DMEC: Welcome to Absence Management Perspectives: A DMEC Podcast. The Disability Management Employer Coalition, or DMEC as we're known by most people, provides focused education, knowledge and networking opportunities for absence and disability management professionals. DMEC has become a leading voice in the industry and represents more than 20,000 professionals from organizations of all sizes across the United States and in Canada. This podcast series focuses on industry perspectives and delves into issues that affect DMEC members and the community as a whole. We're thrilled to have you with us and hope you'll Visit us at www.dmec.org to get a full picture of what we have to offer. From webinars and publications to conferences, certifications, and much more. Let's get started and meet the people behind the processes. Hi, we're glad you're listening. I'm Heather Grimshaw with DMEC and we're talking about the concept of integrated disability and absence management today. Integrated disability and absence management has been a hallmark of DMEC since its inception and we've asked Brian Bass, DMC CEO, to share some context about why it is so important for employers as well as employees. So to start off our conversation, Brian, I'm hoping you will explain really what integrated disability and absence management is for our listeners.

Bryon E. Bass, CLMS: Sure, Heather. Integrated disability management really refers to a holistic approach to managing employee absences, including both short-term and long-term absences as well as disabilities. The strategy generally integrates various aspects of absence management into a cohesive framework which includes things like regulatory compliance, employee support, return to work programs, and accommodations for disabilities. Fundamentally at its core, when it was first incepted, workers compensation, short- and long-term disability benefits, group health benefits, injury and illness prevention programs, employee assistance programs, and wellness and health management programs, along with case management, rehabilitation and return to work programs, were all intended to be coordinated clinically and administratively to reduce the incidence and impact of employee disabilities and absence. So that's really what integrated disability and absence management is in totality.

Heather Grimshaw: That's really helpful. Thank you for that. I like the reference to a cohesive framework too. I think that's helpful to get that visual. So In a recent CEO's desk column titled Where's Your Moxie? You talk about having a deja vu moment when you think about and write about integrated disability and absence management or IDAM. Will you talk a little bit about that and how you've seen the discussion change and evolve during your career?

Heather Grimshaw: It's really interesting to hear you share that context, which brings it full circle. And I especially appreciate the timing there, so how that's evolved. And I think it'll help listeners kind of travel along that pathway. So thank you for that. So DMEC awarded the inaugural Coletta Carruthers Innovation Award this year, actually this month, which highlights the value of taking an integrated approach to disability and absence management. As you've chatted about here, will you talk a little bit about what prompted this award, why it's important, and why those who design and advocate for this integrated approach need to be recognized?

Heather Grimshaw: I think that's really helpful and I think the headline for your column, “Where Is Your Moxie” is also, it alludes to that innovation and frankly, a little bit of the bravery that the founders of DMEC had certainly when they introduced or really pushed this concept, which was not welcomed by all, as I understand it.

Bryon E. Bass, CLMS: That's right. That's right. And I think that's. It's important to recognize that a lot of organizations didn't really recognize or understand why, you know, why do I need to be concerned about this? And I think that's the. There's some of that still out there today. I think there's a lack of understanding fundamentally around all of these leave rights, and not just leave rights, accommodation rights and discrimination rights. And now these paid leave benefits that are becoming ever present in state level and maybe federal level at some point, employers still, I don't really understand all those things. And that's why DMEC is still here. I mean, it's really our mission to get in front of every employer that's out there so that they are aware of what components of a disability and absence management program looks like, how those benefits both provide benefit to the employer and to their employees, and then how they can ensure that they're offering benefits across the continuum that is equitable and fair and brings in DEIBA principles to ensure that no one is left behind and that we have programs that are meeting people where they are. And then we think about these point solutions. I just talked about when there's different types of events that happen in individual's lives, then perhaps there's another mechanism of support that we can provide to them. There's just so much that we can do in this space and we have so far to go. I think we've only really scratched the surface of what we could do with a holistic program at the employer level.

Heather Grimshaw: Yeah, I think that's a really helpful piece there, especially the equitable component. And it leads me into my next question, which is how common is it for employers to take this type of integrated disability and absence management approach? And are you seeing changes there?

Heather Grimshaw: It seems to continue to get more complicated and complex. Before we move on, you've mentioned the OG5 a few times and I'm hoping that you will explain that for listeners.

Bryon E. Bass, CLMS: Yeah, I'd be happy to. So when I Refer to the OG5, for those of us that have been in the industry for quite some time, there were five original states that offered statutory disability insurance benefits that were provided at the state level. And so those were California, which I mentioned earlier when I talked about Sharon and Marsha being in California, Hawaii, New York, New Jersey and Rhode Island. So those are the OG5 that really started out providing paid benefits as they're related to disability and absence.

Heather Grimshaw: Thank you so much. So in addition to the value of taking an integrated approach to disability and absence management, which I understand positively influences compliance for employers, you've also talked about a bottom line incentive for employers to consider it. Would you talk a little bit more about this?

Bryon E. Bass, CLMS: Yeah, I'd be happy to talk about the overall incentive for employers. So when we take a step back, I mean, I talked a little bit about cost management, cost avoidance and things of that nature, but we also touched a little bit on the employee experience. And a well-integrated program really improves the overall employee experience because it simplifies processes and it ensures a faster and more consistent service, which then of course enhances the employee satisfaction and retention overall. That's very important. But I think it's also important from the perspective that as an employee you could be directed to the services that are going to help you through whatever your situation is. When it comes to an employee's own serious health condition or disability or underlying diagnosis, there are fundamentally benefits that are available to employees in the health, in the health benefits realm, also from eap, there's a variety of things that are available. And so if there's an understanding of that in the overall delivery of the program, then employees can be directed to the right benefit or the right support mechanism at the right time for their particular need. As a result, if you think about some of the payoff associated with this, and this has been studied over the years, many, many, many times, and if we go out, you'll probably find many, many sources on this as well. I know there's many sources out there and I have some of them in my own research folders. But employers who adopt a more coordinated approach in their benefits and do some of those things that I was talking about in terms of ensuring that the proper case management is happening, ensuring that individuals are seeing the proper healthcare to deal with their particular situation, ensure that they're available to support mechanisms that are available to them to help them through their particular situation, that results in overall efficiency of the claims management process, resulting in the ability to either remain at work or get back to work faster than they would otherwise. So then that helps the employee by getting back to full capacity in terms of receiving their full pay. It helps the employer in terms of producing and providing their product or service overall. And then also one of the other things that we look at is there's also an opportunity for overpayments to occur in a non-integrated or coordinated environment. So let's think about today, what's happening from a paid family and medical leave perspective? There's a base benefit that's generally available to employees in a particular state. And many employers today have some type of paid leave benefit that they provide to individuals. Especially when you talk about a multi-state employer where they may have employees in states that don't have a paid family medical leave program today. And so as a result, they have, let's say they have a program that provides an individual with 66% of their pay, 2/3 of their pay, while they're out in that particular state, in a state that doesn't have a paid family medical leave program, they would just pay that directly to the employee. There'd be no need to do any type of calculation and understand what type of benefit they're receiving from that paid family medical leave perspective, et cetera. However, when you get into individuals that are in states where they get these other types of benefits, that's where it becomes a little bit more complicated and there's this risk of overpayments or what Generally is called payroll leakage. And then as those things happen, the question becomes, well, how do you recover what's been overpaid and not always successful in doing that? It's a terrible experience for the employee. They've received the money, they've probably spent the money and they've used it because, let's be frank, many employees today are living paycheck to paycheck and it's difficult then to receive the overpayment back from that individual. So that's a leakage aspect. So those are just some examples of some of the bottom line incentives for employers on why it's important to look at coordinating these processes in such a way that improves the employee experience overall. We get the employee the supports that they need at the time that they need them by the right providers and the right resources. And you have overall cost management at the employer perspective to ensure you're not overpaying individuals or you're not paying a lot more for benefits. An individual is just out there without the support mechanisms and they're just out there lingering and no one's there to help them get through the process.

Heather Grimshaw: Yeah, I'm happy that you just used that term, the support mechanism, because it does sound like that integrated or comprehensive or coordinated approach really does build that support framework for employees. And you've given some great examples of how an integrated approach really results in better employee experiences. For the rank and file employee is an integrated approach. Is an employer that takes an integrated approach something that employees recognize or is that more kind of weedy in the background type of a concept?

Bryon E. Bass, CLMS: From an overall fundamental perspective, an employee is not going to be aware of the specific terminology or structure behind an integrated disability and absence management program, but they will definitely recognize the streamlined processes and the consistent support that they're receiving, which actually contributes to that positive experience that I was talking about during the difficult times that they're experiencing. I, and I know many others have friends that work in organizations, maybe even smaller organizations, where things are not completely understood. There's not any navigation that's provided. And typically I've heard horror stories about the experiences that employees have had trying to navigate through the system on their own, not knowing where to go, not knowing who to call, there isn't information available in their employee handbook. I mean, there's a variety of different things that are just fundamentals that are part of that cohesive framework that if employers could provide those base fundamentals, it would improve, improve the employee experience overall. But the gold star goes to those who really incorporate and understand the whole continuum of those benefits and what's the right way of coordinating and ensuring that the right resources are provided at the right time to the employee as they need them.

Heather Grimshaw: It's that experiential piece. So even as you said, even if an employee can't say, oh, they don't take an integrated approach, which, let's face it, that most employees would not be able to do that, they sense it, they feel it. And that does, as you noted, affect their ability and interest in returning to work and all of those other pieces and parts. And speaking of the pieces and parts, data is an essential piece to the integrated disability and absence management picture, as you've noted a few times during our conversation today. Would you share some insights into how taking an integrated approach can help employers identify and potentially mitigate trends within their organizations to improve employee health and ideally, curtail costs?

Bryon E. Bass, CLMS: Yeah. So data is a pretty critical component to understanding the overall health of any program. I am a self-professed data junkie. I love data. It's something that I dig into no matter what the situation is. It's just something that I like to do because it provides such insight into what might be happening in terms of trends across various types of claims you can see. Or you might be in an integrated disability and absence management environment. For example, if you have your carrier or your TPA providing you with insights into the top diagnostic categories that your company is experiencing in terms of absence, that will give you insights into what types of health management programs might you want to incorporate in from your health insurance vendor or by identifying that you may need a point solution to come in place. So a good example is a lot of employers or companies today, one of their top five diagnostic categories or conditions is mental health. And usually it's in the top five, like I said. And there's what supports can you provide to individuals from a mental health perspective? Well, generally we have employee assistance programs, and employee assistance programs are one of the most underutilized benefits that are available to employees. And we know there's a lot of reasons around that. And we can have a whole other podcast around mental health and stigma and the difficulty it is in ensuring that individuals are getting the support that they need when they're having mental health challenges. But the point is that as you see that data, you understand that data, you could go even a little bit further and you could ask yourself, well, where am I seeing a higher prevalence of those types of claims versus other parts of the organization? And maybe it might be in a particular manufacturing facility, or maybe it might be in a particular state and there might be other resources that are available in that location or that locality that you might be able to provide to the individual, or there might also be an indication that there might be something wrong from an HR perspective. And in my experience working in private industry on the employer side, I have identified through my career a few instances where we had what I call a toxic management team. And as a result that reflected in overall incidents of absence and some of the diagnostic aspects of what's happening with those particular individuals in terms of the stress that they're under and maybe the mental health impact it can have when you have a toxic environment like that. So data is very, very important. It's difficult though to get all the data available in one place. And so there is a recognition that for some larger employers and even some middle sized employers that there's an ability to use data warehouses where there's an aggregation of various types of data that come from different sources. So maybe you have your workers comp information comes in, you have your disability and absence management information comes in, your accommodation information, you have your employee survey information, maybe you have performance review information, you have safety information. There's a lot of different pieces of data that can all come together and then you can work with those data aggregators to analyze and put together profiles based on the aggregation of the data that you're seeing and really dive in and understand what might be going on again within the population overall, what might be driving it. And then you can put in different types of approaches to improve, mitigate those risks and curtail costs by making informed decisions around the holistic view of the employee's health and absence management.

Heather Grimshaw: And being able to identify what may be driving some of these issues for employers is promising because then not only does it help the existing workforce, it also bodes so well for the future workforce as well as that company overall. So really that's exciting and a nice hopeful way to end our conversation about integrated disability and absence management, which there are so many different pieces and parts. So we'll have to continue our conversation.

Bryon E. Bass, CLMS: Absolutely, we certainly will. There's. We're always going to be talking about integrated disability and absence management. It's something we've been talking about for 30 years and we'll probably be talking about it for another 30.

Heather Grimshaw: Well, thank you so much, Brian.

Bryon E. Bass, CLMS: Oh, well, thank you.