Validation of the Practice

As part of the field survey, respondents were asked to evaluate each of the four domains and associated tasks, rating them for importance, criticality and difficulty. Five-point scales were used, with zero as the lowest and four as the highest. Importance was defined as the degree to which the domain or task is essential to the competent practice of an entry-level CDMS. Criticality was defined as the degree to which inability to perform the duties in the domain or the task would cause harm. Difficulty was defined as the degree of difficulty the domains and tasks would pose for an entry-level CDMS. Reliability of the data was confirmed as part of the survey.

Of the four domains, Domain II, workplace intervention for disability prevention, received the highest mean rating for importance of 3.11. Domain I, disability and work interruption case management, received the second-highest mean rating for importance of 3.06. Domain III, program development, management and evaluation, received an average mean rating of 2.71, followed by Domain IV, employment leaves and benefits administration at 2.22.

Respondent ratings for criticality followed the same pattern, with Domain II, workplace intervention for disability prevention, receiving the highest mean score of 2.28, followed by Domain I, disability and work interruption case management, at 2.20; Domain III, program development, management and evaluation, 1.80; and Domain IV, employment leaves and benefits administration, at 1.71. With regard to difficulty, the highest mean rating was given to Domain III, program development, management and evaluation, with a mean rating of 2.02, followed by Domain I, disability and work interruption case management, 1.95; Domain II, workplace intervention for disability prevention, 1.89, and Domain IV, employment leaves and benefits administration, 1.64.

Within each domain, tasks were rated for frequency, importance, criticality and difficulty. Based upon statistical analysis, tasks for Domain I, disability and work interruption case management, were given relatively high ratings for importance and criticality, while tasks in Domain II, workplace intervention for disability prevention, were considered relatively difficult. Tasks within Domain III, program development, management and evaluation, were rated as less critical, although they were considered moderately to very important.

Responses of different subgroups among respondents were evaluated to detect if there were any significant differences. Subgroups were defined by years of experience as a disability management professional, monthly average open caseload, number of companies/employers for whom services are provided, classification of current employer, highest level of education, and annual income from disability management. In general, the analysis revealed close agreements.

 

Domain IV – Employment Leaves and Benefits Administration

Of particular note in the role and function study findings, as noted earlier, was the emergence of a fourth domain. Evidence of a new area of practice was evident from the initial subject-matter expert discussion. Initially, it was thought that Domain III, program development, management and evaluation, had expanded with additional tasks and responsibilities. What became clear from the discussions among the subject matter experts, however, was that a distinct domain had been identified, which became Domain IV, employment leaves and benefits administration.

Tasks within the domain include:

• Manage employment leaves in accordance with local, state and federal requirements in order to maintain legal and regulatory compliance.
• Administer health and welfare plans consistent with government regulations and corporate requirements in order to provide appropriate employee entitlements as they pertain to work interruptions.
• Manage payroll and systems data relevant to employment leaves and benefits by maintaining accurate records in order to comply with legal and regulatory requirements (e.g., Sarbanes-Oxley, employment and benefits laws).
• Identify risks associated with work interruptions and employment leaves by referring to pertinent internal and external resources and regulations in order to influence organizational decision making.

The emergency of Domain IV affirms the main impetus that drives change within disability management: responsiveness to the demands of employers while continuing to meet the needs of employees. As has been witnessed over the years, change in disability management has evolved organically in response to such demands, rather than being prescribed through academic programs. Therefore, the burden of advancing one’s knowledge and skill sets falls to practitioners, who typically have to learn on the job.

For example, when FMLA was first introduced, oversight was usually handled by human resources personnel. However, in time the complexity of managing these leaves and integrating benefits necessitated more than just administrative skills. Greater importance was placed on those who have a claims background, particularly in the disability arena with experience in workers’ compensation and short-term disability cases. Today, disability managers increasingly find themselves involved, even to a limited degree, with FMLA and other non-paid leaves, such as those mandated by states.

Another factor is the overlapping that occurs within most organizations when FMLA runs concurrent with short-term disability. Often, the disability case manager who is handling the short-term disability case becomes a proxy for FMLA administration as well, whether he/she is directly administering it or helping HR or the benefits department with coordination. Whether federal and state leaves are managed in-house or outsourced, there is a distinct need for compliance and claims administration, which puts these leaves under the umbrella of disability management. At the same time, greater integration of leaves and benefits has brought non-traditional practitioners, including those from HR, benefits, risk management and safety, into the field of disability management, along with more traditional disciplines of vocational rehabilitation counseling and occupational health nursing.

There are significant differences, however, between non-paid leaves such as FMLA and paid benefits such as workers’ compensation. In FMLA, the major consideration is compliance, to ensure that job protection is offered in accordance with the law. With paid leaves such as workers’ compensation and short-term disability, the solution is early return to work in order to reduce the duration and cost of the claim. Despite these differences in approach, the leaves have a common denominator: productivity, which also affirms the alignment of FMLA and similar employment leaves and benefits with disability management.

The continued evolution of disability and, most recently, the emergence of Domain IV also underscore the importance of continuing education, to build the competence of those who are entering the field and to elevate the skills of those who are already practicing disability management. Through CDMS certification and educational resources such as the CDMS Commission’s core knowledge curriculum, practitioners of all experience levels are able to advance their skills and build their knowledge in a way that is consistent with demands from the workplace.

 

Conclusion

The field of disability management has expanded and evolved in response to the demands of the world of work. Furthermore, the makeup of the individuals charged with service provision and accountability for integrated disability management offerings is also changing. In order to gauge, document and verify these changes, role and function studies have been critical to defining what is required for competent practice and to maintain the CDMS certification process.

Given the changes in healthcare, the aging of the workforce, requisite skills of practitioners and the continued need to improve and bolster productivity – particularly as employers continue to push to do more with less – disability management will be a critical workplace solution. Recent regulatory changes also highlight the need for continued advancement of competent practice, such as inclusion within FMLA of extended coverage to care for employees whose family members are deployed or returning veterans. In addition, the expertise of certified disability managers will be needed to meet the employment needs of returning veterans who are service-related disabled in greater numbers than any other time in our history, not only to help carry out employer goals to offer employment to disabled veterans, but to meet the economic and work demands of our country.

Another consideration is the impact of healthcare in the workplace. Large employers, in particular, are re-evaluating their models of traditional healthcare coverage and implementing greater integration and coordination among benefits and leaves. Disability managers will play an important role as the liaison between employers that need to control costs and improve productivity and employees who need assistance accessing the benefits and programs they need to recover from injury or illness and manage disease course, return to work, and to become healthier and prevent future absences.

In order to stay abreast with these and other significant changes in the field, disability managers need to elevate their knowledge and skills. Through ongoing role and function studies and the identification of domains, or areas of practice, practitioners will be able to understand and navigate the disability management field in order to advocate for employees and to advance the health and productivity goals of employers whose needs must also be met.

 

Authors’ Note: The authors acknowledge that this article is based on an original report written by Castle Worldwide Incorporated on behalf of the Certification of Disability Management Specialists Commission (CDMS Commission). The data here are used with permission.

 

References

Castle Worldwide. (2009). Certification of Disability Management Specialists Commission Role and Function Analysis.

Rosenthal, D., Hursh, N., Lui, J., Isom, R., Sasson, J. (2007). A Survey of Current Disability Management Practice: Emerging Trends and Implications for Certification. Rehabilitation Counseling Bulletin. 50:2 pp-76-86.

Hursh, N. (December 2005). Signs of the Times: Three Domains of Disability Management. CareManagement

 

DT North, MSOD, CDMS, ABVE-D, is a Commissioner with the Certification of Disability Management Specialists Commission (www.CDMS.org), the only nationally accredited organization that certifies disability management specialists. He is also President of Achieve Consulting Team, Inc. Edwin Quick, CDMS, CRC, CCM, GPHR, is chair of the Certification of Disability Management Specialists Commission, and is also Executive Director, Disability Management Services, for a Fortune 500 company. Contact: info@CDMS.org