When an employee suffered a major illness or injury five or 10 years ago, the employer's attitude was usually simple: Let him go. Workers' compensation or disability insurance would provide income, and the employer wouldn't have to worry about modifying his job or otherwise fitting him back into the workplace.
Times have changed. The costs of workers' compensation and other types of disability insurance are soaring. American employers forked over about $60 billion in workers' comp expenses last year, double the amount spent in 1985. And more and more employers are seeing the advantages of bringing disabled employees back to the job, preferably as quickly as possible.
Cost isn't the only reason. In July, the Americans With Disabilities Act will go into effect, requiring employers with more than 25 employees to provide reasonable access to individuals with disabilities, and to re-employ those workers who are still able to perform the essential elements of their jobs.
"In the last three to five years, you've seen employers become much more willing and desirous to get the disabled worker back into the work force, for a whole variety of reasons," said Mark C. Medairy Jr., a partner with Towson-based benefits consultant Duke & Medairy. "Public relations-wise, it looks good to show that you care about the disabled worker. And from an economic standpoint, the employer is getting someone back who they don't have to completely retrain."
Experts offer the following suggestions for expediting the return of the worker to the job:
* Support medical and vocational rehabilitation. Whether it's getting an employee back in shape after a serious injury or teaching someone new job skills after he loses his ability to do his original job, rehabilitation is now seen as a crucial step in helping an employee regain the capacity to work, according to Mr. Medairy.
Many insurance companies' disability plans now pick up the costs of such rehabilitation, and experts recommend that you find one that does.
"If on the one hand you're telling an individual to go through a rehab program, but on the other hand the medical [plan] doesn't pay for it, you're sending them a mixed message," said Patricia Carlson, a vice president of Travelers Managed Disability Services, an Atlanta-based company that helps companies deal with worker disability issues. It's better, she said, to show your full support of such a program by funding it.
If possible, consider on-site rehabilitation, said Jack Doub, president of Baltimore Therapeutic Equipment Co., a firm that manufactures rehabilitation equipment. By administering therapy on-site, you avoid treating the employee as a patient rather than a worker -- a factor that could help speed recovery.
On-site rehabilitation is heavily emphasized at Bethlehem Steel Corp.'s Sparrows Point plant. At the plant's medical clinic, injured employees prepare to return to their jobs by doing work-hardening exercises that replicate their on-the-job motions with the help of a "work simulator." The clinic, which operates 24 hours a day and provides many other services, treats between 400 and 500 employees per week.
Having the medical clinic on-site permits its team of 40 or so health specialists to learn specifically what the employee's job entails so they can determine which work is and isn't appropriate, said Dr. Miriam Alexander, director of the clinic, which is owned and operated by EHG National Health Services Inc. It also allows Bethlehem Steel to monitor the care and progress of injured employees.
"It certainly does give us some control when we're the one that's treating the employee," said Tom Irish, supervisor of employee benefits for the Sparrows Point plant. "We don't have to wonder what's going on with the outside physician. Any time you have firsthand knowledge of the medical status and course of treatment, you're in the best situation to make decisions about ,, the case."
Even when it's not possible to have a full medical clinic on-site, rehabilitation therapists will often come to your workplace to treat an individual on the job, Patricia Carlson said.
* Contact a disabled employee immediately after an injury occurs. It may sound basic, but calling an employee to ask him how he's doing and to let him know he's missed can help him return to work 21 percent faster than other wise, according to research gathered by the Travelers Managed Disability Services.
"You're letting the employee know that he's desired and wanted, and that his job is still there," Ms. Carlson said.
* Structure disability policies so they encourage a prompt return to work. According to Ms. Carlson, the standard long-term disability policy requires employees to be totally incapacitated before they can receive any benefits. But you can pull employees back to work earlier by offering a plan that does not include a clause requiring total incapacitation and that allows them to receive part-time pay plus disability income benefits.
For example, you might permit an employee to earn up to 80 percent of his salary from both part-time earnings and disability benefits, Ms. Carlson said.
She explained that a normal disability policy provides an employee with 60 percent of his pre-disability salary -- say $600 per week for someone who earns $1,000 per week. If the employee returned to work for one-third of his regular time under the total incapacitation plan, he'd forfeit all of his disability benefits and would receive only $333 -- not a huge incentive to get back on the job.
But a policy that would supplement that $333 with an additional $467 from the disability plan -- thus allowing him to earn 80 percent of his pre-disability salary -- might entice him back earlier.
The main drawback of the total incapacitation concept is that it promotes a negative mind-set for the disabled worker, said Ms. Carlson. "Once you get away from work and you convince yourself that you're totally disabled, it's difficult to get up the next morning and say, I can do this,' " Ms. Carlson said. "But you don't get into that mind-set if you're able to stay on the job for at least some portion of the day, or some portion of the week."
* Accommodate disabled employees. An employee who returns to a job with a disability may need special accommodations to be able to perform her job. These modifications can be relatively simple and inexpensive, such as enlarging a doorway so a wheelchair can fit through it, or putting a cot in a restroom for an ill employee who needs to rest during the afternoon, Ms. Carlson said. Another accommodation could be purchasing a special chair for someone with a back problem.
You may also have to modify the disabled worker's schedule and job duties. Someone returning to work after a serious car accident, for example, may need to start out slowly, working from 8 a.m. to noon or performing a light-duty job until he has eased back into the work environment. Another employee may no longer be able to travel.
At Burgemeister-Bell Inc., an Owings Mills-based plumbing and utility contractor, workers injured on the job can do light-duty work such as sweeping floors and making deliveries until they are able to perform more physically demanding tasks, such as operating heavy equipment. "We think that this gets [the employees] back in the swing of things," said Jeffrey Loveless, a spokesman for the 80-employee company. "It seems to accelerate the recovery process."