Val Lougheed Northern Lights Canada Real Work * Real People * Real Results Organizational Health and Wellness: A Strategic Approach The Disability Benefits System 1-800-361-4642 * www.northernlightscanada.ca * [email protected]
Jun 10, 2015
Val LougheedNorthern Lights Canada
Real Work * Real People * Real Results
Organizational Health and Wellness: A Strategic
Approach
The Disability Benefits System
1-800-361-4642 * www.northernlightscanada.ca * [email protected]
“You don’t want your impairments to define you – you want them to inform you.”
(Hanita Dagan, personal communication, 2005)
www.slideshare.net/vlougheed
#NLCAN
www.northernlightscanada.ca/about/about-val-
lougheed/be-still
Agenda
•Beginning …
•Middle …
•End …
Rated PG-113
People Strongly Cautioned!
May contain bad language, brief nudity, sexual overtones, and drug usage.
Beginning
My Story
Sept. 9, 2003 - morning
Sept. 9 – p.m.
Sept. 15 2003 – Jan. 19 2004
Journey Back to Life
February 2004 – Present
Starting Point
The
Re-organization
of Self
2003 --
Middle
The Disability Benefits System
OVERALL GOALDelivery System
Efficiency
•Recovery and Return to Work as quickly as possible
•Benefits provided at minimum cost
(Rand Report; Reville et al, 2005)
WHAT I NEEDED
• Return to Work Services
• Financial Compensation
ASSESSMENTS
WHAT I GOT• Physio
• Myofascial Release Massage
• Psychological Support
• Head Injury Program
• GRTW
• Financial Compensation
The Lynchpin
The Medical Model
Impairment
Predicts
Disability
BUT
enesis
DISABILITY PARADOX
PERSONAL OUTCOMES
“people are indirectly compelled to remain inactive and assert they are incapable of working in order to continue to receive payments”.
(OECD, 2009, p. 17)
FINANCIAL OUTCOMES
•
HIDDEN COSTS
•
WHY
enesis
#1 --IATROGENESIS
Over Diagnosis and Medicalization of
Factors
#2 -- Work Disability
Work Disability
“People who never lose time from work have better outcomes than people who lose some time from work.”
• odds of a worker ever returning to work drop by 50 percent by 12th week
(ACOEM , 2006, p. 6)
#3 -- Interactions Between Injured
Workers and Insurers (Kilgour et al, 2014; Miller, 2001)
Losing My Grip
My IWRPAugust 2004
SCARF MODEL (Rock, 2008)
LOOKS LIKE
Non-compliance
Malingering
Faking severity of impairment
Doesn’t want to work
Wants to cheat the system
SYSTEM-INDUCED DISABILITY
“benefits system itself has a disabling effect on people”
(OECD, 2009, p. 17)
REWIND
George Engel (1913-1999)
It’s more important to know
what sort of person has a
disease than to know what sort of disease a person
has.(Hippocrates, circa 460 – 377 BC)
Biopsychosocio(economic) Model
Lennart Nordenfelt (1945--)
Nordenfelt on Disability
Only has meaning when associated with action and placed in context
► doing something, somewhere
► must understand the something and the somewhere
(Nordenfelt, 2003)
DISABILITY IS NOT A MEDICAL CONCEPT
Impairment
does not Predict
Disability(ACOEM, 2006; De Paolo, 2013; Franche et al,
2005; Loisel, 2009; Nordenfelt, 2003; Prigatano, 1999; Waddell, 2010; Wright,
1992)
End
Future Directions
Bell Aliant Halifax
Accept and Assist
vs.
Deny and Defend
(Burnstein, 2014)
A New (Fantastical)Return to Work Benefits System
Focus on interaction between person and
society
FUNCTIONAL FACTORS
Person
Environment
System
PERSON ENVIRONMENT
SYSTEM
The Lynchpin
The Role of the Physican
“shift away from complete reliance on physician certification for work absences (Certificate of Disability) to co-operation between the employee and his or her employer with the use of medical input, advice and support”
(CMA, 2001, p. 1)
RETURN TO WORK TEAM
• Person
• RTW Co-ordinator
• Employer
• Insurer• Union Rep, Health Care Provider, Therapist(s), etc .
►role of each stakeholder is calibrated to match up more effectively with the situation at hand(Davis, Badii & Yassi, as cited in Franche et. al., 2005, p. 533)
Calibration of Roles
“where workplace and worker involvement should be high, and healthcare provider involvement more modest”
(Franche et. al., 2005, p. 533)
•focus of involvement centres around work-site based interventions
(Davis, Badii & Yassi, as cited in Franche et. al., 2005, p. 533)
Results of this Approach
• Gross Absence Rate (unscheduled absences : scheduled working
time) (‘09) 4.5% -- 3.6% (‘13) • SDB as % salary (STD payments : total payroll)
(‘09) 1.36% -- 0.99% (‘13)
• Denials ~ 1% - usually wrong basket • Grievances on denials – rare • Relationship with Union - positive• # of Health Assessments – increased (some referred
by Union)• # of IMEs for SDB adjudication – rare• # of IMEs for HA’s and SDB mgmnt - frequent*
(Burnstein, 2014)
REAL SAVINGSPersonal and Financial
1. Understand ‘Disability’
2. Positive Regard
3. Trust
TRUSTTRUST ▲
꞊
TIME ▼ +
COST ▼
(Covey, 2006)
Back in “a” SaddleSeptember 2007
• Officially change role/ title
• Re-organize NL
• Home office
Northern Lights Canada is a person-centred organization committed to providing innovative, responsive links to real work.
We offer 4 major divisions of service: • Vocational Rehabilitation Services • Employment Services • Employer Services• Corporate Training
For more information, please contact us: 1-800-361-4642
www.northernlightscanada.ca
Voc Rehab Canada (VRCAN) is a national consortium of experienced regional vocational rehabilitation companies. VRCAN provides customers with single-point access to VR services anywhere they are needed in Canada, whether on an individual service or contract basis.
Member companies include:Argus Management Consultants,
Inc. Sandra Preeper & Associates
Advantage Rehabilitation Consultants Ltd.
Rehabilitation Alternatives Limited / Vocational Alternatives Software
OPTIMA Rehabilitation CVE Inc.
Northern Lights Canada Occupational Rehabilitation Group of Canada (ORGOC)
Western Rehabilitation Specialists Inc.
Diversified Rehabilitation Group
Genesis Rehabilitation Ltd. Rehabilitation FocusFor more information, please feel free to contact us at 1-800-361-
4642