Employee Leaves and Benefits Administration Offer New Opportunities to Specialists

 

From its roots in insurance rehabilitation, through its establishment as a specialty practice in the 1990s, disability management has continued to evolve. As a practice, disability management has traditionally emphasized interventions for individuals who become ill, injured or disabled on the job, particularly with regard to early return-to-work (RTW). Over the years, disability management has expanded to include non-occupational illness or injuries, which are covered by short-term and long-term disability. In time, the practice of integrated disability management (for occupational and non-occupational cases) has encompassed prevention, wellness, absence management and safety (Rosenthal et al, 2007, p. 76).

Today, disability management is a recognized specialty practice offering a wide variety of services and solutions to help people with illnesses, injuries and disabilities stay at work, or successfully return to work and maximize productivity. The Certified Disability Management Specialist (CDMS) – a professional who is accredited by the Certification of Disability Management Specialists Commission (CDMS Commission) – possesses specialized knowledge and expertise to analyze, prevent and mitigate the human and economic impact of disability (CDMS Commission, 2011).

The evolution of disability management has been driven, in large part, by the needs of employers to control the economic and human costs associated with disability, and to mitigate the impact on productivity due to unscheduled absences and the inability to perform the full scope of duties. Some of the systems driving this need include workers’ compensation, short-term disability, and other paid leaves such as state-mandated paid sick time and paid family leave. Increasingly, other benefits and leaves, such as the federal, state, and local family and medical leave acts (e.g., the federal Family and Medical Leave Act (FMLA) and federal and state anti-discrimination disability laws, such as the Americans with Disabilities Act Amendments Act) have created the need for employers to monitor, coordinate and manage employee leaves and thus reduce the impact of absenteeism. This latest change in disability management, particularly in the large employer work setting, is part of an overall strategy of managing leaves to ensure that employees have the access to the resources they need, while also promoting workplace productivity.

To meet both employers’ and employees’ needs, the roles and responsibilities of the disability manager have expanded. In addition to the traditional professional approaches associated with occupational health nursing and vocational rehabilitation, the practice of disability management now intersects with human resource and benefit program arenas on the organizational chart. This blend of disciplines is seen most clearly in the latest practice area or domain of disability management, as identified in the CDMS Commission’s 2009 role and function study (Castle Worldwide, 2009). The study established a domain within the practice of disability management known as Domain IV: employment leaves and benefits administration. The implication of Domain IV on the disability management practice will be discussed in-depth in this article.

The role of the CDMS is to optimize quality of care, productivity, organizational health and regulatory compliance. The current era has ushered in increased regulatory scrutiny, greater emphasis on improving the quality and efficiency of healthcare delivery, and greater individual accountability in those areas through greater shared costs associated with traditional healthcare offerings. In this climate, the role of the CDMS to manage health and wellness improvement, as well as injury and disability prevention, in the workplace is congruent with overall healthcare goals.

In this article, the authors will discuss the state of disability management today as determined by the results of the CDMS Commission’s role and function study, and the implications for the practice. As companies large and small seek to control costs, improve productivity, and, in an uncertain economic environment, to do more with less, the practice of disability management will likely be in the spotlight as a proven solution for addressing the needs of employers and employees alike.

 

Role and Function Study – Previous Findings

Every five years, the CDMS Commission conducts a national role and function study to define the roles and responsibilities of a CDMS. The purpose of the study is to identify the current job functions performed in the field of disability management and to define the required knowledge and skills associated with competent practice of a CDMS. The study is conducted in accordance to established standards of the professional certification community, based upon logically sound and legally defensible procedures drawn from psychometric literature and case law (Castle Worldwide, 2009). Standards for the role and function study also comply with the National Commission for Certifying Agencies (NCCA), which is the accrediting body of the Institute for Credentialing Excellence (ICE). The role and function study process, which includes convening a panel of subject-matter experts and conducting a field survey of certified and non-certified professionals, is essential for maintaining NCCA accreditation of the CDMS credentialing process.

Through the role and function study, the knowledge and skills necessary for proficient and competent performance by a CDMS are identified. These results enable the CDMS Commission to ensure that its certification process and examination remain valid and relevant, based on current practice in the field. The final stage of the role and function study was completed in mid-2011 with a standard-setting committee comprised of a separate group of subject matter experts from industry and academia. The standard setting committee validated the content of the examination and provided the basis for the cut score for the exam. The cut score is set as a performance standard, meaning that a candidate scoring at or above the cut is minimally competent and therefore qualified for certification.

The most recent role and function survey was the third such study conducted by the CDMS Commission. In 1999, the commission launched its first role and function study to define the practice of disability management based on objective job analysis. In 2004, the commission conducted a follow-up role and function study to determine changes in domains of practice (Rosenthal et al, 2007, p. 76). As the results of these previous role and function studies illustrate, the practice of disability management was dynamic and evolving, which emphasized continued efforts to define the practice.

The 1999 role and function study identified two levels of practice. The first, Level I, was managerial or administrative in nature, in which practitioners had limited direct contact with injured workers. A greater emphasis in Level I was placed on designing disability programs. Level II was more service-oriented, involving direct contact with injured workers within the context of a disability management program (Rosenthal et al, 2007, p. 77). The 2004 follow-up study revealed significant changes in disability management; from two levels of service as confirmed in 1999 to three domains or areas of practice. The 2004 role and function study identified the three domains as disability case management (closely associated with Level II from the 1999 study), disability prevention and workplace intervention (a blend of Levels I and II), and program development, management and evaluation (closely associated with Level I).

As Rosenthal et al observed, “Disability managers are increasingly becoming skilled practitioners of outcome-based and evidence-based approaches to illness, injury, and disability as each relates to work and work productivity. A significant implication of the current study is the foundation for future research on the practice of case management, prevention and productivity; the application of different RTW paradigms with emerging stakeholders (e.g., aging workers or different ethnic groups); and the increasing emphasis on consistent outcome measures to monitor the impact of services and programs” (2007, p. 83).

The three domains identified in the 2004 role and function study were described as signs of the times, demonstrating how disability management had evolved since the founding of the CDMS Commission in 1995. Hursh observed that the daily responsibilities of disability managers were still largely defined at the time by the first domain of disability case management. However, the other two – Domain II, disability prevention and workplace intervention, and Domain III, program development, management and evaluation – had become increasingly significant. “This growth reflects how disability managers are handling broader duties that take them beyond the traditional area of workers’ compensation and into new workplace initiatives such as integrated disability management (which also focuses on short-term disability) and absence management” (Hursh, 2005).

In time, it would become clear that the evolution of disability management was continuing apace, with the emergence of yet another practice domain, known as Domain IV, as identified in the latest study.