Workability in Michigan - Distortion and Abuse Reduction

7/31/2019 Workability in Michigan - Distortion and Abuse Reduction

1/22

Workability In Michigan

Distortion and Abuse

Reduction in theStay At Work/Return To Work

Process

Revision: March 29, 2012

Author: WIM Workability In Michigan Distortion and Abuse Subgroup

Preventing Needless Work Disability byHelping People Stay Employed


2/22


What is WIM Workability in Michigan?

Advocacy group with a wide variety ofstakeholders.

Grass-roots approach to transform:

Disability benefits

Workers compensation systems and the

outcomes they produce.


3/22


ACOEM GUIDELINES

American College of Occupational andEnvironmental Medicine (ACOEM)

Preventing Needless Work Disability by

Helping People Stay Employed


4/22


Recommendation 1

Adopt a Disability Prevention Model

1. Increase awareness of how rarely disability ismedically required

2. Urgency is required because prolonged time awayfrom work is harmful

NOTE: After 12 weeks off, an employee has only a50% chance of ever returning to work.


5/22


Recommendation 2

Address Behavioral and CircumstantialRealities That Create and Prolong WorkDisability

3. Acknowledging and dealing with normal humanreactions

4. Investigating and addressing social and workplacerealities

5. Finding a better way to effectively address

psychiatric conditions6. Reducing distortion of the medical treatment

process by hidden financial agendas


6/22


Recommendation 3

Acknowledge the Contribution ofMotivation on Outcomes and Make changesto Improve Incentive Alignment

7. Paying physicians for disability prevention work toincrease their professional commitment

8. Supporting appropriate patient advocacy by gettingtreating physicians out of a loyalties bind

9. Increasing real-time availability of on-the-jobrecovery, transitional work programs, andpermanent job modifications

10. Being rigorous, yet fair in order to reduce minorabuses and cynicisms

11. Devising better strategies to deal with bad-faithbehaviors


7/22Workability In Michigan

Recommendation 4

Invest in System and InfrastructureImprovements12. Educating physicians on Why and How to play a

role in preventing disability13. Disseminating medical evidence regarding recovery

benefits of staying at work and being active14. Simplifying/standardizing information exchange

methods between Employers/payers and medicaloffices

15. Improving/standardizing methods and tools that

provide data for Stay-at-work and Return to-workdecision-making

16. Increasing the study of and knowledge about Stay-at-work and Return-to-work


8/22Workability In Michigan

Distortion and Abuse Prevention

6. Reduce distortion of the medical treatmentprocess by hidden financial agendas;

7. Pay/reward physicians for DisabilityPrevention Work to increase ProfessionalCommitment; and

10. Be rigorous, yet fair in order to reduceminor abuses and cynicism.


9/22


Top 4 Abuses and Distortions

1. There is limited or no financial, productivity or other benefitto a manager or supervisor to participate in the Stay-at-Work/Return-to-Work process;

2. Physicians are often not paid or rewarded for their

participation in Stay-at-Work/Return-to-Work managementprocess;

3. The reimbursement/liabilities gaps between work-relatedand non-work-related benefits results in abuses to achieve

the most beneficial option; and

4. Treatment providers are chosen to manipulate the desiredoutcome.


10/22


#1: There is limited or no financial, productivity orother benefit to a manager or supervisor toparticipate in the Stay-at-Work/Return-to-Work

process.

TYPICAL ABUSES AND DISTORTIONS:

Restricted workers are more burden than value in thework place.

Restrictions increase the burden on the employer

Managing disabilities requires extra time

Disability management is not reflected in departmentperformance assessment.


11/22



process.

REALITIES:

Supervisors/Managers lack RTW/SAW education. Duration of the absence changes motivations &

behaviors

Focusing only on financial and productivity demands

may not improve disability management. Disability management can often be inconsistent with

organizational culture


12/22



process.

RECOMMENDATIONS:

Educate managers and supervisors in SAW/RTW Establish measurable standards of performance

Hold managers & supervisors accountable formeasureable quality disability management.

Provide appropriate integrated programs to supportmanagers


13/22


#2: Physicians are often not paid or rewarded fortheir participation in Stay-at-Work/Return-to-Workmanagement process


Extra or fair compensation is not provided

Lack of a perceived value for participating


14/22


#2: Physicians are often not paid or rewarded fortheir participation in Stay-at-Work/Return-to-Work

management process

REALITIES:

We should be compensating and rewardingPhysicians for efforts


15/22


#2: Physicians are often not paid or rewarded fortheir participation in Stay-at-Work/Return-to-Work

management process

RECOMMENDATIONS:

Remember to say Thank You

Reward Physicians with repeat business


16/22


#3: The reimbursement/ liabilities gaps betweenwork-related and non-work-related benefits results

in abuses to achieve the most beneficial option


Workers Compensation versus disability plans

Benefit Durations Social Security Disability Insurance Impacts Medical Reimbursements


17/22




REALITIES:

Workers compensation is statutory

Solutions are limited


18/22




RECOMMENDATIONS:

Discourage plans that provide 100% pay while off

work

Consider Employee Funded Buy-Ups

Narrow gap between disability pay and WC

Manage time-off on non-work related disability topay for increased benefit


19/22


#4: Treatment providers are chosen to manipulatedesired outcomes


Employees choose providers who conform to their

needs and wants; and

Employers choose providers who conform to theirneeds and wants.


20/22



REALITIES:

There are treatment providers:

Who will keep employees off of work when notmedically necessary; and

Who will provide medical opinions that enablesystem manipulation.

There are also treatment providers: Who are reputable, skilled, and objective.


21/22



RECOMMENDATIONS:

Identify and only select treatment providers who

are reputable, skilled, and objective; and

Educate employees.


22/22


THANK YOU!

For more information or to get involved:

www.workabilityim.org
http://www.workabilityim.org/http://www.workabilityim.org/

Documents

Workability in Michigan - Distortion and Abuse Reduction