, CPDM, WCLSFred SchottMaranda Childress, SPHR

Find Strategies for Today’s Workforce at the DMEC Annual ConferenceOn the Leading Edge of IDAM Evolution

9 Disability Meets Mobility (the App) What to ask from vendors who design the mobile apps used by your employees

By Gary T. Anderberg, PhD, SVP, Claim Analytics, Gallagher Bassett Services

The Effects of Extreme ProductivityMeasures to promote optimal productivity & reduce the risk and cost of disability and absence

By Marcia Carruthers, MBA CPDM, DMEC Chairperson

13 19

9 1913

www.dmec.org ▪ @work 3

Editorial PolicyAll articles and content Copyright © DMEC 2015. @Work is the official publication of the Dis-ability Management Employer Coalition (DMEC). The magazine’s goal is to present industry and association news, highlight member achievements and promote the exchange of specialized profes-sional information. The statements and opinions expressed herein are those of the individual au-thors and do not necessarily represent the views of the association, its staff, board of directors or its editors. Likewise, the appearance of advertisers does not constitute an endorsement of products or services featured in this, past or subsequent issues of this publication. DMEC makes no repre-sentations, warranties or assurances as to accuracy of the information contained in the articles, and no content herein is legal advice. Consult your lawyer for legal advice.

@Work welcomes submission of articles of interest to disability and absence management profes-sionals at all levels. Complete instructions to authors are published online at www.dmec.org.

DMEC MembershipIndividuals receive @Work by being members of DMEC. Call 800.789.3632 or go online to www.dmec.org for more information.

Contact DMECMail: 5173 Waring Road Suite 134, San Diego, CA 92120-2705

Phone: Editor Peter Mead at 541.434.9029 or fax at 888.455.5526

Other DMEC Business: Call 800.789.3632, fax to 877.789.3632, or email to [email protected]

SponsorsDiamond SponsorMetLife

Platinum SponsorsAetnaAon HewittBroadspireCIGNALiberty Mutual Lincoln Financial GroupPrudentialSedgwick CMSSpring Consulting Group The HartfordThe Reed GroupThe StandardUnum

Gold SponsorsAnthem LifeMercerPacific Resources

Virtual Education ForumUnum

Leadership SeriesLiberty Mutual

DMEC National BoardChairman of the BoardMarcia Carruthers, MBA, ARM, CPDM

TreasurerJoe Wozniak, CPDM

Chief Executive OfficerTerri Rhodes, MBA, CPDM, CCMP

COLUMNS

Absence Mattersby Denise Fleury, MBA Integrated Disability and Absence Management and the Growing Importance of the Employee Experience

24

Prevention & Advocacyby Michael J. Dunst, MBA The Transformation of 24-Hour Coverage

25

Financial Fitnessby Phil Bruen Integration Is in Eyes of the Beholder

29

ADAby Elizabeth W. Stivers, JD, and Heidi Bimrose, CRCDo Lean Organizations Drive Employees to File Leave and Disability?

26

Employment Lawby Jeff Nowak, JD FAQs at the Intersection of FMLA and Workers’ Compensationt

23

Metricsby Crystal Fernalld, JD, and Deborah Labonar, PhDWhat Your LOA Data Reveals About Your ADA Programs

30

Coming Soon: Leadership Series Call Center White Paper

America’s 2.5 million call center workers operate under high stress, and it shows: they have three times the average use of FMLA, and high intermittent leave rates.

Visit www.dmec.org in early August for solutions that apply to many work units in the Leadership Series white paper, Best Practices Manag-ing Absence in Call Centers.

The Returning Soldierby Tyler Arvig, PsyD Substance Abuse at Work

27

People Data Drives Resultsby Rene Gates, MBAUtilize People Data to Identify Savings Opportunities

28

Employee absences can turn costly

Complex regulations may leave you spinning

And administration drains valuable energy

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When employees miss work, it can cost your company. There’s the direct hit of lost time and productivity, as well as the energy that goes into complying with FMLA and other leave entitlements. That’s why businesses turn to Unum for disability and leave management. We’re a leader in managing employee absence, offering expertise on ADA and other regulations. Our tailored solutions mean HR can spend less time on administration and more time building your business. For more information about the support Unum offers, call one of our expert representatives or visit unum.com/powerfulchange.

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© 2013 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group

and its insuring subsidiaries. Insurance products are underwritten by the subsidiaries of Unum Group. NS13-312


The CEO DeskJuly2015

Our Collective VoiceIam thrilled to be delivering my first CEO

message to DMEC members. I have always been impressed with the people associated

with DMEC and their shared passion for the collective work we do for integrated absence and disability management (IDAM).

I have been working in this field almost my entire adult life. DMEC helped me in my early career as an absence and disability professional working in corporate America, providing the tools and resources I needed to do my job.

DMEC introduced me to like-minded professionals who shared similar problems and challenges. I was presented with boundless net-working opportunities through DMEC confer-ences and chapter meetings with many people who not only helped me professionally, but have also become friends. DMEC is like that. I want DMEC to be that organization for you.

It was the collective voice of DMEC that helped me find my voice as an IDAM profes-sional, and I am proud to serve as your leader now to help shape the next generation of indus-try professionals.

Finding a collective voice is a challenge and a necessity. We continue to work with the organizational barriers that prevent full IDAM integration. And the challenge of social integra-tion in a four-generation workforce is growing. Our collective voice evolves as we meet these opportunities to improve.

DMEC’s 2015 Annual Conference shines a light on this. Keynote speaker Lindsey Pol-lak, spokesperson for The Hartford, will share her insights on “Today’s Unprecedented Work-

place: A Compilation of Four Generations.” How can a collective team voice emerge in such a diverse workforce? As we continue to evolve our absence and disability management best practices, we also must evolve the way we pro-vide IDAM to meet the communication styles and fulfill the expectations of our amazingly diverse employees.

Another long-term DMEC member and thought leader is Adrienne Paler, Leave of Ab-sence and Accommodation Program Manager at Amazon, who has a great history of impor-tant contributions to DMEC. Paler and her team will describe building a program in one of the fastest-growing corporations in the United States. We’re eager to make her experience part of our professional collective voice.

The DMEC Annual Conference has often been a staging ground for sharing innovation, discussing results from projects, and bringing new ideas to the IDAM profession. Fifteen years ago, Maria Henderson (now the Sr. Direc-tor, Workforce Health, Pacific Gas and Electric Company) led a DMEC Annual Conference session to gather employer input for the Em-ployer Measures of Productivity, Absence, and Quality (EMPAQ). This year, her PG&E team will be highlighting its “Workforce Health Re-search.”

The 2015 DMEC Annual Conference is an exciting event. It and the information in this issue of DMEC @ Work will expand our col-lective voice.

“It was the collective voice of DMEC that helped me find my voice as an IDAM professional, and I am

proud to serve as your leader now to help shape the next generation of industry professionals.”

Terri Rhodes, MBACPDM, CCMP

President and CEO, DMEC

COMPLIANCEMemos

The Equal Employment Opportunity Commission (EEOC) on April 20, 2015, proposed a new rule to govern the use of

incentives in wellness programs, offering more guidance following the agency’s aggressive litiga-tion against Honeywell in October 2014.

That litigation left some employers wonder-ing how to comply with the Americans with Dis-abilities Act (ADA) when offering incentives and/or penalties for employee participation in well-ness programs. The proposed rule appears more permissive of the use of penalties and defines when wellness incentives become “coercive.”

Employers face many questions now. Does the proposed rule provide enough clarity on how rewards and penalties are allowed in wellness pro-grams? If so, will the rule be sufficient to maintain the current model of providing wellness programs with incentives as part of health plans? If not, will Congress intervene on behalf of employers?

The comment period for the EEOC’s pro-posed rule ended June 19. Now the EEOC is assessing comments and considering changes to the rule before publishing a final rule. Congress has already engaged with this process. Following a corporate outcry over the Honeywell lawsuit, identical Preserving Employee Wellness Program Act (PEWPA) bills were introduced in the House

and Senate on March 2. Depending on the EEOC’s final position in its rule and how long the agency takes to issue the final rule, Congress could advance PEWPA.

Significant changes proposed in the draft rule include:

• “Reasonably designed.” If an employee health program seeks information about em-ployee health or medical examinations, the pro-gram must be “reasonably designed” to promote health or prevent disease.

• Cutting incentives. Employers may of-fer incentives of up to 30% of the total cost of employee-only coverage, down from 30% of em-ployee-plus-spouse coverage under current law. The EEOC also excluded the additional 20% incen-tive for tobacco cessation programs, potentially increasing the employee’s cost to the point where it could be in conflict with the Affordable Care Act’s 9.5% affordability rate rule.

• Employee notice. Employers must give em-ployees a notice describing what medical infor-mation will be collected, with whom it will be shared, how it will be used, and how it will be kept confidential.

Learn more key details at http://tinyurl.com/EEOC-wellness and at www.dmec.org> Resources & Info>Legislative Updates.


CM#7: EEOC’s Proposed Wellness Program Rule

John C. Garner, CEBS, CLU, CFCI, CMC

Chief Compliance OfficerBolton & Co

While the insurance world waited for the Supreme Court’s decision on sub-sidies for health insurance in the fed-

erally facilitated exchanges, the court has been un-usually busy with regard to other benefit-related cases. Recent actions involve retiree health ben-efits, the individual mandate and contraceptive coverage under the Affordable Care Act (ACA), and the definition of disability under the ADA.

In M&G Polymers v. Tackett, the Supreme Court rejected a long-standing presumption in the 6th Circuit regarding whether an employer obligated itself to continue providing retiree

health benefits. In a victory for employers, the Supreme Court sent the case back to the 6th Cir-cuit for further proceedings based on a narrower reading of contract law.

The Supreme Court revived the University of Notre Dame’s challenge to ACA rules related to coverage for contraceptives. The Supreme Court granted Notre Dame’s appeal and instructed the 7th Circuit Court of Appeals to review the uni-versity’s “free exercise of religion” claim.

Learn more key details at www.dmec.org>Resources & Info>Legislative Updates.

Compliance Memos continued on p. 18

CM#8: Supreme Court Actions Related to Benefits

2 2

1 Anthem Life pilot results, 2011.

Life and Disability products underwritten by Anthem Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

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FEATURE:Disability&AbsenceManagement

Find Strategies for

Today’s Workforce

Whatever keeps you up at night—“Why is Return to Work still so hard?” or “How to comply with this new ADA requirement?”—is addressed in Annual Confer-ence sessions.

From your first handshake with professional friends before the opening session to chats at the airport on the way home, it’s all about surrounding you with answers.

Asking your questions and sharing solutions at the DMEC Annual Conference are key to sustaining your career and the marketplace that serves you. Conference registration is open through July 29th at www.dmec.org.

Ever-Growing AgendaAt DMEC’s 20th Annual Conference, you’ll hear

from leading corporations on the cutting edge of innova-tion: Amazon, Chevron Corporation, Cisco Systems, Mi-chelin North America, Pacific Gas & Electric, and many more.

Many of the 50 sessions on the agenda are new, need-to-know topics for employers: Navigating Section 503 of the Rehabilitation Act, Post-FMLA Accommodation, Paid Sick Leave, Accommodating Pregnancy-Related Limita-tions (After Young v. UPS), and Reasonable Accommoda-tion for “Invisible Disabilities.”

But don’t let the familiar topics of some sessions fool you. Between the ever-changing regulatory and benefits landscape, and new tools for program implementation, even the “basics” are changing. Professionals need updates. Your organization can find new opportunities in such fa-miliar topics as: Leveraging Integrated Data to Manage

“There are conversations during lunches and at night time. At DMEC, people aren’t afraid to share their stories, their successes, and their challenges in an honest way so people can learn.”

Terri L. Rhodes, MBADMEC Chief Executive Officer

mployers come to the DMEC Annual

Conference for answers, from the first

conference in 1996 to the 20th Annual

Conference in San Francisco, August 2 – 5, 2015E


at the DMEC Annual Conference

Absence, Managing Complex Condi-tions in the Workplace, Transitional Work, and Retaining an Aging Work-force.

Daytime and evening activities create face-to-face networking with your peers and thought leaders to dis-cuss your concerns and discover new ideas and tools.

The Conference Experience“There are conversations dur-

ing lunches and at night time. At DMEC, people aren’t afraid to share their stories, their successes, and their challenges in an honest way so people can learn,” said Terri Rhodes, DMEC CEO. Rhodes has used DMEC net-working throughout her career, wheth-er working for third-party administra-tors (TPAs), employers, or consultants.

“You can get some great informa-tion from your peers at the annual con-ference, including lessons learned on a complicated issue, such as converting sick time over to a short-term disabil-ity program,” said Maria Henderson, Sr. Director, Workforce Health, Pacific Gas and Electric Company. “In the past, I’ve shared policies and forms, even full communication packages with other organizations. We all ben-efit when we increase the level of pro-fessionalism in the industry.”

“As a vendor, I benefit from learn-ing what’s on employers’ minds,” not-ed Jackie Willingham, VP Benefits,

The Standard. So does Dan Arkins, Regional Director, Group Disability, MetLife. “I’ve watched the conference mature over the years to become a world-class, industry-recognized event

that vendors, brokers, and consultants need to attend because that’s where our customers go,” said Arkins.

Vendors have always been key contributors at the DMEC Annual Conference. “We had exhibitors right from the beginning,” said Marcia Carruthers, DMEC Chairman of the Board. “We have always felt it impor-tant to bring to the attention of our members the leading product and service providers, especially those that have integrated or coordinated proj-ects and a focus on Return to Work (RTW).”

Said Arkins, “The beauty of DMEC is its employer focus. DMEC has really stuck to its knitting around

helping employers solve their practical problems.”

Willingham said that with employ-er budgets restricted, people tell her this is the one conference they attend.

To help those who can’t also attend the DMEC Compliance Conference, the Annual Conference now includes a full track of sessions on federal compli-ance topics such as Family and Medi-cal Leave Act (FMLA) and Americans with Disabilities Act (ADA).

Driving the Arc of Evolution: Expanding the IDM Model

The 2015 DMEC Annual Confer-ence continues a proud 20-year tradi-tion of driving advances in the profes-sion. At DMEC’s first conference in 1996, integrated disability management (IDM) captured the attention of em-ployers as the best process to reduce dis-ability claim cost and support employee productivity. Rhodes was one of the early innovators who took advantage of increased data management capability to expand the IDM model.

Applying cost metrics from work-ers’ compensation (WC) to short-term disability (STD) and long-term dis-ability (LTD) claims, Rhodes identified larger trends driving costs across mul-tiple insurance silos. “We found WC costs were not really driving costs in the organization. A small disabled popula-tion with nonoccupational disabilities was driving a significant portion of

10 @work ▪ July 2015 Vol. 7, No 3

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“In the beginning, the only statutory program was workers’ compensation. It was the one program that taught us how to manage claims.”

Marcia Carruthers, MBADMEC Board Chairperson

medical and pharmacy costs,” she said. The Annual Conference continued to develop education and networking around IDM concerns such as this.

Another key concern: employers wanted to benchmark their program performance against that of other em-ployers. To a large extent, “insurers weren’t doing benchmarking in the ear-ly 1990s,” said Rhodes. Or if they did, the benchmarking was only against the insurer’s book of business—a great first step, but often not as far or as systematic as employers wanted to go.

Employers began to network to get what they wanted, and the conference provided one venue where that hap-pened. DMEC played a key role in early development of the Employer Measures of Productivity, Absence, and Quality (EMPAQ®), which was sponsored by the National Business Group on Health (NBGH). Henderson conducted a ses-sion on EMPAQ at the Annual Confer-ence and shared the DMEC employer input to help NBGH develop this tool.

The project required robust data-sets from employers actively pursuing IDM, structured around metrics that are meaningful to employers. “What are the standard data points?” asked Rhodes. “They didn’t exist prior to that.”

Beginning in 2000, the EMPAQ project devoted considerable energy to bringing employers together to identify those meaningful metrics before build-ing the dataset. After some inactive years, the EMPAQ tool is again active, giving employers more benchmarking options.

And EMPAQ is not the only such ambitious project. A similar bench-marking project focused on Family and Medical Leave Act (FMLA) claims is being developed by Adrienne Paler, HR Program Manager, Leaves and Accom-modations at Amazon. Paler is a mem-ber of the DMEC Employer Advisory Council and a presenter at the 2015 conference.

From IDM to IDAMThe IDM model was maturing,

and employers were using the confer-ence to share their experience and ex-pand their program capabilities. “In the beginning, the only statutory program was workers’ compensation. It was the one program that taught us how to manage claims,” said Carruthers. Usu-ally based in Risk Management under corporate Financial departments, WC has fiscal and statistical rigor that can

be exported to employee benefits such as STD and LTD, usually based in Hu-man Resources (HR).

While the IDM model grew, land-mark laws were passed that shaped new employer needs and the way DMEC would grow: the ADA, the FMLA, and the Health Insurance Portability and Accountability Act (HIPAA). That trend has grown, with a burgeoning list of state and municipal laws guarantee-ing employees a right to unpaid, job-


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protected leaves and now proposals to make FMLA a paid benefit.

Back in 1993, not all employ-ers understood the future impact of ADA and FMLA. Nor did the ven-dors. Some early innovators such as Sedgwick and Matrix Absence Man-agement launched outsourced FMLA case management before 2000. But a fully competitive market for these ser-vices didn’t emerge until 2007 or 2008, said Rhodes, “when the market just ex-ploded.”

By then, some employers were in a state of crisis over how to manage inter-mittent FMLA leaves. Sessions focused on managing absences from unpaid, job-protected FMLA and ADA leaves were drawing the largest attendance at DMEC webinars and are a staple at the DMEC Annual Conference.

Managing Change

DMEC had focused on behavioral risk management to expand the IDM model into prevention and employee productivity. This theme has continued in webinars, the 2014 Behavioral Risk Management Survey, and other vehicles. DMEC responded to employer needs by refocusing its spring conference from be-havioral risk management to compliance with ADA, FMLA, and other statutory, job-protected leaves.

IDM became integrated disability and absence management (IDAM) at DMEC.

“I give DMEC leadership a huge amount of credit for refocusing the spring conference to FMLA and ADA compliance. The timing was impec-cable,” said Arkins.

Arkins can appreciate the need to be flexible in meeting employer needs in the ever-changing IDAM profession and marketplace. In 2000, a partnership of his company (MetLife) and Travelers provided a one-source IDM product for employers named “Synchrony.” They discovered that most employers pre-ferred a modular approach to IDM, se-

lecting the best-in-breed services tailored to their particular needs, rather than buying an off-the-shelf integration solu-tion from one external source. The prod-uct was eventually pulled off the market.

DMEC has had its own change to manage. By 2010, two trends began converging:

• Due to federal mental health parity requirements, more employers began to deliver mental health services through their group health plans, creating less demand for custom “carve-in” or “carve-out” behavioral health programs.

• Relentless growth in statutory pro-grams was making absence management a higher priority than behavioral health for many employers.

The needs and focus of DMEC mem-bers shifted, and so did the DMEC

spring conference. DMEC made it a priority to put the “A” (for absence) in IDAM.

Come to DMEC’s 20th Annual Con-ference in San Francisco, August 2 – 5, for the contacts, tools, and tactics your organization needs to maintain employ-ee productivity. Scout the future of our profession from IDM to IDAM to the productive workplace that your organi-zation wants to see.

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The Effects ofExtreme Productivity

In addition to absenteeism, stress fuels presenteeism, when employees are at work but not operating at their optimal capacity. Stress can also contribute to increased turnover and litigation, as well as decreases in productiv-ity, commitment, customer service, and business reputa-tion. Stress driven by excessive demands may contribute to difficulty managing emotions, focusing attention, making decisions, and thinking clearly or objectively. Fatigue from stress and disturbed sleep may cause irrita-bility and contribute to accidents. Stress may affect indi-vidual job performance as well as the work performance of teams. Some individuals cope better with stress than others, and some are more resilient following adversity.

Given this complex array of stress factors and per-sonal resilience, employers clearly need an integrated approach to identify and assist employees experiencing high levels of stress. The onus is on employers to take a hard look at workplace practices and consider what is being done to help overworked, stressed-out employees be healthier, be optimally productive, and achieve bet-ter work-life balance. These efforts present a new line of defense to prevent disability claims or lessen their sever-ity and reduce the amount of leave time requested by employees.

Job Stress and the GenerationsJob stress not only differs by industry and job type

but also by generation. Millennials (also known as Gen-

“The onus is on employers to take a hard look at workplace practices and consider what is being done to help overworked, stressed-out employees be healthier, be optimally productive, and achieve better work-life balance.”

Marcia Carruthers, MBADMEC Board Chairperson

s employees hit the wall from work pressures

driven by their organizations’ extreme produc-

tivity goals, employers bear the costs in a variety

of ways.A


Measures to promote optimal productivity and reduce the risk and cost of

disability and absence

AuthorMarcia Carruthers, MBA, CPDMDMEC Board Chairperson

eration Y), for example, tend to be ex-ceptionally resilient, which is a posi-tive attribute in a stressful, demanding work environment. These technology-savvy multitaskers crave better work-life balance through greater flexibility in work hours, work environment, networking opportunities, and dress code. Born between 1982 and 2000, the Millennials’ heavy focus on per-sonal lifestyle motivates them to work hard in order to play hard.

Young workers also desire and ex-pect to have a voice to offer up new ideas. Employers need to listen bet-ter and blend the fresh perspective of younger employees with the expe-rience of older workers. If younger workers are shut down, they tend to get frustrated quickly and lose inter-est and motivation — working only for the money and taking off as much time as they can until they find a new job. Tapping into the ideas and energy of Millennials is a must.

In addition, Millennials provide an example for other workers, includ-ing their Baby Boom parents, in areas of stress management, work-life bal-ance, and seeking meaning and relax-ation through personal connections.

The Importance of the Manager

Employee experience of corporate culture goes beyond the mission state-ment or company policies. One of the direct influencers of how employ-ees perceive the work environment is their relationship with their boss.

A Harvard Business Review ar-ticle on two studies of employee mo-tivation highlighted the role of the manager. It found that the best way to improve overall motivation was to sat-isfy four common “drives”: the drive

to acquire (related to the company’s reward system); the drive to bond (corporate culture); the drive to com-prehend (job design); and the drive to defend (performance-management and resource-allocation processes). While managers may have limited impact on certain aspects, such as the compensation system, they play an important role in praise, recognition, and doling out choice assignments, as

well as allocations from bonus pools that distinguish between top and bot-tom performers.

“Many supervisors are regarded well by their employees precisely be-cause they foster a highly motivating local environment, even if the organi-zation as a whole falls short. On the other hand, some managers create a toxic local climate within a highly motivated organization,” the article stated.

Direct supervisors and manag-ers are the ones who communicate the corporate values by what they say

and do. This includes frequency and modes of communication. For ex-ample, the supervisor stopping by an office, cubicle, or workstation to ask “How’s it going?” is far more effective for employee stress management and motivation than an e-mail missive.

Managers need to ask themselves two pertinent questions: How do your direct reports experience corpo-rate culture through you? Are your interactions with employees support-ive, while still promoting excellence, accountability, and productivity?

Intervention, Employee Participation, and Ethics

Many employers offer employ-ees incentives for participating and achieving goals in health and well-ness programs. Corporations may lower health insurance premiums, reduce copayments for doctor visits, or even give cash to employees who participate in health risk assessments (HRAs), reduce their body mass in-dex, join smoking cessation programs and remain tobacco free, or take other specific actions. These practices are becoming more common as employ-ers recognize that without widespread

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employee buy-in, even the best inter-ventions will not be effective.

However, rewards and incentives may fail to offset what some employ-ees perceive as an intrusion into their privacy and their right to manage their own lives and health. Employers must take the potential for employee resis-tance into account and address it as they explore interventions to improve health and manage stress, resiliency, and productivity.

In addition, as assessments and interventions expand from physical to behavioral health, employers must ask themselves: Do employees perceive a fundamental difference between measuring their blood pressure and conducting a brain scan for cognitive function? Or, if an HRA detects the potential for depression, what is the appropriate response? Is this an issue that an employee should take up with

his or her doctor, or can an employer intervene with programs and support?

It is not always easy to determine the line between employee privacy and program participation. However, employers, insurers, and third-party providers must consider such ethical issues as they venture into these gray areas. Each party must ask: What is the right thing to do to promote health while respecting employee pri-vacy?

Stress and Neuroscience — New Opportunities in an Expanding Frontier

Integrative neuroscience — a mul-tidisciplinary approach that looks at the links among our brains, our be-haviors, and the ways we adapt — is providing us with a better appreciation of the short- and long-term impact of stress on the brain. While this is a new

frontier for many employers, under-standing the neurological impact of stress helps make the case for health management programs that build re-siliency and promote mental health. Below is a headline summary of some of the recent findings in integrative neuroscience.

Stress and brain cells. Chronic stress, which is prevalent in many work environments, not only accelerates our loss of neurons (nerve cells) but also impacts how our brain generates new neurons. Unremitting stress creates an overall loss of brain cells and affects our ability to deal with stress on an ongo-ing basis.

Stress and the immune system. A preliminary study of caregivers of family members with chronic medi-cal illnesses found a link between stress and immune function, suggesting that people who face stress could be at high-

er risk for illnesses such as depression, heart disease, and diabetes.

Stress and exercise. An article in the Journal of the American Medical Association focusing on older women revealed that long-term regular physical activity, including walking, was associ-ated with significantly better cognitive function. These neuroscience findings may require us to expand our view of what interventions may help not only overall physical health but also brain function — and are easy to implement.

Stress and gender. Neurosci-ence also reveals significant differences among people—including between the genders—in dealing with stress. For example, a man’s focused performance at rest tends to start at a lower level and then reaches a peak when under a certain amount of stress. A woman’s performance, on the other hand, tends to start at a higher level and may de-cline under high-stress conditions. This knowledge can lead employers to con-sider how different environments and job stressors affect the performance of individuals and might better help us deal more effectively with employees.

Stress and trauma. Employers may begin to use integrative neuro-science research results by combining physical and behavior health programs to help employees deal with specific job-related stresses and even traumatic events (for example, when bank em-ployees are confronted by robbers). When we suddenly need to make life-and-death decisions, our brains react by minimizing the reflecting part of the prefrontal cortex so that our rapid, almost automatic primitive survival pathways can work with maximum speed. Employers can put training programs in place that help employees prepare these automatic responses for particular situations, improve workers’ decision process, and decrease the over-all traumatic impact on employees.

Employers should be aware that scientific advances in the area of brain

health and development are leading to an explosion of programs and offer-ings. Some are scientifically developed and tested; others are mere games. In this rapidly expanding field, the ul-timate line that separates health pro-grams from games and impact from hype may require guidance or approval from an oversight group, such as the U.S. Food and Drug Administration.

As science crosses the laboratory boundaries and passes into the work-

place landscape, employers will have a wider array of cutting-edge programs to evaluate for applicability and ef-fectiveness. Further, as employers in-crease their use of stress-reduction and resiliency programs, best practices will emerge backed by both science and proven profitability and productivity results relative to an array of industries.

ConclusionWe work in highly charged envi-

ronments, and the push to produce more in less time continually grows. The recession that began in 2008 and is finally over only added to the stress and anxiety felt by employees who are already being stretched to the limit. It appears that no lessons were learned, and the “new normal” continues to include excessive work hours and little work-life balance. Employers need

to respond with programs to sup-port physical and behavioral health to achieve optimal productivity before their most valuable resource—their human capital—hits the wall.

There is no “one-size-fits-all” solu-tion to promote optimal productivity. Job descriptions, industry demands, age of employees, competitive pressure,

16 @work ▪ July 2015 Vol. 7, No 3

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“Without this effort to refocus on optimal work practices, the corporate push for extreme produc-tivity can become self-defeating, resulting in less output and profitability, and higher disability and absence costs.”

and a host of other factors call for a cus-tomized approach. What might work for one group — for example, encour-aging executives to leave their laptops and PDAs at work when they are on vacation — will not address the needs of another, such as production workers performing physically demanding jobs over long shifts.

To take action that is right for their industry, work environment, and cor-porate culture, companies need to first consider the value of employee health, safety, effectiveness, and satisfaction. Without this effort to refocus on opti-mal work practices, the corporate push for extreme productivity can become self-defeating, resulting in less output and profitability, and higher disability and absence costs.

References1. Final Report, Corporate Return to Work Policies and Practices: A National Study, June 1, 2012, Burton Blatt Institute, Final Report, Dr. Kenneth Mitchell, Retrieve from: http://bbi.syr.edu/projects/Return_To_Work/docs/RTW_study_final_report.pdf

2. Retrieved from Job Accommodation Net-work, http://askjan.org/media/downloads/Low CostHighImpact.pdf

3. Chetty S, AR Friedman, K Taravosh-Lahn, ED Kirby, C Mirescu, F Guo, D Krupik, A Nicho-las, AC Geraghty, A Krishnamurthy, M-K Tsai, D Covarrubias, AT Wong, DD Francis, RM Sapol-sky, TD Palmer, D Pleasure, & D Kaufer. (De-cember 2014). Stress and glucocorticoids promote oligodendrogenesis in the adult hippocampus, Molecular Psychiatry. Reviewed at http://news-center.berkeley.edu/2014/02/11/chronic-stress-predisposes-brain-to-mental-illness/

4. Elsevier. (2008, 27 August). Chronic stress alters our genetic immune response. Science-Daily. www.sciencedaily.com/releases/2008/ 08/080827100816.htm

5. Weuve J, JH Kang, J Manson, MMB Bre-teler, J Ware, & F Grodstein. (2004, September 22/29). Physical activity, including walking, and cognitive function in older women, Journal of the American Medical Association.

6. University of Pennsylvania School of Medi-cine. (2007, November 20). Response to stress is gender specific. Social Cognitive and Affective Neuroscience. Reviewed at http://psychcentral.com/news/2007/11/20/response-to-stress-is-gender-specific/1559.html

7. Spangler NW. (2013, August). Employer Practice for Addressing Stress & Building Re-silience, Partnership for Workplace Mental Health. Retrieved at http://www.workplace-mentalhealth.org/stress_whitepaper

A version of this article was first published on IRMI.com and is reproduced with permis-sion. Copyright 2014, International Risk Man-agement Institute, Inc.


Your employees aren’t numbers. They’re valued players on your team. Our plans and programs help keep them well and at work. But if they need to be out, we help them get back in ways that fit them.

Caring makes the difference.

We get to know your employees’ strengths and challenges. Then we connect them with customized support, like skill-building or physical therapy.

It’s a new way to build a productive, engaged workforce. And more, to show you care.

To learn more, speak with your Aetna rep. Or visit us at www.aetnaworking.com.

The caring approach to productivity

Disability insurance plans/policies are offered, administered and/or underwritten by Aetna Life Insurance Company (Aetna). Disability insurance plans/policies contain exclusions and limitations. This material is for information only.

Visit our booth at the 2015 DMEC Annual Conference in San Francisco, August 2 – 5.

©2015 Aetna Inc.2015045

Compliance Memo, from page 6

CM#9: New State and Local Employment LawsCalifornia Family Rights Act (CFRA). Under the new regulations, employers must have a good faith, objective rea-son to doubt the validity of a medical certification of the need for leave. The new regulations also prohibit employ-ers from contacting doctors, except to authenticate a medical certification. The new regulations also extend the scope of the law to unusual leave situa-tions, such as employees with no fixed worksite, or who become eligible for CFRA leave while on another leave, or working for two or more employers.

Massachusetts Earned Sick Time Law af-fects employers with more than 10 em-ployees, even if only 1 works primarily in Massachusetts. Employees in the state—including part-time, temporary and seasonal employees—can accrue and use sick time based on all hours worked, including hours worked out-side the state. Under proposed regula-tions, employers can define their own “year” for purposes of accrual and use of sick time, and can require employees to use a full shift of earned sick time if the absence required the employer to hire a replacement for the shift.

Wyoming identify theft and data breach laws were harmonized, and the defini-tion of personally identifiable informa-tion covered under the law was broad-ened. Similar laws in Montana take effect on October 1, 2015.

Utah Antidiscrimination Act was amended to protect breastfeeding mothers from discrimination for breastfeeding or having related medical conditions.

Oakland California paid sick leave law allows employees to earn either 5 or 9 sick days, depending on the employer size. The law is part of Proposition FF, which also increased the city’s mini-mum wage to $12.25 per hour. The law took effect March 2, 2015, affect-ing people already employed.

Oregon Paid Sick Leave takes effect Jan. 1, 2016 (just announced at press time.)

North Dakota Century Code 14-02.4-03 was amended to add accommoda-tions in the workplace for pregnancy to

the existing requirement of accommo-dations for disability (physical or men-tal) and religion. The law takes effect on August 1, 2015.

Nebraska Fair Employment Practices Act was amended to clarify workplace protections for pregnant workers. The amendments also required affirmative action protections for pregnant work-ers. The law will take effect early in September, based on a formula.

Learn more details at www.dmec.org> Resources & Info>Legislative Updates.

18 @work ▪ July 2015 Vol. 7, No 3

Their absence is your lossIt’s no secret. When employees miss work, costs increase and productivity suffers. Mercer can help you find the connections between health and absence management, enabling you to improve compliance, streamline administration, and get the most out of your most valuable asset — your people.

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Disability MeetsMobility (the App)

What to ask from vendors who design the mobile apps used by your employees

for their leaves or disability claims

Group health plans have been quick to roll out apps for their subscribers to replace or supplement their long-standing online portals. Disability and workers’ compensa-tion (WC) carriers and third-party administrators (TPAs) are beginning to follow suit. As integrated disability and absence management professionals, we owe it to our indus-try and our partners to ask some questions about these apps and their potential to enhance our services.

If our profession establishes a collective voice to set standards for apps, we may be able to promote voluntary compliance toward several important goals:

• Improve the experience of the claimant/employee;• Help drive better disability, productivity, and health

outcomes;• Possibly reduce the incidence of litigation (in WC

claims) or of delayed Return to Work (RTW) and general claimant dissatisfaction with the disability process;

• Avoid a scenario in which we win the integration war in our organization, only to see our claimants boxed into silos again, because the claim apps they use are totally uncoordinated.

What We NeedWhat should DMEC members be looking for in

apps to help their employees who encounter an episode

“(Let’s) avoid a scenario in which we win the integration war in our orga-nization, only to see our claimants boxed into silos again, because the claim apps they use are totally uncoordinated.”

Gary T. Anderberg, PhDSVP Claim Analytics, Gallagher Bassett Services

ost of us now live on the planet of the apps. We

have apps (applications) on our smartphones

and tablets for shopping, movie tickets, airline

reservations, finding new dining experiences,

and so on. Nearly two-thirds of adult Americans

have a smartphone today.MAuthorGary T. Anderberg, PhDSVP Claim Analytics, Gallagher Bassett Services

of disability, whether occupational or nonoccupational? Here are eight basic questions to ask a current or prospec-tive disability or WC vendor:

1. Just another portal? Online claimant portals have been around for some time for short-term dis-ability (STD) and WC. Most of them take the “name, rank, and serial number” approach to facili-tate the intake of basic claim infor-mation and return some minimal claim information in response to a few everyday questions. Compared to the variety and level of service offered by modern “retail” apps, the classic online portal is primi-tive, the computer equivalent of a quill pen. While a 21st-century app should include these functions where appropriate, this is merely a starting point.

2. Where am I? Filing a claim is a step into the unknown for most

people. You’re hurt or ill, and your regular paycheck is being replaced by… well, by what? What should you do now? What comes next? What medical information do you have to provide? About how long should it take? What doctor should you go to? Adjusters try to explain all this in what is often a hurried and complicated phone call, fol-lowed by a long letter that arrives several days later. A mobile app can provide you with an illustrat-ed, step-by-step process map with FAQs for each step along the way to guide and inform you about the steps particular to your disability plan or WC jurisdiction.

3. How do I get paid? The adjuster will do his or her best to explain this, but a well-designed, secure app can show you each aspect of your claim and how it is being handled. You can look up the his-tory of benefit payments already

made by date and amount, and see what payments are scheduled for the near future. This information helps your claimants navigate not only the claim experience but also their daily lives while they are out on a claim. In short, the app can replace a lot of telephone hand-holding and can do it instantly, with no voicemail/callback delays.

4. What do I do next? Of course, the adjuster can provide a quick sum-mary, but a user-friendly app will show your claimant what’s sched-uled—the next provider appoint-ment, such as a functional capacity evaluation or independent medical examination—with an explanation of what this procedure is for and what your claimant should expect.

5. What medical provider do I see? The app will show your claimant not only who the doctor is but also provide travel instructions for how

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to get to the facility. The app will also provide informa-tion about the provider and why he or she is recom-mended to help claimants with their specific type of dis-ability. (Your group health plan probably provides this kind of information. Shouldn’t your disability or WC carrier or TPA be equally helpful when your livelihood is at stake?)

6. What’s RTW mean? Your app has a whole section on how the carrier or TPA helps you return to work and explains the workings of your benefits such as tempo-rary partial disability, Return to Work, STD, or LTD. The navigation bar and the app design let your claim-ant ask lots of questions and get immediate answers.

7. What if I have a different question? The app lets your claimant text the adjuster with short questions to get a prompt response. No more telephone tag. Prompt communication is the key to claimant satisfaction with the process.

8. How am I doing? Apps are very useful for solicit-ing user feedback. A well-designed app will allow the claimant to register delight or dismay as part of any encounter with no more than a couple of taps in the app. If the claimant feels poorly served, he or she can be flagged for immediate attention and remediation.

Getting over the TopNow, since this is DMEC and we understand the tre-

mendous value of integration, let’s ask another question. The new claimant apps that are appearing are all dedicated to the usual silos—STD, WC, group health. Shouldn’t there be a movement toward integration in the app world? One app that helps the claimant regardless of the payment silo his or her disability happens to fall into? Shouldn’t the “ask-an-adjuster” feature function in the same way, regard-less of which silo is answering your claimant’s question? Do we have to go through the same old silo issues all over again? Perhaps we can all get smarter, along with our smart-phones—and avoid a situation where a 20-something app developer can kill 20 years of integration progress. If you agree and would like to join me in taking collective action, contact me at DMEC’s 20th Annual Conference in San Francisco, August 2–5 (just look for the patriarchal white beard), or contact me by email at [email protected].

References1. Pew Research Center survey findings, accessed at http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/

22 @work ▪ July 2015 Vol. 7, No 3

Company membership entitles all employees at your company to receive member benefits. Let your colleagues know that all they have to do is sign up:

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your individual contact info.

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EMPLOYMENTLaw


FAQs at the Intersection of FMLA and Workers’ CompensationAdministering worker’s compensation

benefits in conjunction with Family and Medical Leave Act (FMLA) leave can

create issues that trip up even the most experi-enced human resources (HR) professional. Fol-lowing are some of the most common questions that arise in this area.

Can an employer run FMLA leave concurrently with a workers’ compensation absence?

Put simply, if a workers’ compensation (WC) injury rises to the level of a serious health condition under the FMLA, any absence asso-ciated with the injury should be designated as FMLA. If an employer fails to designate such absence under the FMLA, it arguably provides the employee with more leave than he or she is legally entitled to under the FMLA. Take, for example, an employee who suffers a job-related injury that results in a three-month leave of ab-sence, having received WC benefits during the absence. Four months later, the employee then takes leave to care for a parent. If the original WC absence was not also designated as FMLA leave, the employee may still be entitled to 12 weeks of FMLA leave.

Can an employer exhaust accrued paid leave while the employee is out on workers’ compensation and FMLA leave?

Where an employee is collecting WC bene-fits during FMLA leave, the employer cannot re-quire the employee to substitute any paid leave, since the absence is covered by the payments under the WC plan. However, the employer and employee can voluntarily agree to have ac-crued paid leave supplement WC benefits, since WC benefits typically only provide replacement income for two-thirds of an employee’s salary. Of course, since WC benefits often do not start payment until several days after injury, an em-

ployer can require the employee to use accrued paid leave until the WC benefits commence.

How does light duty affect an employer’s ability to administer FMLA leave?

An employee has the right to reject a light duty job while on FMLA leave, since the enti-tlement for leave is based on the inability to per-form the essential functions of the employee’s current position. In these situations, however, the employee risks losing WC benefits because he or she has rejected a light-duty work oppor-tunity, if the employer’s policy addresses refused light-duty work.

Can an employer use information learned during the workers’ compensation process to make deter-minations as to FMLA leave?

Yes, indeed! As the FMLA regulations make clear:

If an employee is on FMLA leave running con-currently with a workers’ compensation absence and the provisions of the workers’ compensation statute permit the employer or the employer’s representative to request additional informa-tion from the employee’s workers’ compensation healthcare provider, the FMLA does not pre-vent the employer from following the workers’ compensation provisions, and information re-ceived under those provisions may be consid-ered in determining the employee’s entitlement to FMLA-protected leave.As the Department of Labor makes clear,

information received under such a policy or plan may be considered in determining the em-ployee’s entitlement to FMLA leave. Note: If the employee does not provide the information required for receipt of WC benefits, the failure to do so will not affect the employee’s entitle-ment to take unpaid FMLA leave.

Jeff Nowak, JDCo-chair

Labor & Employment Practice of Franczek

Radelet P.C., Blog Author

FMLAinsights.com

ABSENCEMatters

24 @work ▪ July 2015 Vol. 7, No 3

IDAM and the Growing Importance of the Employee Experience

Employers commonly expect that integrat-ed disability and absence management (IDAM) should simplify and streamline

absence management processes.1 Today, there is also a growing belief that integration should deliver more than efficiency, cost savings, and increased productivity: it should also deliver a “great employee experience.”

This concept has its origins in the business model for a “great customer experience,” which reaches beyond good customer service results to the delivery of an excellent customer experience at all touchpoints. Today, human resources practitio-ners have heightened awareness of the employee as their internal customer, with a clear focus on the business need for high employee engagement, loyalty, and retention. Employers should look for their IDAM service providers to deliver that ex-cellent “employee experience” on their behalf.

Building the Excellent “Employee Experience” Know the customer. IDAM providers should

understand the employer’s vision, culture, and business environment. Provider staff should re-ceive this training at program rollout, with fre-quent updates. Emerging expectations include the use of electronic feeds to prepopulate em-ployee data fields, avoiding redundant questions. Using multiple channels for employee and man-ager feedback and satisfaction surveys, and incor-porating changes rapidly will become common.

Workforce demographics. The workforce pres-ence of Boomers (26%) and Traditionalists (14%) will diminish. Millennials will surpass both these groups, gaining a 75% workforce share within 10 years.2 In addition, today’s workforce reflects more global diversity than ever before.

Employers need their IDAM providers to educate employee-facing claim staff to recognize and adapt real-time interactions to demographic and cultural differences as well as to individual

needs. Younger employees are more likely to be self-reliant and comfortable with online self-ser-vice resources. Boomers may be more responsive to proactive Return to Work efforts, due to their cultural norms of “hard work and long hours,” but may be less likely to research online for an-swers to their absence questions.

Build quality and efficiency into all processes. Enhancing employee productivity includes not wasting employee time and ensuring interactions are efficient and accurate — “one and done.” Employers expect faster cycles of continuous process improvement, rapidly incorporating cus-tomer feedback and continually smoothing the employee experience.

Technology rules! Quick, easy access to seem-ingly unlimited information is now expected by hundreds of millions of people around the globe. By June 2013, use of mobile devices surpassed that of desktops by 60% to 40%.3 Employees expect personalized information delivered in a timely manner in their preferred method of com-munication. Self-service, chat sessions, and push communications with eligibility, payments, and claim updates are becoming standard expecta-tions. Emerging expectations are for IDAM ser-vice providers to make better decisions, faster — and communicate them almost instantaneously.

Technology advances and developing the “great employee experience” will significantly in-fluence employer and provider IDAM adminis-trative initiatives for the rest of this decade.

References1. Fleury, D. (2014, July). Creating simplicity in the

complex world of absence management, Absence Mat-ters column, DMEC @Work.

2. Hayes, J. (2014, October). Employee centric: HR de-livering great experiences. Society for Human Resourc-es Management webcast, retrieved from http://www.shrm.org/multimedia/webcasts/pages/1014haynes.aspx

3. Ibid.

Denise Fleury, MBA, SPHRSVP Disability and

Absence Management Sedgwick

PREVENTION&Advocacy


The Transformation of 24-Hour CoverageBack in the mid-1990s, companies were

beginning to look into integration of disability income (DI) and workers’

compensation (WC) insurance. Conceptually, the intent was to have a sin-

gle resource managing claims for both, stream-lining process and response times, as well as potentially resulting in cost savings through increased data sharing. (Some carriers tried to include healthcare as well, but with limited success.) However, technology posed a huge hurdle. At that time, system integration did not exist. All the necessary information was housed in separate, distinct systems or “silos” that didn’t and couldn’t “speak” to each other.

This approach required resources to be knowledgeable about the complexities and nu-ances of each state’s WC requirements, making it challenging for an administrator to have a single, deeply experienced resource who could oversee both WC and DI.

Also, the concept of integrating leave management was not yet on the industry’s radar; the industry was not offering any dis-counts for the packaged products, which could have helped entice employers to purchase the bundled option. As a result, integrated WC/DI struggled as companies failed to show no-table returns on investment.

Fast-forward to now: a better set of capa-bilities is in place to cover employees from a 24-hour perspective, and it is possible to inte-grate a diverse set of benefits: short-term dis-ability; Family and Medical Leave Act (FMLA) administration (both federal and state); lost time; WC claims management; plus a vari-ety of wellness initiatives that track individu-als and provide them with opportunities for round-the-clock assistance.

There’s also much more integration from a systems perspective. The data sharing between

WC and DI has increased across the industry, including lost time data. Even though WC and DI have different decision-makers, the claims associated with them are better tracked and integrated.

Additionally, the wellness and disease management services available to employees help fill in any gaps around the other pro-grams. These services assist employees with coping mechanisms to help keep them at work and reduce the amount of intermittent leave they may need to take. They have created a more holistic approach to managing employ-ees and their various needs on an individual, personal basis.

Wellness has been a fairly underutilized benefit for employees. With the passage of the Affordable Care Act, employers have shifted focus to wellness programs to help reduce over-all healthcare expenses. They are focusing on financial incentives to help drive participation (with the goal of ultimately reducing health-care costs). This also includes better leveraging of available data to make more informed deci-sions regarding programs and offered benefits.

The old pronouncement about the demise of 24-hour care was premature. In fact, as em-ployers and their vendor partners continue to develop their abilities to integrate or coordi-nate benefits and care, 24-hour care is evolving into a reality before our eyes.

Moving forward, the keys to success will rest on the availability of more programs and services that support employees, better inte-gration of systems and the data they capture, and increased focus on how we improve the overall productivity of the employee in the workforce.

Michael J. Dunst, MBA AVP National Practice

Leader, Group BenefitsAbsence Management

The Hartford

ADA

26 @work ▪ July 2015 Vol. 7, No 3

Do Lean Organizations Drive Employees to File Leave & Disability?

Any layoff or reduction of employees produces a profound emotional impact on the “survivors” remaining in the

workforce.Following a layoff, these employees experi-

ence considerable stress. First of all, their sense of security can be seriously shaken. They may have concerns about their own vulnerability to layoff as well as about significant changes in their work environment related to layoffs: changes in teams, disrupted relationships, work redistribution, and a likely increase in everyone’s workload.

Research has suggested that job insecurity can lead to an increased rate of absence because of a stressor effect but also can lead to a decreased rate of absence because of a disciplinary effect. This research indicated that the stressor effect is stronger than the disciplinary effect.1

Unum conducted internal research to inves-tigate the impact of these effects on its national client group size block within its short-term dis-ability (STD) book of business that experienced a minimum 10% workforce reduction in any given year comparing year eligibility feeds be-tween 2011 and 2013. Of these organizations, 60% had an increase in STD incidence the year after workforce reductions took place.

Unum also investigated this same group of organizations to determine whether there was a change in the number of behavioral health claims filed during the year after the layoffs compared to the prior year. Of the organizations that ex-perienced an increase in STD claim incidence, 83% had an increase in behavioral health claims over the prior year, an indication of psychological stress in the remaining workforce.

Understanding the impact on your remain-ing workforce following a layoff can help guide efforts to reduce an uptick in behavioral health claims. Identify factors that contribute to your remaining workforce’s distress, and then consider

your options in handling their concerns and your productivity needs:

Loss of former coworkers. Acknowledge em-ployee feelings and continued job anxiety.

Guilt about not losing their own jobs. Treat exiting employees with dignity. Work at engag-ing employees who are losing their “work bud-dies” in the team and at team building to allow the formation of new buddies.

Ongoing job insecurity. Follow up on how things are going. Remind your employees how important they are to the success of the busi-ness. Set realistic priorities, and be transparent about performance expectations.

Often increased workloads. Support needed vacations and breaks. Encourage teamwork, and involve employees in rethinking how to get the work done.

For employers, the costs of a layoff can be delayed with claim impacts that appear later. The increased incidence of STD and behavioral health claims may not appear until the year fol-lowing the layoff — just when managers start believing they are “out of the woods” after a painful period.

Finally, use your benefit structure. Remind people about your employee assistance program and focus on Return to Work when managing STD claims. Offer voluntary accommodations to people taking leave for their own serious health condition, taking care not to interfere with their Family and Medical Leave Act rights. The situation is not easy for anyone; however, as management, take all the steps you can to ease the transition and support remaining employees.

References1. Blekesaune, M. (2012). Job insecurity and sickness ab-

sence: Correlations between attrition and absence in 36 occupational groups. Scandinavian Journal of Public Health, 40:668-673.

Elizabeth W. Stivers, JDAVP and Senior Counsel

Employment LawUnum

Heidi Bimrose, CRC, CEBSDirector, Health &

Productivity Development Unum

THEReturningSoldier


Tyler Arvig, PsyD, LPClinical Director

of OperationsBehavioral Medical

Interventions

Substance Abuse at WorkIn the light of reintegration challenges and

the potential severity of post-traumatic stress disorder (PTSD) experienced by some

veterans, it is no surprise that some may turn to substance use (commonly alcohol) to cope. Alcohol numbs and serves as a central nervous system depressant, which counteracts the highly aroused/anxious state some veterans may feel and allows them to avoid disturbing thoughts and feelings.

The combination of factors making any individual veteran at risk for substance use is too complex to make predictions. But based on clinical experience, we can provide two useful observations:

1) The risk of substance use problems for returning veterans is not as high as suggested in pop culture. Returning veterans have only an approximately 10% rate of substance use disor-ders, which is not markedly higher than that of the general U.S. population.1

2) If substance use problems do arise, it is often after a stressor abates.2 Thus, after the stress of combat and military service, the shift to reintegration and returning to work may be high-risk times for veterans.

Employee assistance programs (EAPs) are an effective resource for alcohol- or drug-relat-ed problems but are often underutilized.3 If an employer sees evidence that an employee has a substance use problem, EAP referral should be a first-line recommendation. EAP can then help the employee secure appropriate treatment and intervention.

Supervisors should be trained regarding EAP options and referral for employees. If a supervisor becomes aware of an employee with a concern that may benefit from EAP (e.g., an employee openly discussing personal issues or admitting problems at work), EAP contact in-formation should be given to the employee with a supportive, nonjudgmental suggestion to use this resource. Emphasized should be that all employees have problems at times that would

benefit from some help; it is not punitive; and it is confidential and free. Consultation with HR may be appropriate to determine the best course of action to get the employee the needed help; but if at all possible, the supervisor should at least begin the conversation with the employee to maintain a supportive working relationship.

Depending on the severity of use, the vet-eran may require a brief leave of absence (us-ing Family and Medical Leave Act or disability benefits), a flexible schedule, or workplace ac-commodations. Among veterans, substance use disorders rarely exist in isolation, so the treat-ment required will probably need to address several clinical issues; as a result, treatment may be somewhat more frequent or intensive.

These temporary inconveniences for the employer will be rewarded once the veteran has taken the time and effort to address the sub-stance use problem and learn to live without this negative coping mechanism. In turn, the skill set and work ethic that made the veteran such an appealing employment candidate can be maximized, which aids in maintaining the health of your workplace.

References1. US Department of Veterans Affairs (January 2014). PTSD and substance abuse in veterans. Retrieved from: http://www.ptsd.va.gov/public/problems/ptsd_substance_abuse_veterans.asp2. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C., American Psychiatric Association (2013).

2. Volpicelli J, JH Balaraman, MA Wallace, and D Bux. (1999) The role of uncontrollable trauma in the develop-ment of PTSD and alcohol addiction. Alcohol Research and Health, 23(4). Retrieved from: http://pubs.niaaa.nih.gov/publications/arh23-4/256-262.pdf

3. National Council on Alcoholism and Drug Depen-dence. Alcohol and other drugs in the workplace. Re-trieved from: http://ncadd.org/images/stories/PDF/alco-holandotherdrugsintheworkplace.pdf

PEOPLEDataDrivesResults

28 @work ▪ July 2015 Vol. 7, No 3

Rene Gates MBA, PMP, CSM

Executive VP Optis

Too often, organizations implement a dis-ability management program, integrate their disparate sources of people data,

and then stall out before analyzing their data to identify trends and cost-savings opportunities.

Some simple practices can shine a more focused light on your people data and suggest changes to ensure compliance, improve perfor-mance, and cut costs.

Go Beyond Your FMLA DataFamily and Medical Leave Act (FMLA) us-

age data is only the starting point. By integrating your organization’s time-and-attendance data with its FMLA data, you can analyze discrepancies be-tween authorized leave days and actual days ab-sent. Audit reports can help pinpoint areas of the organization in which employees may be taking time off without it being classified as FMLA or where employees are informally extending or be-ginning absences beyond their approved lengths.

With that insight, you can realize cost sav-ings by tightening your time-tracking around leaves, including:

• Ensuring that all absence days are ap-propriately classified under FMLA or state regulations.

• Identifying opportunities for additional training to reduce discrepancies, since supervisor confusion around your poli-cies may be the reason for the problem.

Capture Your Compliance MetricsIf you are managing your FMLA or Ameri-

cans with Disability Act programs internally, ei-ther manually or by using a tracking system, be sure to capture all necessary data to report on compliance with regulations and your internal best practices. These types of reports confirm that your program is functioning as designed and can also be used in the case of a governmental audit:

Task Completion Report provides valu-able information on adherence to preset case management timelines. This will shed light on which of your company’s cases are being proac-tively managed—and which are in need of ad-ditional attention.

Accommodation Management Report can track the amount of interaction that has oc-curred on a requested accommodation, includ-ing the time between when the request was made, restrictions received, and an accommo-dation determined and offered.

Leave Requests Report can also help identify unnecessary lag times between the date a leave request is made and the date its initial notice letter is sent.

Assess Program Results Across Your Organization While reviewing trends and metrics for the

overall organization provides a quick glance at program results, a deep dive into these metrics for individual units can be even more telling. Integration of your employee demographics and organization structure data (e.g., business units, divisions, etc.) can assist in pinpointing areas for program intervention, such as:

Pockets of high utilization may be ripe for assessment of new equipment or procedures to allow for more employees to stay at work with accommodations.

Units with extended durations may not be making full use of company Return to Work programs.

Sudden changes to a unit’s trend line that don’t match the overall company trend line may point to a local program or process change that nega-tively impacted a particular type of position.

By fully utilizing your people data, you can uncover a wealth of information about your programs and how they are being executed on the front line with your employees.

Utilize People Data to Identify Savings Opportunities

FINANCIALFitness


Integration Is in Eyes of the Beholder

What constitutes the “integration” piece in integrated disability and absence management? Surely you’ve

had to address this question in your day-to-day routine, whether at a broker meeting with your clients, or as a human resources (HR) manager explaining your benefit program to colleagues.

As benefits professionals, we all can prob-ably roll-off an impressive definition for “inte-gration” in disability and absence management. However, “integration” can rightfully mean different things to different people, depending on their perspective. For example, what types of benefits products and services (short-term disability and long-term disability) are being in-tegrated, what statutory programs are in place (Family and Medical Leave Act (FMLA), work-ers’ compensation)? To what extent do these programs fit together or interact?

So, the big reveal here is that... integration is likely quite unique to each particular program based upon factors such as the mix of insurance products, services, and the integration strategy. It’s important to understand that recognition of these differences is vital to ensuring that the right program strategies are in place.

Although there is no general “one size fits all” approach, consistency in process and methodology is needed. Program in-consistencies can occur among various em-ployer locations or even among areas on a single site, potentially causing a breakdown in process and detracting from the goals and objectives of your integration strategy. We cannot stress too highly the importance of the following strategies to drive program consistency:

Ongoing communication to demonstrate leadership endorsement and to promote overall education, understanding, value, and benefit of the programs.

Training programs to drive detailed in-

struction and process consistency for front line managers, with multiple training meth-ods and online options to support flexibility for multiple sites; and

Clarify data and reporting methods from the outset, and measure and react to pro-gram results—because only with accurate, meaningful metrics can you understand whether your program objectives are being achieved.

Other important program-level features and strategies to consider, whether develop-ing a new program, or enhancing an exist-ing program to achieve greater results:

The role of wellness in the integrated environment, viewed from medical and fi-nancial perspectives, considering employee assistance programs (EAPs) for support in this area;

Strategies and programs for Stay at Work, rehabilitation, and Return to Work that suit the unique culture and employee demo-graphics of each employer; and

Integration as appropriate with other programs such as workers’ compensation and/or healthcare, EAP, time and atten-dance, and wellness programs.

To your organization, “integration” might mean anything, from simply devel-oping clear and easily accessible informa-tion addressing all absence policies, to a comprehensive and integrated program that includes, for example, formal active occu-pational and nonoccupational transitional Return to Work programs or coordinated disability and health case management. In either case, find a vendor partner that clear-ly understands your organization’s needs and develops a program to fit your unique program objectives and situation.

Phil Bruen VP, MetLife Disability and

Absence Management

METRICS

30 @work ▪ July 2015 Vol. 7, No 3

What Your LOA Data Reveals About Your ADA Programs

Do you currently track your employees’ leaves of absence through objective data and reports, or are you relying on

self-report surveys to understand your organiza-tion’s practices?

Tracking absence formally provides value beyond understanding leave of absence (LOA) patterns and trends. While LOA patterns can help companies understand and engage Ameri-cans with Disabilities Act (ADA) programs and ultimately improve employees’ ability to Stay at Work, tracking absence formally can also help improve attendance of employees with health and disability-related issues.

For example, an employer with high inter-mittent Family and Medical Leave Act (FMLA) usage recently partnered with an absence man-agement provider to do a deep dive on its Re-turn to Work (RTW) process. Because an initial analysis of the data suggested limited accommo-dations were being provided, focus was placed on determining whether there were more op-portunities for offers of transitional work and reasonable accommodations at the locations with the highest usage of intermittent FMLA. Many considerations were reviewed, specifical-ly, each claimant employee’s functional capac-ity, functional impairment and limitation, and medically based restrictions. Of the 89 claims reviewed, 79 employees were offered some sort of job modification to help them RTW.

In many instances, workplace accommo-dations such as modified equipment or extra breaks were incorporated. This resulted in an average of 33 saved days per claim. Out of the 10 remaining claims, any employee who could not RTW and did not have available leave time was sent for further review under a formal ADA program to see whether leave would be a rea-sonable accommodation. Ultimately, all 89 em-ployees were engaged through either an RTW

or formal accommodation review. In a second example, an employer used

data to guide elements of its accommodation program, as the employer’s short-term disability incidence rate was well above industry bench-marks. Analysis found that mental health claims made up a large percentage of the claims.

The company’s goal was to drive down the lost time and associated costs of its disability program through reduction in claim incidence and duration. To achieve this goal, the company determined what could help these employees RTW, with or without a reasonable accom-modation, while also seeing what other accom-modations could be made, such as additional breaks or free counseling services at the work-place. After using data to develop targeted ac-commodations over a two-year period, the com-pany had a 13% drop in overall mental health claim incidence and a 24% drop in the average duration of these claims. In this example, the data helped the employer focus its strategy and resources on leading cost drivers.

These are just two examples of how com-panies maintained effective ADA programs par-allel to absence-reduction efforts. When devel-oping absence strategy, it is important to assess how workplace practices may contribute to em-ployment disparities, as well as to understand which parts of the absence process and which disability-related issues give rise to the most sig-nificant challenges. Using leave of absence and disability data to create targeted accommoda-tion solutions can ultimately improve employee attendance.

Crystal Fernalld, JD Absence Leader

Aon Hewitt

Deborah Labonar, PhD Senior Leader

Absence AnalyticsAon Hewitt

www.SettleLTD.com Settle LTD Claims When: • Resistance to voc rehab or RTW, • Permanent disability, • Unclear/multiple Medical Prognoses, • Disputed claim or medical treatment, • Policy limits will be reached. Advantages to a Structured Settlement: • Motivates the claimant to settle, • Payments scheduled as desired, • Settle the claim at present value, • Transfer risk and administrative cost, • Reduce or eliminate reserves.

Can’t Settle? Transfer Exposure! Ask [email protected] • 323-887-9200Angel Viera CSSC, CA #0D20706, Los Angeles

Structured Financial AssociatesThis information is not legal or tax advice.Please consult your legal and tax experts.

Register online today at www.dmec.orgJob Seekers» Find jobs targeted at your specialty without having to

wade through thousands of irrelevant postings—for free.

» Never miss new opportunities! Set up email alerts that will notify you of new job postings meeting your criteria.

» Post your resume anonymously—stay connected to the employment market while maintaining full control over your confi dential information.

Employers» Put your opening in front of the largest pool of

qualifi ed candidates on the planet. By using the DMEC Career Center, you gain unparalleled access to our unique membership.

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DMECNews

32 @work ▪ July 2015 Vol. 7, No 3

Compliance Conference BlossomsHeld near the nation’s cherry blossom-

festooned capital, the 2015 DMEC FMLA/ADAAA Employer Compli-

ance Conference flowered to a record attendance of 314, a healthy 11% hike over last year’s record.

“This location, the topics presented, and the lineup of presenters from the EEOC, the DOL, and several legal experts had the right chemistry for employers,” said DMEC CEO Terri Rhodes. “This year’s record attendance validated that the conference meets a substantial employer need in a very positive way.”

In a dramatic preface to the conference, on March 25, the Supreme Court in Young vs. Unit-ed Parcel Service, Inc.. established criteria for em-ployers in managing their obligations under the Pregnancy Discrimination Act (PDA). Employ-ers have been concerned about PDA litigation due to a revised guidance by the Equal Employ-ment Opportunity Commission (EEOC) in July 2014, with an aggressive interpretation of the PDA and plans to ramp up litigation.

EEOC Commissioner Victoria Lipnic was one of the two minority commissioners who had opposed the EEOC’s guidance. She told her DMEC audience that it was “going beyond what the statutory language required, and we, as an ad-ministrative agency, were in fact legislating.” The EEOC’s aggressive interpretation “was promptly rejected by the Supreme Court,” she said.

Lipnic shared the podium with Jeff Nowak, a Labor and Employment Practice co-chair at Franczek Radelet in Chicago. Nowak described the protocol the Supreme Court applied in Young to determine which party holds the burden of proof in PDA litigation (a “burden-shifting approach” introduced in McDonnell Douglas v. Green).

The plaintiff’s case must establish: • She is a member of a protected class;• She sought an accommodation;• The employer did not accommodate;• The employer did accommodate non-

pregnant employees similar in ability or inability to work.

Once that case is established, the defendant/employer must provide a nondiscriminatory rea-son for its refusal to accommodate. To claim that accommodating a pregnant employee is more expensive or less convenient than other accom-modations typically is not adequate, Nowak said. If a reason for not accommodating appears nondiscriminatory, a plaintiff still can win by es-tablishing that the employer’s policies impose a significant burden on pregnant workers and that they give rise to an “inference of intentional dis-crimination,” Nowak said.

Lipnic said that the Supreme Court “com-pletely laid out a road map for potential plain-tiffs to prove their case.” Nowak observed that plaintiffs have another legal road map through the Americans with Disabilities Act (ADA), since it was amended to broaden the definition of disability.

“Many pregnancy-related impairments will fall within the realm of the ADA,” he said. “If these cases are analyzed under an ADA frame-work, they render the whole burden shift (un-der the PDA) moot. It’s now an ADA question, rather than a PDA question.”

Even under the PDA, Lipnic said, “the real bottom line, in my view, is that you take a great risk if you are not providing accommodation to pregnant employees.”

Reaching a similar conclusion in another ses-sion was Frank Alvarez, National Coordinator of Disability, Leave & Health Management Practice at Jackson Lewis PC in New York. Although the Supreme Court denied the EEOC’s move to cre-ate “most-favored nation” status for pregnancy leaves under the PDA, Alvarez said, “employers are encouraged to review all transitional, Return to Work, and reasonable accommodation poli-cies to be sure they provide for pregnancy leaves.”

Other general session highlights:

FMLA Enforcement: Strategic EdgeThe U.S. Department of Labor Wage and

Hour Division (WHD), which en-forces the Family and Medical Leave Act (FMLA), is developing a strategic approach to litigation. In the confer-ence’s opening session, Laura Fort-man, Principal Deputy Administra-tor, said WHD will take advantage of enforcement opportunities to in-fluence entire industries or spotlight widely held employer practices that are contrary to law and regulation.

ADAAA Case Law Favors EmployersThe EEOC agenda lost ground

in other courts in the last year, too. Courts required the EEOC to allow employers more freedom to determine the essential functions of a job. And courts did not significantly penalize employers for an inability to accom-modate or for a delay in determining the necessity of an accommodation. Presented by Frank Alvarez.

EEOC Accommodation Investigation In a complaint about failure to

accommodate, the EEOC’s initial in-vestigator has the power to dismiss a

complaint if the employer provides facts that clearly counter the claim. Employers should document every action and employee communica-tion because their case will live or die by the documentation they provide. Minimizing or “stonewalling” by the employer forces the investigator to continue to develop the case. Pre-sented by Amber Cheek, JD, Disabil-ity Inclusion and ADA Compliance Manager, University of Missouri, and Roy Matheson, President, Reason-ableAccommodation.com.

DMEC will be releasing an important industry white paper, Best Practices Man-

aging Absence in Call Centers, at the Annual Conference in San Francisco. Following the conference, the white paper will be available at www.dmec.org. This project, jointly developed by DMEC and its Leadership Series part-ner Liberty Mutual, is based on em-ployer participation in a March 26 live session in Dallas and a May 7 webinar.

Many integrated disability and absence management (IDAM) profes-sionals serve call centers and their em-ployees. Nearly 2.5 million Americans work in call centers, with some centers based in public utilities, healthcare,

and other sectors not immediately identified as “retail.” Some call cen-ter jobs have returned to the United States since the offshoring boom of a decade ago. Now the U.S. Bureau of Labor Statistics projects that this em-ployment sector will grow at the same pace as the overall economy.

If you’re one of the rare IDAM professionals who doesn’t have respon-sibilities for call center workers, the 2015 Leadership Series white paper is still important for you. Productivity can be measured in such detail in call centers that they are the laboratories where employers develop productivity strategies to apply systemwide; some of the practices your organization uses

today were developed in call centers.The first Leadership Series in

2005 focused on call centers, estab-lishing a high standard for rigor on practical issues and program best practices. In the decade since then, FMLA and ADA compliance issues have expanded dramatically, joined by state and municipal laws. Dallas, a large call center employment hub for many national organizations, is the perfect site for in-the-trenches in-sights for the 2015 Leadership Series.

Look for your copy of the white paper in August. Visit www.dmec.org> Conferences & Events > Leadership Series.


Leadership Series Returns to Call Center Roots

DMEC has made several staff changes in the last two months to maintain service

and continue growth.“Long-term DMEC staff have

improved processes and capabilities, so we can promote from within to fill most staffing needs. And we’re pleased to introduce Tasha Patterson, a new Marketing Manager who will help us continue to grow and expand services,”

said DMEC CEO Terri Rhodes. Tasha Patterson has an MBA-Marketing and International Business and has been a marketing manager for more than a decade. Patterson most recently was Se-nior Marketing Manager of the Medi-cal Group Management Association.

The National Board recently pro-moted Rhodes to the post of Chief Ex-ecutive Officer after nearly three years as Executive Director.

Assisting Rhodes with responsi-bilities across all areas of DMEC op-erations is Lisa McGrath, now Deputy Administrator, formerly the Director of Conferences and Education.

JoAnne Spitale, the former assis-tant to McGrath, is now the Confer-ence Manager. Rachel Ankerholz has expanded responsibilities as IT and Da-tabase Manager.

DMEC Adjusts Staff to Sustain Growth

Absence Direct .................................21

Aetna .................................................17

Anthem Life .....................................10

Aon Hewitt ......................................35

Bolton & Co. ................................31

Broadspire ........................................14

CIGNA.............................................34

Lincoln Financial Group ................12

Liberty Mutual .................................11

Mercer ..............................................18

MetLife .............................................20

Pacific Resources ..............................36

Prudential .........................................10

Reasonable Accommodation ..........15

Reed Group ......................................11

Sedgwick CMS ................................6

Spring Consulting ...........................34

Structured Financial Associates ......31

The Hartford ....................................16

Unum ...............................................4

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873225 10/13 © 2013 Cigna.

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Whether your company is small or large, using internal resources or relying on vendor expertise, Spring can help piece it all together.

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Visit www.SpringGroup.com for more information about Spring and to download our helpful guides and whitepapers

34 @work ▪ July 2015 Vol. 7, No 3

When it comes to understanding absence, numbers can tell you everything. Aon Hewitt combines risk analysis, custom program design, and delivery solutions to uncover your challenges and bring your absence strategy to life.

Let Aon transform your absence story. Learn more at aon.com/360absence.

Risk. Reinsurance. Human Resources.

Aon Hewitt360° Absence Solutions

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Economy & Finance