A Challenge for RIMS

In case you hadn't noticed, a great shift in work-related impairment is under way. Career-ending work disability is an increasingly obsolete concept. But careers accompanied by any health risk, ironically, have become increasingly common.

By Peter Rousmaniere

More people seem to be living with health problems, and not just at assisted living facilities where breakfast groups engage in daily "organ recitals." My twin brother, for example, would have been, a generation ago, permanently disabled by a skiing accident in which he broke both legs. Instead, he was back at work running a 13,000-circulation newspaper. Then he was stricken with cancer. Again, he came back to work, where he's happily at his job.

His tale of survival is not unique. A recent study of cancer survivors reported that 75 percent of those who left work due to the disease later returned to work. Of those who returned, 83 percent continued to work for at least four years.

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In another instance, I talked recently with a man in his 40s named Robert, whose first 15 years of adulthood, lived in part as a homeless man, was almost destroyed by bipolar disease. He is now employed in hospital housekeeping. He told me that "work is my medication."

There are upward of a half million Social Security disability insurance beneficiaries of working age who've been diagnosed with schizophrenia, depression or severe mental illness yet, according to advocates, are willing and able to work. Their greatest on-the-job risk is failing to take their medications.

Moving from individual cases to an entire industry, the domestic call center industry, which employs more than two million people, experiences huge labor turnover and high rates of work injuries and nonoccupational illnesses, problems which are tightly connected.

Now ask yourself this. If you were the workers' comp insurer, an employer, a call center worker, a hospital housekeeping employee, or even my twin brother, who would you prefer to be in charge of workers' comp?

Would you want someone who has deep in-the-crease knowledge of workers' comp but is light on other human resource issues? Or, would it be someone who has a moderate understanding of workers' comp and health care, counseling, discipline and issues related to the Family Medical Leave Act? Would your preference change if the employer was about to introduce a high-deductible health plan with generous amounts of consumer counseling on all aspects of health?

My guess is that we would elect the HR generalist over the narrow workers' comp specialist. Here is why. Worker injuries are declining. Survivor rates from personal health problems are increasing. Behavioral risks of mental illness and substance abuse have remained constant. Employers are more proficient in managing absences. The result is that managing injury risk is best managed as a subset of many human resource risks.

Three nonprofit organizations have been paying attention to this trend. They are the National Business Group on Health, the Disability Management Employers Coalition and the Integrated Benefits Institute. DMEC is even holding a panel on call centers at its annual meeting in July. Today these bodies are relatively small, but they are leading in the hunt for solutions in workers' comp, long-term disability and short-term disability. That's what counts. Within three years, I predict that they will merge and forge a risk management society to rival the Risk and Insurance Management Society Inc.

PETER ROUSMANIERE, a Vermont-based consultant and writer, is the workers' comp columnist for Risk & Insurance®.

May 1, 2005

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