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SAN FRANCISCO — When it comes to workers with chronic conditions, employers should focus on providing accommodations and support rather than managing a disease, an expert said during the Disability Management Employer Coalition's 2015 conference in San Francisco.
During a Monday session on chronic conditions in the workplace, Dr. Glenn Pransky, director of the Center for Disability Research at Liberty Mutual Research Center in Hopkinton, Massachusetts, told workers compensation and absence and disability professionals that to adequately prevent disability and presenteeism, they should look beyond an employee's illness.
“If you really focus on work, that's where the best evidence is for decreasing the incidence and the duration of work absence,” Dr. Pransky said. “Why is that? Because problems at work and work absence are complex. They're never just about the disease or the diagnosis. They're about how that problem interacts with the individual and the workplace and their supervisor.”
Dr. Pransky said there's a lot of evidence that chronic conditions lead to higher rates of absence and reduced productivity for employees, including workers comp claimants.
“In a variety of studies, we've seen that at least 40% of the U.S. workforce — young and old — has a significant chronic health condition,” he said. “About half of these people say, 'This condition has an impact on my ability to do my job.'”
A number of programs have been implemented over the years to combat this problem, but they've generated mixed results, Dr. Pransky said.
For example, preplacement examinations that “screen out people who are unfit to do the job” can't predict whether someone will develop a chronic disease, Dr. Pransky said. “If somebody did my preplacement examination for my current job when I was 40, they'd have no way of predicting that as I got older my blood pressure would go up and cholesterol would get a little bit higher.”
In addition, because of the Americans with Disabilities Act, employers have to “be on really solid evidentiary ground” if they're going to withhold a job due to a medical condition, Dr. Pransky said.
Regarding wellness programs, the people who participate do tend to have better short-term disability and long-term disability outcomes, he said, but there's a low rate of engagement among the workers who could benefit the most.
He noted that there's also little evidence at this point that such programs make a long-term difference.
Employers should instead put stock in training supervisors and accommodating workers, Dr. Pransky said.
When it comes to a workers comp claim, many supervisors feel responsible to make sure an injury really did occur at work; and when it comes to short- or long-term disability, they feel it's their job to make sure a person isn't faking it, he said.
“The problem with that is it sets up a very negative dynamic between the supervisor and the employee,” he said.
Dr. Pransky said he encourages workers comp and disability and absence management processionals to train supervisors to be supportive and helpful and to focus on problem solving, which could include ergonomics and accommodations that help workers in the short term.
When medical restrictions prevent injured employees from returning to work in a light-duty capacity, more employers are looking to outside organizations to accommodate them in the interim.