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Does your workplace have a culture of sick leave?

This article is also published in the HR Professional Magazine, HRPA Today.

nycpaidsickleave

A colleague once remarked to me that seven people in his department, out of a company of 400 people, had claimed short-term disability (STD) for stress leave in the last two years. I asked how this could be – is there something going on in the workplace? “No,” he replied. “It’s just that it’s known that if you get divorced or separated, you get to take stress leave.”

I asked a few other colleagues in the insurance industry if they have ever seen this phenomenon. “Absolutely not,” said a disability case manager at The Co-operators Life. “Stress leave is serious, and the medical evidence required is quite extensive.” Another colleague at the same insurer mentioned that almost half of her department had experienced a divorce, but they all worked through it.

What was it about that workplace which made STD so commonplace?

Here are some reasons why a company might have a culture of sick leave:

1. There is something fundamentally wrong with the workplace

Ask yourself – is your workplace a positive or negative place to work? Don’t take low turnover as a sign that employees are happy. You may need to examine how they feel about the relationship with their supervisors. Does your environment have any unhealthy chemicals that may lead to sickness? Are there any pressures at work that may cause an employee to prefer to be at home, earning only 60 per cent of their wage?

Recommendation: Look inwards first, and be proactive to assess your company before a worker’s compensation board forces you to change. Speak to your claims adjudicator, whether they are an internal employee, a third-party administrator or an insurance carrier. Ask them if they detect any signs that the workplace may be the cause, and what you can do to fix it.

2. The benefit exists, so it’s used

Even the presence of the benefit in an employee booklet can lead employees to believe that it’s a “perk,” like other “benefits” of their plan.

Recommendation: Communicate that short-term disability is meant for disability – not an elective sick leave – and claims will be audited for validity of disability. Try to remove any perception that it’s a “perk” of the job.

3. Employees teach each other how to use the benefit
If distinct cliques exist within a workplace, they tend to help each other out. It can happen where the STD approval process is discovered, and one employee tells the rest how to make a claim.

Recommendation: Ask your claims adjudicator if they can see a pattern: do claims come in at the same time of year? Do employees work in the same department? Don’t be afraid to ask more questions or change the process of applying to STD. Require a minimum level of medical evidence, especially if you see that the same doctor is signing off on multiple claims.

I recognize that a unionized environment can make it tough to change plan design wording, but processes and scrutiny can be increased without necessarily going to collective bargaining.

4. Doctors will usually sign off

Doctors have little time, and would prefer to help their patient take time off if they can. They also have a legal obligation to listen to a patient’s claim and do something about it. If they’re found to have known about something, and refused to recommend time off, it could be their name listed as a defendant.

Dave Crisp, former SVP HR at The Hudson’s Bay Company and blogger at www.balance-and-results.com, warns against requiring too much medical scrutiny for short sick claims (under five days).

“What the company is really doing is punishing the employee for being sick, by making them waste their and the doctor’s time.

Instead, give your employees some leeway, but always call them at home to ask how they are doing. The manager does not need to ask outright, ‘Are you really sick?’ Just their presence on the phone asks the question.”

Recommendation: Stop requiring doctor’s notes for very short-term sick claims, but don’t be afraid to ask for a second medical opinion for a weekly indemnity claim.

5. Adjudicators caught between a rock and a hard place

Adjudicators are tasked with a tough job – it’s their responsibility to respect the employer’s money, while making sure that employees are taken care of. Their goal is to manage the two conflicting interests. This can be a difficult task, especially compounded with the volume of claimants, all demanding to be paid at once.

Although there are excellent adjudicators, it does happen when an adjudicator errs on the side of caution by paying out a claim without doing any extra diligence, which is required by their job description.

Workplace safety boards are notoriously understaffed, which is why some companies have decided to hire private investigators or require a second medical opinion, in order to put an extra eye on their claims.

Recommendation: Be proactive and chat with your STD claims adjudicator. Ask them what their practices are, and see if there’s any room in the budget for requiring a second medical opinion (can be $500 to $2,000).

6. Front-line management might not have a solid handle on the details

Do your front-line mangers know what to do in the event of a claim? Do they realize how much it costs the company? It may seem obvious, but many are not trained on the specifics of how E.I., worker’s compensation and STD interact.

Crisp says that STD claims plummeted when two things happened: one, WSIB and STD claims were deducted from store managers’ budgets; and two, managers were required to call employees and ask them how they are feeling. Once they showed genuine concern for the employee, they saw that people were returning to work faster and had fewer follow-up claims.

Recommendation: Hold yearly training seminars, complete with dummy forms, of what to do if one of their employees gets sick. Educate them on the hard costs of a claim, and consider deducting it from their budget. Require that managers call employees to ask how they are feeling, and make it clear that it must be a genuine call.

7. Holidays are approaching, and employees don’t feel as if they’re given enough vacation time

Summer is busy season for Beneplan’s STD adjudication department, and Crisp has noticed that Mondays and Fridays have a third more sick claims than other days of the week. We have seen many situations when an employee was denied extra vacation time, only to see them submit an STD claim when it came down to the wire.

Crisp remembers a time when one employee took 10 Mondays off and was then disciplined for it. He eventually admitted that he had a drinking problem. The union subsequently intervened, since alcoholism is an illness, and the company had to retroactively pay him back for the suspension. “The employer could have nipped it in the bud by simply asking the employee how they felt, and if there’s anything they can do – from there, they could have sent them to rehab without launching a grievance.”

Recommendation: Reconsider whether you can allow the employee to take some extra vacation, even if it’s unpaid. If you absolutely cannot give the time off, and they do end up making a claim, make it very clear that you care about their wellbeing, but that any disingenuous claim will have consequences.

8. A hostile union environment can exacerbate claims

In our own short-term disability department, we have noticed that unionized workplaces experience an average of five times more claims than non-unionized environments.

Recommendation: As you would do with a non-unionized environment, you can require a certain minimum level of evidence, speak to the adjudicator and ask if they see any trends, and see if there is any room to add additional surveillance to the workplace, in order to determine unsafe practices that can be corrected.

9. Employees want to delay an imminent termination
Adjudicators have noticed that whenever our administration team receives a list of employees going on layoffs (for the purpose of extending benefits), the STD claims start trickling in.

Recommendation: If you are about to announce a layoff, proactively announce that you are aware of this being a time when many sick claims are submitted, and that while you do care about the health of every employee, your priority is to ensure that the sick leave budget is be preserved for colleagues who truly need it – tell them that if sick leave is abused, and the company has to cut the benefit as a result, it will be the people with real illnesses who will suffer the most.

Conclusion
You don’t have to feel helpless if you are faced with a pile of sick leave claims. Examine your workplace, show genuine concern for employees’ health and have a discussion with your adjudicator. If there are motivated individuals, all of the proactive actions in the world may not deter them from making an inauthentic claim, especially if a past precedent has been set. However, it’s never too late to change your process – to ensure that those who need the benefit most can continue to have access.