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Workers Compensation Issues

Integrated Disability Management

Joe Galusha | April 20, 2018

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Organizations appear to be at an intersection of new compliance requirements with the Americans with Disability Act (ADA), Equal Employment Opportunity Commission (EEOC), and the aging workforce.

In 2017, according to the Social Security Administration, there were 8.7 million Americans of working age receiving Social Security Disability Benefits. This is an increase of 8 percent since 2010 and 32 percent since 2003. In that same year, more than 2.2 million Americans applied for Social Security Disability Benefits, with 762,000 being approved. To put these numbers in context, according to World Population Review, the state of Virginia, our 12th largest state, currently has a population of just over 8.5 million. This is a disturbing realization, but what may be more relevant to organizations are the more than 1.4 million Americans who applied for disability in 2017 and were not classified as fully disabled.

Disabled Workers by Calendar Year - Galusha - April 2018

Source:Social Security Administration

Within the numbers, there's something easy to overlook—these individuals are currently part of the workforce and are in need of temporary or permanent accommodation. According to Rhonda Dorton, a registered nurse and president of AAA Evaluations, a company that provides objective assessments used for disability determinations, "of the 1000s of applicants we see each year, many of those who are not classified as fully disabled have partial limitations and share their difficulty in being able to find or hold a job. It concerns me that organizations are struggling to accommodate their injury or illness, and the significant amount of litigation also reported."

These trends are having obvious social and economic impact, resulting in government agencies like the EEOC putting more pressure on employers to accommodate partially disabled workers. Recently, the EEOC outlined its strategic priorities for enforcement. According to Aon Disability Management Thought Leader Christina Bergman, "Of note was an increased ADAAA focus on employers' inflexible leave policies as well as employers who contradict the accommodation requirements by wanting employees to be 100 percent healed prior to returning to work."

The Cost of Disability and Workforce Age

Median Age of Labor Force - Galusha - April 2018

In addition to compliance with EEOC requirements, employers are also becoming very aware of the impact of an aging American workforce on disability in the workplace and related costs. According to the US Bureau of Labor Statistics, the median age of the US workforce has increased from 38 to 42 since 1996, and in many industries, the percentage of workers over the age of 45 make up more than half of the workforce.

One significant impact of this relatively slow demographic shift in workers' age is an increase in the average loss workdays from work-related injuries. One study of 393 companies indicated workers over the age of 45 lost an average of 13 days more per loss-time injury than their younger counterparts (Source: Aon Laser Database). More tenured workers typically are at higher wages resulting in higher workers compensation reimbursement levels and have other factors, such as higher frequency of litigation resulting in significantly higher average workers compensation claim costs (73 percent higher) in the same Aon study.  

Time to Combine Efforts

The United States is likely to see a similar or growing percentage of aging workers in the workforce through the next decade, leaving little doubt that current disability trends in the United States will continue. This will continue to support the need for tighter regulation and compliance efforts while at the same time placing increased financial pressures on organizations to fund workers compensation programs. According to Ms. Bergman, absence management programs face increasing complexity in balancing Social Security, workers compensation, and nonoccupational health programs, noting that among many of the aging, injuries and illness considerations can overlap into each of these various benefit buckets, making it even more difficult for an employer to navigate through the sea of obligations.

Historically, most organizations approached compliance with ADA requirements and workers compensation disability management in a very secular manner. Integration is really not that difficult; at the core of a successful absence management program are policies that incorporate the needs of both occupational as well as nonoccupational return-to-work issues and well-constructed physical demands assessments (PDAs). When considering policy development, it is recommended that the development of the absence management program not be limited to simply risk management, safety, and human resources but also include representation from other stakeholders, such as claims, operations, and finance.

Constructing the Policy

There are several key elements that illustrate the power of integration and should be considered when creating a return-to-work program. First, it is important to recognize that the difference between permanent impairment under workers compensation does not necessarily equate to a permanent disability or an exception under the ADA. As an example, an individual with a permanent partial disability is not automatically to be considered permanently disabled under ADA statutes unless it is proven they cannot be reasonably accommodated. Such interpretation and considerations must be made on a consistent basis, regardless of an occupational or nonoccupational cause. The basis for making decisions must be objectively sound. 

Second, injuries must be evaluated independently by reviewing preinjury job description requirements with clearly identified essential job demands in comparison to the capabilities of the individual under review. Leveraging PDAs with consistent protocols across both occupational and nonoccupational programs creates efficiencies and, once again, supports objectivity in decision-making. An integrated approach goes a long way in avoiding mistakes that can result in costly fines and penalties.

It is critically important that at the core of an effective absence management program is that each job description is supported by a validated PDA. A properly constructed PDA contains the most relevant and essential job-related physical task requirements that can be used to support multiple organizational objectives, such as the following.

  • Post-offer employment testing. Unfortunately, many organizations abandoned or have not considered these tests due to concerns regarding ADA compliance. Progressive organizations have proven that, when using well-constructed PDAs, testing can be done fairly and effectively in full compliance with regulations.
  • Temporary transitional duty task identification. PDAs can be loaded into a database and matched up with physician determined work restrictions to create an efficient and more successful return-to-work placement.
  • Permanent restrictions and the ADA Amendment Act interactive process. Predetermined PDAs are critical to the process of making decisions around reasonable accommodation in comparison to the essential task requirements.
  • Work hardening. Occupational health practitioners can use PDAs to successfully sequence relevant physical and occupational therapy to support a returning worker's progression to work full time with minimal operational interference.
  • Job and task rotation. PDAs support decisions around "smart rotation" or managing individual exposure to tasks involving ergonomic risk indicators (such as bending, twisting, lifting, pushing, and pulling) by limiting time on a particular task to a small part of the workday.

Source: EHS Today, Michael Bergman , August 2017.


In the foreseeable future, organizations will continue to experience an intersection of an aging workforce and an increased regulatory focus on the accommodation of disabilities. If this isn't considered, it could be highly disruptive, causing increased workers compensation costs and the potential for costly fines and penalties. An integrated disability or absence management program can change the paradigm of return-to-work efforts from being focused on the disability to being ability focused. In addition, a well-defined program will help create organizational synergies to improve hiring practices, increase training effectiveness, and provide the formal documentation needed to assist in meeting regulatory requirements, not as an afterthought, but as an assimilated operational element.

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