September, 2012 – Disability Management Services assist employers and employees as they work to reduce the impact to the employee and the business when an employee experiences a disability. Accurate medical adjudication of claims and return to work intervention are the first crucial steps in returning an employee to work from disability.
Managing disability claims effectively requires participation and cooperation from a variety of internal and external stakeholders, including attending physicians, disabled employees, unions and other stakeholders. Their buy-in from the beginning of the process can significantly impact how efficiently disabled employees return to work.
Medical Assessments are used in the workplace to evaluate the medical and physical condition of an individual. Such assessments may be done to assess the suitability of an individual for a particular job, for example a job demanding certain strengths, flexibility, dexterity or other physical characteristics. Assessments are also used to determine progress along a recovery path and its expected duration.
From an insurance perspective and relative to a job, an assessment may be needed to determine the condition of a person who has been injured or has suffered illness in order to determine a recovery plan which will enable them to return to their current line of work, or if that is not possible an alternative type of work.
Assessments may be simple and done quickly by one qualified individual, or may be complex and require a team of professionals with various specializations over an extended period of time, employing different types of examinations and evaluations. As a result, the knowledge and experience required to organize and manage assessments effectively and efficiently has developed into its own specialization.
Medical Assessments – Employer/Employee Advantage:
Many employers have created disability management programs that include most every aspect required to effectively manage absence in the workplace – with the exception of “medically” adjudicating and managing absences.
From an employee’s standpoint, medical adjudication and management is an important step in verifying and managing each aspect of a short or long term absence. When an absence is managed medically, the employee is provided with the support required to return to the workplace, whether that return be graduated or full-time.
Medical assessments perform a dual function in the return to work process. A medical assessment will verify a reported disability and provide confirmation to the employer/insurer that the employee is disabled and not able to perform the necessary duties of their pre-disability job.
A medical assessment will also aid in returning the employee to the workplace when they have been absent due to an illness and/or injury. Identifying return to work options for the disabled employee is not possible when the employer has not been provided with restrictions and limitations with respect to the employee’s disability. Often employees provide an employer with what they believe to be appropriate return to work data from their treating physician when in fact the employer does not have what is required to ensure a safe and effective return to work.
Medical Assessments in Conjunction with Short/Long-Term Disability:
When an employee is absent from the workplace and receiving short or long-term disability, insurers will on occasion utilize a medical assessment for a variety of reasons including:
- Verification of claim where medical is not clear/available;
- Continuation of claim – to verify disability;
- Return to work – where the employee is experiencing difficulty with a graduated or full time return to work and employee may be falling back to the disability claim repeatedly.
Dual Diagnosis Claims:
The face of disability is changing for both insurers and employers/employees alike. Insurers are experiencing an insurgence of claims that have both a physical and a mental health component. Other claims are strictly mental health or physical in nature.
Due to the increase in dual diagnosis claims, insurers and employers are experiencing additional stressors in both adjudicating the initial diagnosis, and providing effective and meaningful return to work plans for employees. With the changing demographic of claims, and the fact that often the second diagnosis does not come to light until the claim has been initially approved, medical assessments are proving to be an effective means to verify illness or injury and provide essential return to work assistance to both parties.
In short, use of a medical assessment during a casual absence, short or long-term disability situation is often necessary to validate disability and assist both the employee and employer in a return to work situation. Successful return to work where an employee is able to safely and effectively return to their pre-disability position is key in retaining employees.
Medical Assessments Available:
- Independent Chiropractic;
- Independent Functional Abilities Evaluation/Functional Capacity Evaluation;
- Physical Demands Analysis/Independent Job Site Analysis;
- Independent Neurology Evaluation;
- Independent Neuropsychology Examination;
- Independent Oral and Maxillofacial Examination;
- Independent Orthopaedic Evaluation;
- Independent Physiatry Evaluation;
- Independent Psychology Evaluation;
- Independent Psychiatry Evaluation;
- Independent Rheumatology Assessment;
- Independent Vocational Evaluations;
- Independent Neuro-psycho-vocational Evaluations;
- Independent Psycho-vocational Evaluations.
A.R.S. understands the importance of effective claim management, adjudication and return to work through the use of medical assessments. A.R.S. provides a wide variety of medical assessments nationwide to employers, insurers and various Workers Compensation Board(s) across Canada. A.R.S. specializes in providing services in remote locations where other organizations cannot.
For additional information regarding A.R.S.’ nationwide medical assessment services and all other Employer Services offered by A.R.S. visit www.arsi.ca.