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For Mark Briskie, a disability management specialist for UCLA Healthcare, two types of phone calls are music to his ears.

The first is when the voice at the other end of the line, typically an employee who has been ill or injured due to causes that may or may not be work-related, asks about assistance returning to work. This call is a sign that the worker has accepted the company's return to work concept.

The other type of call Briskie welcomes is when a department director tells him there is temporary, modified work available and inquires if any employees need an assignment.

This type of call is a signal that shows that management is participating in the program.

"The good managers also get creative," says Briskie, who has worked in the disability management field since the mid-'80s. "They figure out a way to change a job or reassign some job tasks so that someone can return to work."

Among managers, Briskie also says, attitudes and acceptance have improved, and that goes a long way to facilitating return to work placements for employees with medical restrictions.

Both types of calls, Briskie says, are a sign that the injured worker and senior managers have accepted the return to work program at UCLA Healthcare, which operates two primary hospitals and several clinics throughout the Los Angeles area.

For many companies, return to work programs such as the one at UCLA Healthcare are the cornerstones of integrated disability management and absence management programs aimed at reducing absenteeism in the workplace.

With integrated disability management programs, employees who have occupational and nonoccupational illnesses and injuries are able to access the same return to work services, even though they are covered by different benefit programs.

Looking beyond disability management, workers' compensation and short-term disability to employee absences, including paid sick leave or paid time off, and new federal entitlements such as the Family Medical Leave Act (FMLA), absence management is the next step on a broader spectrum.

Absence management may also encompass other workplace benefits such as an employee assistance program. Such programs offer assistance to employees who have personal issues such as childcare or eldercare concerns, financial or legal problems or substance abuse problems.

"Whatever the approach and regardless of whether it's an integrated disability management program or an absence management program, employers are seeking solutions to mitigate the impact of employee absences," says Marybeth Stevens, manager of workplace absence and disability management programs for the General Electric Co.

According to the consulting firm Watson Wyatt, the combined costs of absenteeism and disability may gobble up as much as 17 percent of a company's bottom line.

Further, in a 2001/2002 study, Watson Wyatt said the number of surveyed employers who use an integrated approach to disability and absence management has doubled to 51 percent from 25 percent in a 1996 survey.

To be most effective, workplace initiatives to reduce the incidence of employee absences and shorten the duration of time that employees are away from work need a level of cooperation from managers, supervisors, employees, human resources, unions, risk managers and employee assistance program personnel.

With that support and acceptance, the absence management initiatives will gain the necessary traction to establish a footing in the workplace.

"That 'buy-in' is critical," says Carol A. Harnett, assistant vice president and national practice leader, Group Disability and Life Practices, for Hartford Life. "There are still employers out there that struggle with whether absenteeism is really an issue."

Traditionally, disability management has succeeded when the CEO and upper-level management bought into the concept. The reality of workers' comp claim costs and the impact on productivity made the case for disability management as a cost-reduction strategy.

With absence management, those within the corporation fighting for its cause may be middle managers responsible for employee assistance programs, wellness or disability management functions. Having seen the results of a sound disability management program, they have the confidence that focusing on short-term disability, FMLA-related cases and the misuse of paid time off will also carry benefits.

SELLING THE CONCEPT

Selling senior executives on the importance of absence management will likely require both quantitative and qualitative approaches.

A quantitative approach begins with tracking employee absences, including one- and two-day incidents that may not be closely monitored. While an isolated case of an unscheduled two-day absence may seem minor, in the aggregate the impact on a company's productivity can be substantial.

Qualitatively, absence management can target workplace issues such as improvements in morale and job satisfaction, and the interaction between unions and management.

It also highlights the importance of a high level of service from medical staff and outside service providers to improve the response rate when an employee becomes ill or injured and is off the job.

As a result, companies that look to determine the effectiveness and efficiency of absence management programs will, in the end, be rewarded.

This means not only examining the impact on productivity and profits, but also taking a close look at employees who can take advantage of return to work, wellness, employee assistance and work/life balance programs.

Measuring the outcomes of these programs is critical, particularly when companies are scrutinizing the cost of health care and other human services. Disability management and absence management programs must be able to show the benefits they produce compared with the cost incurred.

For companies that embrace the importance of their employees and look for a return on their investment, absence management is not measured in a reduction in lost days alone.

Companies also look at factors such as improved morale and employee retention, which can translate directly into productivity.

Simply put, when experienced employees are in the workplace and doing their jobs, there can be a positive impact from product quality to customer service.

Briskie says the recognition that "employees are our most important asset" is a core belief at the University of California. "As a major employer in California, we want to do whatever we can to assist any of our employees in returning to work as productive members of our workforce following an illness or injury," he says.

Employee support and involvement are also critical to the success of absence management programs. This may include confidential surveys that assess workplace satisfaction to uncover factors that may be contributing to absenteeism, such as conflicts with co-workers or supervisors.

Or, employers may use confidential surveys to determine what health and wellness issues they should address. In addition, companies may seek feedback from employees on their experience with workplace programs, such as absence reporting systems.

Employee communication about the programs--who is eligible and when, how they work, and the benefit to employees and to the company--should also be a priority when implementing an absence management program.

The message to employees should be that if there is a good reason for an absence, such as an illness or injury, they are entitled to recuperate. For many employers, absence management is a process of educating employees about paid time off and sick leave as a benefit not as an entitlement.

These are benefits to be used when needed, not taken at will as vacation or personal days. Employees should understand how important it is that they be on the job, and that assistance is available to help them get back to work.

That assistance most likely includes a return to work program offering help with modified duties and temporary assignments for ill and injured workers.

"A typical case might involve a nurse with a back injury, which prevents that person from returning to patient care," Briskie says. "I work with nurses to place them in assignments such as case management, special research programs, or nonpatient care jobs where they can use their medical skills and background, which is valuable, while not having to lift and move patients."

The more employees understand how absence management programs work, the greater the chances are that they will participate. The more employees benefit, the more likely the employer will suffer fewer lost work days. Absence management programs need to show this type of return on investment in order for management to accept these initiatives and provide meaningful support.

AN BRUNELLE is manager of the integrated disability benefits group at AECOM, a global architecture and engineering firm headquartered in Los Angeles. She is also chairwoman of the Certification of Disability Management Specialists Commission, a certifying body for disability management specialists.

NORMAN HURSH is director of vocational rehabilitation services at the Sargent College Clinical Centers at Boston University.

May 1, 2005

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