Congress of AVAPES on Rehabilitation and Inclusion Dr. jur. Friedrich Mehrhoff, German Social Accident Insurance, Berlin Sao Paulo, November 2011 “Global.

Congress of AVAPES on Rehabilitation and Inclusion

Dr. jur. Friedrich Mehrhoff, German Social Accident Insurance, Berlin

Sao Paulo, November 2011

“Global success factors of Return-to-work”

DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 2

German Social Accident Insurance

• Back to work after work accidents and occupational diseases

• Close contact to enterprises as their members

• Liability for safety and health at work and rehabilitation

• “Rehabilitation” comprises acute treatment, medical rehabilitation and social participation.


Statutory Accident Insurance in Germany

A comprehensive

service

Compensation (financial benefits, pensions)

Rehabilitation (medical treatment, vocational and

social rehabilitation)

Prevention (preventive measures)


Facts

Around 500 million people in working age are disabled worldwide (WHO-report 2010).

80% of disabilities are not inborn, but developed during life time.

Most of them become invalid, unemployed and dependant of long-term benefits.


Thesis

Return-to-work strategies attract traditional vocational rehabilitation to the enterprises / employers by prevention programs close to the worksite.


Vocational rehabilitationReturn-to-Work

as a global movement


Return on Investment

The state increases the prosperity of the society that corresponds to its workforce and its working longer and harder (demographic factor).

Employers need their skilled workers fit for work on a long-term base and want to strengthen their work capacities.

Health providers are paid for supporting their clients on their way back to work. This main reason of financing a health care system must respected by physicians.

Insurers profit from investing in RTW instead of paying early and permanent compensation. 80% of the costs are paid for only 20% of the cases.


Terms

InclusionRehabilitation

Disability Management

Return to

work


Return to Work (RTW)

Stakeholders

State / social partners

Disabled persons / users

Service providers /professionals

Insurers / payers


Key questions around the world

How employees with disabilities can receive comprehensive medical, vocational and social services out of one hand?

How employers can be motivated and supported in their activities by reintegrating disabled employees at the

workplaces?

How medical services can act close to the working life with the link to vocational rehabilitation and social inclusion?

How payers, which pay health services can support these challenges?


Success factors

Strategies

Case

Management

Collaboration among insurers

Acceptance by the disabled

Early Intervention

Holistic Approach


Key elements of success

Early intervention

• No application!• Early information• Pro-active management• Close contacts to work places



• Bio-psycho-social model (ICF)• Employer’s liability • The key-role of physicians and clinics• Prevention and Rehabilitation

Holistic Approach


RTW - Chain

Activities of Services

Employability

Health and Safety

Health Promotion / Wellbeing


Rehabilitation


Case Management

• Paradigm-shift from Compensation to Management• Disability Manager as experts• Efficiency: 80% of the costs in 20% of cases• Individual plans correspond to CRPD



Art. 26, 1 a / UN-CRPD„Habilitation and Rehabilitation“

“Services and programs begin at the earliest stage, and are based on the multidisciplinary assessment of individual needs and strengths…”



Employer

Consensus-based

Employee

International Labour Organisation (www.ilo.org)

NIDMAR / Canada(www.nidmar.ca)

DGUV (www.dguv.de)

Employment

contract


Global Standard in Disability Management

Qualifying experts

Disability Managementwww.disability-manager.de

www.ifdm2012.comLondon

Quality audit in enterprises


Certified Disability Management Professional

CDMP

Persuadeemployers

Networking

Legal

knowlegdeMedical aids

Evaluation

Assessment

Ethical behaviour

CaseManagement

Social competence


Qualifying experts in Germany

German Social Accident Insurancewww.dguv.de

Certification and Recertification

Canadian Initiativewww.nidmar.ca

726 Disability Managerswww.disability-manager.de

25 moduls offered by

Educational partners


CDMPWorking in enterprises

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Audit and Certification in Germany

German Social Accident Insurancewww.dguv.de

Financial incentives by insurers

Ford Germanywww.ford.de

Standards for Service providers

Auditor in Germanywww.iqpr.de


Collaboration among insurers

• Social security branches• Federal approaches• Needs of smaller enterprises• Regional Centers of Competence



Acceptance by the Disabled

UN-Convention on the Rights of People with Disabilities (CRPD) in 2008.

Codification in social and labor law by compulsory duties and incentives for RTW.

Action Plans for implementing CRPD in the society.



Art. 27, CRPD „Work and Employment“

„ (1) States parties shall safeguard and promote the realization of the right to work, including for those who acquire a disability during the course of employment, by taking appropriate steps, including through

legislation, to, inter alia:

(k) Promote vocational and professional rehabilitation, job retention and return to work programmes for persons with disabilities.


Conclusion: Criteria for a successful RTW

• A holistic case management which takes all needs and abilities of persons with health problems into consideration.

• A strong support from the social partners (employers and employees) make programms in RTW successful.


• Actors need strategic partners for combining activities in prevention, acute treatment, medical rehabilitation, vocational and social participation.

• Employers and Insurers should qualify their staff in disability management standards and finance incentives for

comprehensive service of health providers.

• People with disabilities should be strengthened as their own case manager (participation) based on CRPD (inclusion!).


• Employers need and expect an advice-service “out of one hand” for their reintegration activities covering safety and health promotion and RTW.

• Rehabilitation International should contribute to provide global guideline and standards in RTW including structural, process and outcome criterias.


International Cooperation

•International Labour Organisation (ILO)

•International Social Security Association (ISSA)

•Rehabilitation International (RI)

•International Disability Management Standard Council (IDMSC)


Further Information

• www.disability-manager.de• www.ifdm2012.com• www.dguv.de• E-Mail: [email protected]• www.issa.int• www.idmsc.org• www.riglobal.org


Thank you for your attention!

Congress of AVAPES on Rehabilitation and Inclusion Dr. jur. Friedrich Mehrhoff, German Social Accident Insurance, Berlin Sao Paulo, November 2011 “Global.

Documents

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