By integrating absence and disability management, employers leverage the information they have more effectively, create more positive employee experiences, and remove undue burdens to access, explains Sara Elder, JD, vice president of operations, Sedgwick. Learn how to protect your absence and disability managers from feeling like air traffic controllers in this episode of the DMEC podcast.
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 18,000 professionals from or organizations of all sizes across the United States and Canada. This podcast series will focus on industry perspectives and provide the opportunity to delve more deeply 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.
Heather Grimshaw: Hi, we're glad you're listening. I'm Heather Grimshaw, Communications Manager for DMEC, and we're talking today about why integrating disability and absence management is valuable for employers. We've asked Sara Elder, Vice President of Operations for Sedgwick, to join us and discuss this topic, which was explored in the column titled Streamline Claims to Reduce Confusion and Avoid Mistakes that was published in @Work magazine. We'll unlock that column for listeners and we'll include the link in the Notes section of this episode. Sara, we're glad you're with us.
Heather Grimshaw: So one of the main takeaways from the column is that reviewing workers’ compensation claims in silos can cause mistakes. Since some employers have different teams managing workers compensation, short- and long-term disability, and other types of absences, how do you ensure information sharing about these cases between the groups doing this work in a timely manner?
Sara Elder: Well, Heather, it's a pleasure to be here and always happy to provide insights on steps for integrating absence management. Your first question, I think, is one that is a challenge for most companies, particularly when it comes to workers comp. Workers comp has a lot of its own nuances. It has a lot of prescriptive steps that have to be followed in order to comply with a state's workers comp protocol. So it is an area where you typically see companies challenged with the issue of where does the workers comp journey end, where does the leave journey begin, and where does the ADA journey begin? So there is not necessarily a silver bullet solution, but there are ways to ensure that the touch points are connected in a way so as not to compromise compliance interests as they relate to Ada and as they relate to FMLA. And one particular way for that to happen is first and foremost, whether you're outsourcing or whether you're keeping it internally is to ensure that there's awareness among all of the folks that are touching that within your company that there's awareness of how the pieces interconnect. I think one of the deficits that I typically see with companies is that they do not have a good compliance training regimen. That explains to managers and HR representatives how these pieces are related and how to navigate that Bermuda Triangle, so to speak. And I think when you educate them, they can be much better partners in terms of helping ensure that the proper considerations apply so that a worker's comp situation is not addressed in isolation, without regard to accommodation considerations, et cetera. And I can give you an example from experience. In my prior life, prior to joining Cedwicks, I worked for a company that had a consent decree that related to its administration of workers compensation leaves of absence. The EEOC focused primarily on how it was administered, suggested that the facts indicated that leave was not treated as an accommodation option. And consequently, we at the time had to focus on ways to connect the dots between what was happening in the workers comp claim and how that would impact accommodation considerations. And one of the ways to do that is to make a determination as to how you're going to use the workers compensation information. That can run the gamut that can run the gamut from having those that are adjudicating the accommodation issues, ensuring that they have access to the workers comp information in some way or another that the internal lawyers feel is compliant and not crossing any particular line. One could be to use workers comp decisions as a proxy when it's a leave decision, where you can then include in a communication that although they may not be eligible, say, for FMLA or estate leave, that the leave time is being treated as an accommodation consistent with company policy and applicable law. There could be instances where reports could be utilized where there might be a mismatch between who might be managing the workers comp piece, on the one hand, and who might be a TPA, on the other hand, in order to track and have visibility to what's happening on the workers comp case. But the end goal for at least having some solution for this is to improve the employee experience so that a communication that they get lets them know what's happening both from a compensation point of view and what's happening from a job protection point of view. So I think the first and foremost, there just needs to be a strategy that a company has around. How are we going to leverage the information that we have in order? One, to ensure that it's factoring in the decisions and then two, that it is creating a positive employee experience. And then three, that it's not going to pose an undue burden to the employee to have to chase down information because a company is not leveraging information that exists. And you could say that the same goes for on the short term disability side. I know from my experience with most interactions I've had where I've had the ability to kind of pick the brain of an EEOC representative. And I don't want to speak for them, and I do not speak for them. But I think their interest is in compliance with the spirit of the law. And their interest is in ensuring that a company does not have a policy or a practice that has a chilling effect on an employee's ability to gain their Ada rights. And as you can imagine, just practically speaking, does it not have a chilling effect if you have a process in place where you're not leveraging existing information and you're using an employee's failure to return specific paperwork as a way to deny or you're requiring extra paperwork, and that could drive up their cost in terms of getting an adjudication of the rights that they're trying to obtain. So I think the concentration needs to be how do you leverage the existing paperwork? How do you get the groups involved in these processes to be aware of the why behind the effort and the need to partner effectively to ensure that the information can be sliced in order to meet the needs of the particular law that's being implemented or the particular right that's being enforced and protected.
Heather Grimshaw: I'm realizing that the question itself includes a brief overview of what we mean by integration, but I think your answer to that question of how you ensure information sharing between these cases really illustrates that beautifully. And I know that there will be some people listening to our podcast episode who may not know all of the nuances to integration. And so again, while that question does include a brief overview of really separating those workers compensation claims from all of the other absence related claims, please weigh in if you have any additional insights that you'd like to share about that.
Sara Elder: Yeah, I think it's important for a company to think of integration beyond just the processes of managing a claim from beginning to end and figuring out how to assign those various pieces of managing the claim. It's sort of like an assembly line. You're building a car and there are the different elements that go into it. And certainly you have to have processes in place to build the car to make sure it's completed in a compliant manner and the end user is going to be interested in what the car is. But there's something always overarching from an integration point of view, and that is how do those pieces and if we were even to use the car analogy, how do those steps fit into something bigger? From the standpoint of the whole? What I'm getting at is when you're really integrating process steps, it's a manifestation, there should be a manifestation of what your culture is. And in the card context, it might be what the brand is, but keeping it to absence management, what is the philosophy of the company around wellness? What is the company's philosophy around well-being? And are the processes that are in place a reflection of that? What I find often is that, as attorneys (and I have my JD), I always refer to myself as a recovering attorney now that I'm in operations. But I often find that with very good intentions, employers treat some of the absence management steps almost as if it's a law school problem and it gets bogged down into what ifs and solving for those what ifs and that's smart, that's going to keep you compliant. But that effort can often translate to practices that deviate from what might make sense from an employee relations standpoint or a wellness standpoint or a well-being standpoint. And there are ways to balance that so that what is ultimately developed can give maybe greater weight to the employee experience. Because, let's face it, the more the employee understands what they need to do and that process is simplified for them, the easier it is to administer it, the easier it is for them to understand what their obligations, the less risk you have around that you didn't explain things in a manner that they could understand their rights or execute on their rights. And I think what often happens and what I see sometimes is the concern around abuse is so prevalent in large measure because when there is abuse, it's those claims that take an inordinate amount of time of a manager and of an HR representative and of an internal resource group that a company may have dedicated to absence management. And so it makes it seem like it's a bigger issue than it really is. And so a lot of companies try to solve for those potentially abusive situations when the reality is statistics show that it's a very small number. I think DMEC has produced information in the past that maybe it's around 2% where abuse is involved. Employees typically want to work. They need to be paid. So if it's an unpaid leave that's involved or an Ada leave that's not being compensated, that's hurting their pocket, their emotional state, their psyche. So this notion that they're playing games is not necessarily true. And so when policies are developed to curb abuse without regard to, doesn't it just make sense to go ahead and give this time in XYZ circumstances, have some quick, simple, easy approaches to accommodation so that we're not bogging? This life changing event bogging the employee incurring the life changing event down when they're already having stressors in their life relative to their situation. And so I think what I often see is it looks really nice on paper and in theory we're going to do this process. We're going to make sure separate paperwork is going out to show that we are adjudicating Ada and that we appreciate that the inquiry for Ada is different than short term disability. You have to ask yourself, is that necessary? Where is that point of diminishing return? And how does that interfere with what an employee who's ill should be having to deal with and what they need to understand? So if you were writing a paper for a professor that might really look good in terms of, boy, did you really cover your bases in terms of being compliant and demonstrating for all those potential regulators that come in that you had everything your I's dotted, your T's crossed and everything in mind. But what did that do in terms of getting a result? What did that do in terms of helping that employee navigate all that needs to be done, maybe just to get the same end result? Or did what you do translate to them getting denied something because undue emphasis was put on the fact that it needs to be this particular form or in this particular format? And maybe some of our listeners have had different experiences with the EEOC, but I can tell you mine is not that they're going to give you a pat on the back and congratulate (you) for having forms that ultimately prevail over substance. They're going to be more interested in ensuring that rights were obtained and that barriers were not put up around an employee's ability to get the time off. And yeah, maybe there are situations where you could have denied if you were using STD as a proxy, you could have denied it on the Ada end. But did all the effort and cost that went into providing that denial, did that translate to anything meaningful or substantive that's consistent with what you want to do from your employee relations philosophy, your wellness and well-being philosophy? And because they weren't job protected because of that scrutiny, you might have given the situation, did you terminate them anyway? And if you did, did that make sense? So I think what I see often is that the integrations continues to focus on administration and not necessarily on how do you integrate in a manner that fulfills the spirit of the laws as well as the spirit of your employee relations philosophy and your employee relations policies. And I know that was a very long-winded answer, but I hope that got at what you wanted to get at.
Heather Grimshaw: It did. No, I don't think it was long winded at all. And it really illustrates how important it is to look at these policies from that bigger picture perspective. If an organization doesn't have an integrated approach to absence and disability management, how can an employer ensure all of the groups involved are sharing case information so employees are not the main communicator between the short-term disability leave benefits and workers compensation teams?
Sara Elder: I don't see how you can get around having the dots connected without putting the burden on the employee, without having some sort of hub within your organization, whether it's embedded in your human resources and it's your employee relations. Team, or you have a compliance function within your company, or you just tap your HR generalist or a couple of HR generalists for that purpose. But you can't get by without having some connection, some way of connecting the information that's obtained on these different pieces and really almost acting as an air traffic controller over the individuals within your organization that are touching those pieces. If your goal is to take that burden off the employee, the only other way would be to be able to communicate with the employee very carefully and clearly about what their obligations are and make it as simple for them to own the directions that their claim needs to take. So perhaps they call one number and then they explain it all and it gets, um, directed from there, or you layout very clearly. Now, if you have a work-related incident, remember, you need to call the following numbers in workers comp that often still may remain, they need to call their because the workers comp provider might be different from who might be handling the leave in house, or if they're even using a TPA. There are ways to do it virtually. You can send it out when someone opens something, a claim. You can send an email that has that information. It might attach a brochure that might help them own the different component parts. And something I didn't mention before that I do think is important. I think one of the biggest areas of confusion that I see is occ versus non-oc. A lot of managers get the occupational space. It's been drilled into them. Keep your workers comp costs down. Let's find a way to accommodate those restrictions. And somehow they think that those same rules don't apply in the non OC case. And I found it to be a big hurdle to change that mindset, and that thinking. So again, that's where training can come into play to create that mindset around the goal of keeping employees at work and ensuring that they don't necessarily use the categories and the differences as a way to differentiate aspects that don't need to be differentiated, particularly, for example, in the accommodation space.
Heather Grimshaw: I think the emphasis on training is so key, and it's something that I hear a lot of people talk about. And I loved your description of air traffic controllers because I think most people must feel that way to make sure that you're guiding employees and really supporting them appropriately. So, Sara, you've mentioned some hangups or fears that employers have with respect to Ada compliance that can complicate integration. And I'd love to have you share some perspectives on that and hopefully identify some employer concerns that the teams at Sedgwick have encountered regarding Ada compliance.
Sara Elder: One is the extent to which information can be used or is being allowed to be used in a proxy context. I get it. There are pros, there are cons. I can certainly invent scenarios where there could be a risk. I do think that it stems from concern around information sharing, potential leakage of information to individuals who might get information that they don't need to know. And the reality is, you can put controls in place to mitigate those kinds of risks. And the reality is also that if that risk happens to unfortunately play out, there are also steps you can take to reduce it even after the fact. So what we sometimes see is where there's not a comfort level with a proxy approach, you're bogging down the employee and even managers with separate communications about what's happening on the claim that opens up the risk that they're going to miss something and therefore not follow through on something. Or a manager could be confused and think okay, well, I saw that I got the communication on X, but I didn't get a communication on the job protection piece. And you don't want them taking action because they don't know what the total story is about whether the person is job protected or not. I'll give you an example. We see in some survey information coming back from claimants where they are confused because they'll say I thought you communicated to me that I was approved and then I later got more information that I wasn't approved and that I was or I might have been denied or what have you. Well, that's largely because they were getting separate communications that may not have even been timed at the same time or the timing may not have even been the same about here's what's happening on your short-term disability claim and then a couple of days later, here's what's happening on your Ada claim. Or the Ada might be decided faster because of a different threshold about what constitutes a disability versus what might qualify for compensability under a plan. Oftentimes short-term disability needs more information so a communication could go and say hey, you've been approved under the Ada and then a few days later they get information that says we need more information to adjudicate your benefit. Under short term disability the employee doesn't care if it's ABC, STD, what have you. And similarly, some managers may not be sophisticated enough to understand the differences. So if they're getting separate communication, it presents a lot for someone to digest and figure out how they execute on that information. When we do see with the best of intentions companies trying to segregate those processes, it's often without regard to those downstream effects that carry with them execution issues both by their managers and the employee experience issues. It really negatively impacts the employee experience. And it's driving work that may not get done, that maybe a manager has to do for follow up and even extra work that those who are administering it, whether in house or externally, have to put toward the claim, which leads to cost increases, money that could be better spent elsewhere within the company. Again, I always see it with the best of intentions. I look at the compliance considerations. They're kind of guardrails, but there's a lot of play within those guardrails, and sometimes there's acceptable risk that might even exist beyond outside those guardrails that might have greater benefit. If it's going to mean you retain your employees, if it means that it's going to lower your costs, if it means that it's going to help the employee not be stressed out by the process that you've implemented, So sometimes it's okay to color outside those lines. You want to stay on the page, but you just don't want to bog things down in a way that translates to, again, the bad employee experience and ways that complicate how the managers themselves execute on their next steps. In terms of whether they can separate or what they need to do relative to that particular employee and whether they need to look for reassignment or what have you.
Heather Grimshaw: That's really valuable perspective, and it sounds like those steps that you're referencing that clients take ideally to protect themselves and to support those employees and ensure that they're complying with the laws might jeopardize, as you've said, compliance, and also aren't balancing those issues of risk and employee experience. And it sounds like those are mainly prompted by the fears that you have referenced throughout our conversation. Is that fair to say?
Sara Elder: I think you nailed it. I think that you're exactly right.
Heather Grimshaw: It's really helpful for you to have shared these different nuances and really to emphasize that employee experience piece. I think that oftentimes when we're talking about integration, what I've heard is people really focusing on those processes and the paperwork and the laws, and sometimes it seems like that employee experience gets lost. This has been such a helpful conversation. We really appreciate your time and your willingness to share your expertise with us. Thank you so much, Sara.
Sara Elder: My pleasure.