Integration, flexibility, creativity, efficiency and communication are among the keys to successful disability management, say leaders at the Certification of Disability Management Specialists Commission and the employers that won the organization's 2008 leadership awards.

When disability management is integrated with an employer's "actual bottom line ... workings [and] goals of that company, that's when it'll work," notes Maria Henderson, chair-elect of the Certification of Disability Management Specialists Commission. On average, 10% of a company's employees go out on disability leave each year, and those employees account for over 50% of the company's medical costs, she adds.

It's also important to be flexible when designing return-to-work programs and light-duty programs, experts say. It's better for an employee to return to work in a part-time or light-duty capacity than to stay at home just because they're not 100% recovered. For example, someone who's unable to lift boxes might be able to handle paperwork or administrative duties that aren't physically taxing. Or someone who can't work eight consecutive hours perhaps could handle shorter shifts with resting periods.

 "Be creative in really looking at what the restrictions are of a person and matching that with a job," advises Chris Moranda, manager of disability programs for OhioHealth, one of CDMSC's 2008 honorees. "It's the right thing to do to help people return to work."

In addition, Henderson says, "You've got to train your supervisors. You've got to communicate it as a benefit. You've got to have an internal champion who has some subject-matter expertise and can manage these programs. It's not just a policy on an intranet that you can post."

"Every year, when things change, you've got to keep up with it," she continues. "You've got to constantly let people know how it's contributing to the productivity, to the bottom line."

Keeping tight control on disability costs are a particular concern for employers right now. "When there are economic pressures, it does tend to increase the use of disability benefits," especially when layoffs occur, cautions Carol Tavella, a senior manager at Chicago-based consultancy SMART.

Award-winning programs

Harley-Davidson Motor Co. won the 2008 quality leadership award from CDMSC.

In Harley-Davidson's program - developed based on the types of work the employees perform and the types of reported injuries - occupational health nurses and disability management specialists work together, and early intervention services are offered at company facilities.

Physical therapists, occupational therapists, fitness trainers and trained ergonomists are involved with workstation assessments and individualized and group exercise and stretching programs. Transitional duty, onsite therapy and a graduated return-to-work program also are available to assist employees in returning to employment.

"We believe our team approach is the driver behind the success," says Sue Gartner, corporate manager of health and wellness for Harley-Davidson. "We have great collaboration between the occupational health nurses, the safety department (comprised of both union and non-union employees), case managers, physical and occupational therapists, and fitness trainers to get employees back to work in a safe and timely manner. We're always working to improve the health and wellness of our employees. The integrated approach is well-received by employees, and we anticipate it will continue to evolve."

Gartner recommends the team approach, "because each case is unique, [so] team collaboration is vital to getting the best results for both the employee and the company." Henderson pointed to Harley Davidson's learning center, where its 8,000 employees can receive training and earn academic degrees, as what helped set the company apart. "We felt the learning center was an innovative and creative way to prevent disability" by giving workers the skills and knowledge they need to transition to a new type of job after they become physically unable to continue with the previous job.

Marathon Oil Company, OhioHealth and Southern California Edison won honorable mention awards from CDMSC in 2008.

OhioHealth is a regional hospital system with about 13,000 employees. It recently hired a workplace accommodation case manager to help find alternative positions for workers who can't return to their original job because of a disability. With the new specialist, the company saw a notable uptick in its return-to-work rate.

OhioHealth also has a program dedicated to helping employees who are on disability leave find alternative types of work, or transitional work that they can do while they are recovering from illness or injury. It links with a state agency to get funds for adaptive equipment, technology and job trials, where a worker can try a new position for a certain period of time.

In addition, OhioHealth recently started a new "mission budget" dedicated to funding job trials and alternative equipment, such as hearing aids. "We don't want to lose an associate," says Moranda. "We want to keep our associates employed."

OhioHealth provides a self-funded short-term disability benefit that covers 120 days of leave. It also offers a fully insured, employee-paid long-term disability plan that kicks in after 120 days of absence.

Meanwhile, Southern California Edison found success by integrating its disability management program with its employee assistance program, Henderson says. When the two weren't integrated, the company discovered that a lot of its employees who returned to work after a disability leave quickly decided to take another disability leave. Specialized counseling from the EAP has helped to dramatically reduce that rate of recidivism.

Benchmarking data

To help with benchmarking, Tavella says employers should measure their number of disability leaves, average duration of disability leave, cost per employee, cost per claim and return-to-work rate.

On average, employers experience 9.5 short-term disability claims per 100 employees, but that rate is higher in the utility, manufacturing and information industries, according to a recent Empaq report developed by the National Business Group on Health. The average claim duration is 65 calendar days, and the average number of lost workdays per 100 employees is 383. The average employer cost of short-term disability benefits is $326 per employee, and the average cost per active claim is $3,255.

Long-term disability claims are less common, occurring at an average rate of 6.3 per 100 employees. However, according to the Empaq report, they are more expensive, costing an average of almost $20,000 per claim.

Disability Deconstructed

» On average, short-term disability insurance accounts for just 0.2% of total compensation, and long-term disability insurance accounts for just 0.1% of total compensation.

» Last year, 78% of employers offered long-term disability insurance, and 69% of employers provided short-term disability insurance. Both figures do not include employee-paid supplemental insurance.

» 52% of baby boomers say they have either short-term or long-term disability insurance.

» 32% of baby boomers say they would have to tap into their retirement savings if the primary wage earner in their household became disabled.

» 90% of workers underestimate their chances of becoming disabled.

» 56% of workers say they have never discussed with anyone how they would continue to pay for their living expenses if a disability kept them out of work for several months or longer.

Sources: The U.S. Bureau of Labor Statistics; America's Health Insurance Plans; the Council for Disability Awareness; and the Society for Human Resource Management.