Transcript Slide 1
Michele Clopper, MS, OTR/L
Senior Disability Case Manager
This presentation will review the current resources
including federal laws to offer a process to assist
employers and employees with psychiatric
disabilities to stay at work (SAW) or return to work
(RTW).
Gain knowledge of key legislation and employer
benefits to support employees with functional
limitations/impairments related to their disability
Identify the necessary components to facilitate the
reasonable accommodation process
Gain an understanding of the interface of job
analysis and functional limitations
Articulate the importance of the interactive process
Reflect on the value of developing a SAW/RTW
program for individuals with disabilities
According to the Society for Human Resource
Management (SHRM) many employers do not have a
well defined return to work philosophy.
Depression costs employers in the United States over
$44 billion annually
55% of this is from reduced productivity ($12.1 b)
and absenteeism ($11.7b).
Psychosocial Issues and the Return to Work Process
by Miller in 2004
$83.1 b annually with $51.5 b in workplace costs for
depression alone
The economic burden of depression in the United
States: How did it change between 1990- 2000? By
Greenberg…
ADA- Americans with Disabilities Act signed July 26,
1990
ADAAA- “The Amendments Act”of 2008- lower the
threshold to define disability
FMLA- Family Medical Leave Act- 1993
State disability laws
◦ May have a higher threshold than the ADA
◦ Provision of state vocational rehabilitation services
Equal Employment Opportunity Commission (EEOC)
Prohibits discrimination in all areas of employment
including the application process, hiring, firing,
advancement, compensation, training and all other
terms of employment.
Individuals must be qualified- having the skills,
education, and experience- to perform the job with or
without reasonable accommodation
Does not include a diagnosis but a general definition
“A person has a disability if he/she has a
physical/mental impairment that substantially limits
1 or more major life activity, a record of such
impairment, or is regarded as having such an
impairment.
Anyone who engages in the use of illegal drugs is not
protected by the ADA
An individual who is an alcoholic is protected under
the ADA but they must be able to perform the
essential job functions
Additionally, the individual can be terminated if
alcohol adversely affects job performance
Broadens the definition of disability
Reading
Thinking communicating
Concentrating
Communicating
Working
Breathing
Major bodily functions
Walking
Bending…
Employers with 50+ employees or more
Employee must have worked a minimum of 1 year
(1250 hours) to be eligible
With medical certification, employee entitled to job
protection for up 12 weeks per rolling year for time
out of work
◦ Medical information can not exceed what is contained in the
DOL form
Can be continuous or intermittent leave
Employer cannot declare hardship
Re-instatement to the same or equivalent position
20% of the US populations is affected in a any given
year using DSM criteria
~ 44- 57.7 million individuals or 1 in 4
19% diagnosed with a mental disorder alone
3% diagnosed with an addictive and mental disorder
6% addictive disorders alone
Excessive absenteeism
Poor work habits
Reduced productivity
Stress- complicating variable
Refers collectively to all diagnosable mental
disorders characterized by alterations in mood,
thinking, behavior, or a combination
Concentration
Fatigue
Memory
Organization
Multi-tasking
Attendance
Inability to screen out
environmental stimuli
Stress
Interactive abilities
Dealing with change
Responding to feedback
Stigma & discrimination
◦ Does not self identify
Invisible disability
Disclose after a crisis
Reputation
Short term disability plans
Long term disability plans
Employee Assistance Plans (EAP)
STD is mandated in some states- NY, NJ,RI
◦ Provides up to 26 weeks of income protection
◦ Can be a salary %
LTD is usually offered by a vendor
◦ Can have pre-existing condition clauses
Reasonable accommodation benefits
◦ Flexible scheduling
◦ Job coaches
◦ Case management
Vocational rehabilitation services
Retraining
3 out of 10 employees between the ages of 25-65
will be out of work for three plus months at some
time due to disability
Commonly outsourced benefit
Offers a wide variety resources
Referrals which address insurance and geographic
needs
Wellness component
Coaching
Wellness and Prevention Programs
Benefits
ADA & ADAAA- Civil Rights Laws
FML- job protection
STD, EAP, LTD- employer benefits
Need a way to coordinate and provide a program
which coordinates/interfaces
Proactive employer who places value on SAW & RTW
Employee
Nothing
SAW
Accommodation
SAW (FML?)
EAP
SAW
Accommodation
SAW
FML
STD
Out of Work FML
RTW
With or Without
Accommodation
Facilitates the accommodation process
Identifies the employee’s need for support for
success at work
Employer must acknowledge the request
Act quickly
Assign responsibility
Conduct trainings
JAN
Identify stakeholders
Identify essential job duties
Obtain information: functional abilities & limitations
Job analysis
Maintain confidentiality
Pivotal role in any SAW or RTW process
Study –Journal of Occupational Rehabilitation
The supervisor is the key person
Being a support
Making demands
Acknowledging every employee
Setting the tone
Collaboration & communication
Documentation of disability
Be careful as only need the scope to establish need
and functional limitations and abilities
Implement reasonable accommodations
Jobs have essential and marginal functions/duties
Essential duties are the reason a job exists
◦
◦
◦
◦
% of time performing this function
If remove this function the job would be significantly altered
What are the consequences of not performing this duty?
Can other employees perform this duty, if necessary? What
is the impact?
◦ What are the minimal qualifications? Including skills,
training, and experience
Accommodation(s) are given to support the individual
in performing the essential duties of the job
Observe the physical requirements
Force, distance, dimension of tools & materials
necessary to operate the equipment or perform the
activities
The frequency to which the activities need to be
performed
Number of workers that perform the activities
Amount of time spent on each essential function
Degree of skill, education, specialization
Physiological considerations
Psychological considerations
Environmental considerations
Cognitive considerations
Distractions (number of alternating tasks)
Interpersonal demands
Attention to detail
Accuracy
Stress level
Complexity
Critical reasoning
Risk (effect on end result)
Employee
Employer- Supervisor, Human Resources, Benefits
Provider
Union
Council
Others
Triggered by a medical condition
Step 1
Questions requiring answers:
What is the individual’s functional capacity?
What are the functional limitations/ impairments
What are the medical
recommendations/restrictions?
Step 2
What are the essential duties of the position?
◦ Job Analysis
Comparing the essential duties with the functional
abilities and impairments of the individual while
incorporating the medical restrictions
What response can the employer make to keep the
employee at work or to facilitate their successful
return?
Journal of Occupational Medicine-
Flexible schedules
Office/workstation location
Lighting
Job restructuring
Head phones
To do lists
Job coaches
Additional time to learn new responsibilities
Tape recording
Prevention Model from Michael Melnick, OTR/L,
President of Prevention Plus, Inc.
Accountability
Commitment
Communication
Consistency
Flexibility
Inclusion
Respect
Fun
Lab employee
◦ Research
◦ Animal care
Office worker
Accountant/Customer Service Representative
Faculty Assistant
Librarian
Americans with Disabilities Act. Retrieved from: http://www.ada.gov/
Amendments Act. Retrieved from: http://www.ada.gov/
American College of Occupational and Environmental Medicine. (2006).
Preventing Needless Work Disability by Helping People Stay Employed.
Retrieved from: http://www.acoem.org/guidelines.aspx?id=566.
American Occupational Therapy Association. Self Study.
American Occupational Therapy Association. Practice Framework
Boston University Center for Psychiatric Rehabilitation.
http://www.bu.edu/cpr/
Equal Employment Opportunity Commission. http://www.eeoc.gov/
Family Medical Leave Act. http://www.dol.gov/whd/fmla/
Gray, K. (2005). Evidence-Based Employment Services for Persons with
Serious Mental Health Illness. AOTA Mental Health Special Interest Section
Quarterly.
Greenberg, P.E., Kessler, R.C., Birnbaum, H.G., Leong, S.A., et al.
(2003). The economic burden of depression in the United States:
how did it change between 1990-2000? Journal of Clinical
Psychiatry. 64, 1465-1475. doi: 10.4088/JCP.v64n1211.
Holmgren, K. Dahlin Ivanoff, S. (2006). Supervisors views on
employer responsibility in the return to work process. A focus group
study. Retrieved from:
http://www.springerlink.com/content/h858365q4t37838u/fulltext.
html
Job Accommodation Network. http://askjan.org/
Miller, D. (2004). Psychosocial Issues and the Return to Work
Process. Retrieved from: http://aota.org/Pubs/OTP/19972007/Features/2004/f-020904.aspx
US Department of Labor.
http://www.dol.gov/