Need to know
- Insurers are keen to provide rehabilitation support as early as possible because this can reduce absence and improve the outcome for the employee.
- Robust absence procedures will ensure that cases suitable for rehabilitation are identified as early as possible.
- Communication is essential to enable early intervention and maximise the value of rehabilitation support services.
Traditionally bought for their financial benefits, group risk products are increasingly offering valuable rehabilitation services. But, while these can help reduce long-term absence and support employees with serious health conditions, it is important to raise awareness of these services to ensure they are used as effectively as possible.
The most comprehensive form of support is available on group income protection policies, says Mark Witte, senior consultant at Aon Employee Benefits. “Where an employee is, or could potentially be, absent long term, insurers will provide access to vocational rehabilitation support,” he says. “This is overseen by a nurse or rehabilitation specialist who will work with the employee and employer to ensure the right treatment and support is provided to help them return to the workplace.”
Avenues of support
This support can come from various sources, pulling in other employee benefits, as well as the insurer’s own resources. Saumya Barber, rehabilitation services manager at Unum, says: “We'll assess what the employee needs, directing them to their HR department if it’s a benefit or service the employer provides, for example, medical insurance or an ergonomic assessment, or referring them to our employee assistance programme (EAP) if applicable. Where the treatment can’t be provided through existing benefits we would consider funding it ourselves. Each case is different and requires a tailored approach.”
Initial access to these services is usually driven by the employer. For example, some providers offer employers access by phone, email or online, although employees can also make the initial contact with their employer’s consent.
While they will not provide the same level of support available through a vocational rehabilitation service, there are often services available that employees can access without needing authorisation from their employer.
These include EAPs, second medical opinion services, bereavement counselling, and practical and emotional support from providers such as RedArc and cancer charity Maggie’s. “These services can provide really useful support to employees and may help to prevent a group income protection claim altogether,” says Witte.
Early intervention
But, whether it is an EAP or a more tailored vocational rehabilitation service, the key to success is early intervention. Paul Avis, marketing director at Canada Life Group Insurance, says: “We need to know as soon as possible that an employee could potentially be a claim on our group income protection plans. Engaging early greatly improves the chances of an employee returning to work.”
To illustrate this, the average return-to-work time through its early-intervention service is seven weeks, with eight out of 10 employees returned to work within the deferred period. But, where the employer facilitates early intervention in the first four weeks of absence, the average length of absence is just five weeks.
Unfortunately, achieving these results is not easy, with the majority of cases reported to insurers several months after the employee first went off sick. A strategic approach to absence can prevent this delay, says Nick Homer, propositions manager, corporate risk at Zurich. “[Employers] need to have robust procedures around absence to ensure that any cases that could benefit from rehabilitation are identified as quickly as possible,” he adds.
Having triggers in place to flag up any cases that might benefit from early intervention can also help. Homer explains: “We don't need to know about colds and stomach bugs but the sooner we can get involved with a mental health or musculoskeletal case the better the outcomes.”
Insurers can take the hassle out of setting up these systems. For example, as part of its Sick Pay Complete product, Ellipse provides an integrated absence management system, TeamSeer, to ensure it is alerted to any cases that might benefit from rehabilitation as early as possible.
In addition to having the correct procedures in place, communication is also important. As a bare minimum, this includes letting line managers know what support is available so they can direct employees to it. Barber says: “Employers shouldn't keep quiet about these benefits. They provide invaluable support to line managers and HR, who might not have the time or expertise to support someone with health problems, but they also demonstrate the [organisation] is looking after its employees’ health and wellbeing.”
Oracle introduces rehabilitation helpline for managers
Supporting the health and wellbeing of its UK employees is important to technology organisation Oracle. To help achieve this, in November 2015, it introduced a vocational rehabilitation helpline, Swift, for managers in collaboration with Unum, alongside its existing portfolio of healthcare and wellbeing benefits.
This acts like a triage service, says Claire Hallmey, wellbeing manager at Oracle UK. “If an employee has any health issues their manager can call this helpline and get advice from a vocational rehabilitation specialist,” she explains.
“They understand all the products and services we offer and can help the manager to signpost the employee to the most appropriate support. This could include a referral to the employee assistance programme, a desk assessment with the health and safety department or into the private medical plan.”
Since the helpline was introduced, it has made a significant difference. Hallmey says: “We do see a lot of enquiries going through the helpline and it’s also increased the number of referrals that are made while employees are still at work. Helping them at this early stage can make a big difference to their prognosis.”
To ensure it brings as much benefit as possible to employees, Hallmey is planning a new communications programme this year. “When we launched Swift our focus was primarily on managers,” she says. “This year, we’ll also communicate it to employees. It’s important they know this support is available for them.”
Viewpoint: Employers should take steps to ensure re-entry to work is sustainable after absences
Given the range of health reasons an employee may take time off for, and the variable fitness requirements for different professions, there is no one-size-fits-all role that an employer should take in workplace rehabilitation. But broadly the employer’s role is to take appropriate steps to support the individual back to work and to ensure that the re-entry to work is sustainable. In general, good practice guidelines regarding rehabilitation focus on longer-term absences since, compared with shorter periods, these are more likely to result in difficulties returning to work.
Employers have a duty of care towards all of their employees and this does not cease when an employee is absent. The employer should expect to be involved in negotiations that facilitate timely re-entry to work, and should also bear in mind that return to work may not necessitate full recovery of that individual. Keeping in touch during absence is recommended, but this should be done in a way that is acceptable to and sensitive to the circumstances of the absent individual. Where occupational health services are available, employers should be referred or signposted to these as early as possible.
A very important feature of long-term absences is that they often result from long-term, chronic health conditions (or conditions at risk of becoming long-term). Many chronic conditions are treated as a disability under the Equality Act, which states that employers should take steps to remove, reduce or prevent the obstacles a disabled worker faces.
Effective approaches to support a person who has been affected by a mental health condition will differ significantly from those required by a person with, for example, mobility issues. All employers would be advised to seek expert guidance on this aspect and proceed to make adjustments with the full involvement of the returning employee.
Sally Wilson is senior research fellow at the Institute for Employment Studies
