Case management potential area for return-to-work improvement

A survey of employees and supervisors about their company’s return-to-work process points to case management as both a lynchpin of the process and a potential area for improvement—a finding that may resonate beyond this one workplace.

Published: April 23, 2012

Workplaces looking for ways to improve their return-to-work programs—even when these programs are largely successful—may want to turn their attention to one area in particular: case management. This is the upshot of an Institute for Work & Health (IWH) study recently published by Work.

The study, published online ahead of print (DOI:10.3233/WOR-2011-1215), was led by IWH Scientist Dr. Jason Busse. His team surveyed employees and supervisors at a large insurance company about their firm’s return-to-work program following a short-term disability leave due to a non-work-related injury or illness. Although their experiences were largely positive, criticisms seemed to focus on case managers—and not so much on their interactions with employees and supervisors, but on their ability to remove barriers and put programs into place.

It’s worth trying to better understand which case management features work better and which ones are less positively received, says Busse. Areas that may benefit from attention include improving some aspects of case manager-employee interactions and ensuring that support during the return-to-work process is provided, including modifications to work situations when appropriate, says Busse.

Survey captured employees’ and supervisors’ attitudes

In this study, researchers worked with a large Canadian insurance company with 11,000 employees to examine employees’ and supervisors’ attitudes towards their organization’s disability management process. All 389 employees who, from January 1 to March 31, 2007, successfully returned to their job following a short-term disability leave (of more than five days and less than 26 weeks) were asked to fill out a survey about their experience with the disability management process. Their supervisors were asked to fill out a similar survey.

The questionnaire asked respondents to rate the quality of their experience overall, as well as respond to statements (from strongly agree to strongly disagree) in three specific areas:

  • the disability management process (e.g. “Someone contacted me shortly after the case started to explain the process and offer assistance”);
  • case management (e.g. “The case manager returned my call and responded to my questions/concerns in a timely manner” and “My case manager contributed to my recovery”); and
  • overall return-to-work process (e.g. “Co-workers supported the employee’s transition back to work” and “I felt confident that the transition back to work would be successful”).

Eighty-eight employees and 75 supervisors completed the survey. Almost 80 per cent of employees and supervisors reported positive experiences overall with the disability management program. Busse points out that, because surveys were administered to employees who had successfully returned to their jobs, these positive experiences are perhaps not surprising. Nonetheless, even within this group of people who returned to work successfully, some dissatisfaction was reported, most notably with certain aspects of case management.

Case manager as ‘lynchpin of the process’

Successful case management requires skills in communication, diplomacy and relationship-building, as well as in planning, coordinating and evaluating a rehabilitation plan. The case managers at the insurance firm involved in the study seemed to be very good in their interactions with employees—well over 80 per cent of employees indicated that their case manager was clear about roles and processes, prompt in returning calls, polite, respectful, and comfortable to work with.

However, it seems that their follow-through in terms of removing barriers to recovery and putting practices into place to help returning workers was more problematic: 39 per cent of employees (and 26 per cent of supervisors) reported no follow up upon returning to work to help adjust their work situation, 37 per cent of employees felt their case manager did not contribute to their recovery, 29 per cent of employees said the case manager did not remove barriers to recovery, and 27 per cent of employees said they did not receive the help they needed to plan their reintregration into the workplace.

The important role of the case manager was confirmed in the survey’s written comments. More than half of survey respondents added additional comments, and more comments were made about case management than any other category. Half of these were positive, saying how much their case managers really helped them get back to work. About a third were negative, reporting conflicts with case managers that hampered recovery. The rest talked about both positive and negative experiences, with some noting how their experience improved considerably with a change in case manager.

Case managers are the lynchpin of the process, says Busse. How they interact with the claimants seems to have a very large impact. These findings flag areas that may present an opportunity for improving the disability management process.