Insurance program stresses return to work, self-esteem
June 1, 1997 4 minutes read
Insurance program stresses return to work, self-esteem
Goal is to rehabilitate mind and body
Keeping workers’ compensation and disability claims under control has been an ongoing challenge for corporate benefits managers. With a new program called Ability Assurance, The Hartford Group, which is the Simsbury, CT-based multi-line insurance and financial services company, has a new strategy it says will accomplish that goal. What’s more, the cost of the program is currently averaging about 15% less than traditional disability programs.
With its primary focus being the return-to-work potential of the individual employee, the program combines wellness and stress management/self-esteem initiatives with conventional rehabilitation strategies. "It is designed to really encourage and promote the whole concept of health and fitness, and following a healthy lifestyle, to help those with a disabling accident or illness to focus on getting back to a healthy life," explains Tracie J. Foster, assistant director of group disability products.
"We saw the traditional approach [to rehab] as re-active," adds Alicia Heine, MA, CRC, CCM, CDMS, a rehab specialist with The Hartford Group. "Here we are very proactive, providing services as soon as possible."
Also, with such "non-traditional" services as wellness and recreational programs and peer support groups, "We feel we can reach more people" she adds. "We hope they will get an employee more involved in their own return- to-work process."
New elements added
In addition to traditional clinical and vocational rehabilitation programs, Ability Assurance includes a component called the Center for Ability. This center offers:
• an information and referral source for employers, claimants, and their families regarding clinical rehab services, support groups, and recreational and wellness programs;
• the Ability Management Team, which includes an ability analyst (a claims administration specialist); an ability advocate (an individual trained to handle more complicated claims); a registered nurse, and a vocational rehab counselor;
• the Ability Management Agreement, which outlines the responsibilities The Hartford Group and the employer share in ensuring an effective return-to-work process for the employee.
Once a claim has been filed, the Ability Management Team looks at each individual situation to determine the best approach, according to the nature of the disability and the employee’s interests. Once they have identified the most appropriate type of resources for the employee, staff at the Center for Ability seek out and quality-check resources and facilities.
Foster describes a hypothetical process under the new program: "Let’s say an individual is diabetic and begins to lose her sight. If she can’t continue to work in her current capacity, she’ll file a disability claim or, depending on the arrangement her employer has with us, she may be able to contact the center without first filing a claim. The Ability Team will contact the center and explain the situation. The claims doc’ may ask for adaptive computer equipment. If the employee can’t drive, we’ll look for a way to help her get back to work. The center will go through its database, find out who can train her to work on the new equipment and what it will cost. They will also investigate local support groups."
Support groups and other activities that help rebuild self-esteem are a critical component of the program, Heine stresses. "There’s an absolutely huge connection between mind and body," she notes. "A lot of times, we find a person is not returning to work because of mental barriers they’re dealing with trying to get their self-confidence back, as well as their motivation and self-esteem."
In other words, employees need to feel good about themselves in order to feel "physically" ready to return to work. "Interacting with other people is also very important," says Heine. "People tend to isolate themselves when they become injured."
Heine recently worked with an employee in his mid-40s with a traumatic brain injury. "He had been living independently, but [after the injury], the whole family moved in with him," she recalls. "People think they’re doing a real service, but it creates dependency."
To help break that dependency, Heine arranged for the employee to go on a wilderness adventure trip. "His background showed he was very comfortable with the outdoors, so the experience helped leverage the return-to-work process. He’s currently in the process of looking for a job."
It’s important, Heine stresses, to link the activity with the employee’s interests. "We know that outdoor recreation is not good for everybody," she says. "In some cases, we may look at arts-related activities. We want it to be something enjoyable that will increase the employee’s interaction with other folks."
Financial structure rewards compliance
The financial structure of the program also is designed to get employees back to work as soon as possible, notes Foster. "For those who can’t ever go back to work, of course they get full benefits. For those who work with our program, there is the potential for benefits to reduce over time."
Most disability insurance programs generally pay 60% of all claims, Foster explains. In the Ability Assurance program, that same level will apply for the first two or three years. "After that, there is the potential to reduce it to about 30%," she says. "This does not apply to the truly disabled. What we’re trying to do is target those individuals who are taking advantage of the system."
The product was introduced only about one year ago, Foster says, so it is too soon for statistical data on its effectiveness. She does note, however, that "many thousands" of employees are now covered by the program.
[Editor’s Note: For more information on Ability Assurance, contact: Tracie Foster, The Hartford Group, ITT Hartford Life Insurance Companies, Simsbury, CT 06070. Telephone: (860) 843-3554.]
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