Get to the Root of the Claim Sooner Rather Than Later

In today’s times, there remains an increase in disability claims throughout Canada, despite the efforts of MANY case managers to reduce absenteeism for employers. We see the increase in health care costs, benefit costs, production costs, overtime and replacement costs throughout organizations. The numbers continue to rise.

So why isn’t claims management working? 

Because….

You NEVER get to the root of WHY an employee is off on disability. 

Yes, yes, I know. You have a diagnosis and a doctor’s note or letter telling you why.  But with over 30 years in disability management, my expert opinion is that you never, ever get to the root of the problem. With each diagnosis comes an expected recovery time, which seems to come and go, and then months later we realize that ‘Joe’ is still off work for a simple ankle injury that should have healed in 4-6 weeks. Why?

Too many claims managers are managing claims at face value. To be specific, you only manage what you see on paper. If it’s an ankle injury diagnosis – this is what you deal with. You never stop to ask more questions. What else is going on?

At the end of the day, I say this to most employers;  ‘Most people enjoy the jobs they work in.’ Not only do the employees like their jobs, they also like their co-workers. Being at work allows for normalcy in their life as well as it provides a social outlet. However, there is a reason, or more than one reason why they aren’t in a hurry to return to work. GO FIND THE REASON (S)!

I always equate disability management to a 10 pin bowling game. There are 10 barriers (pins) in returning an ill or injured employee back to work. If you haven’t found those 10 reasons early in the claim, you are in for a long haul.  Good luck in shutting that sucker down!

Tippy toeing around disability and the root of the problem isn’t going to help you reduce your numbers. Being tough and aggressive isn’t going to help either. Find compassion with all your ill and injured workers, but be firm in addressing the root of the problem and the solutions that will get your employee back to work sooner rather than later.

Lucie M.H. Fournier RN, COHN(C), BA (Psych)
Founder/Workplace Health Strategist

With over 30 years of experience in disability management, and a return on investment on average of 1:7, Fournier disAbility & Health provides customized and results oriented services in Absenteeism Management including Attendance, Sick Time/Short, Long Term Disability, and WSIB claims for employers across Ontario.

Expertise in 5 distinct niches of disAbility management include:
1. Complex claims management resolution
2. Mental health claim return to work & accommodations
3. Advanced level training for internal claims manager to make a significant impact on the health of the employee and wealth of the organization
4. Transitional Leadership when moving to & from a 3rd party disAbility Management company
5. Sensitive claims & disAbility management of professional staff, such as HR, health team, and/or executives such as supervisors, managers, directors