Managing mental health disability claimsA Canadian-based employee assistance plan provider, Morneau Shepell, conducted a study in 2017 in partnership with The Globe and Mail to better understand the one in five residents who experience a mental health problem or illness within a given year. The results indicated that 72 percent of surveyed employees who reported mental health challenges to their employers said that it negatively impacted their careers.

Whether this career impact was real or perceived, is it any wonder that employees do not wish to disclose mental health conditions to their employers?

Mental Health Claims for Short-Term Disability on the Rise

Now with the pandemic, we are seeing levels of short-term disability mental health claims in North America increase dramatically. This trend is being driven by health care workers with anxiety, depression, and even PTSD, and the fallout from the economic wreckage that has been wrought on the hospitality and entertainment, leisure, retail industries and beyond. Yet, overall claim volumes seem to be holding steady – for the moment at least.

The rise in mental health claims are being countered by employee delays of elective surgeries, the downturn in the economy (which may make people less inclined to file a claim), and possibly working from home. However, it is important to note that this response will result in delayed volume. In other words, these claims have not gone away.

An Impending Tsunami of Claims

So, are we building up to a tsunami of claims with mental health claims leading the way? Fred Schott, director of operations and research at The Council For Disability Awareness has written a number of papers on this topic, which provide great insights.

I’m afraid that, as a very famous British war-time leader once said, “this is the end of the beginning…” and to make suggestions as to what will happen when life gets back to ‘normal,’ as if a switch will turn, may be fantasy.

The New Normal?

What if this is the new normal and, as we are seeing in the United States, things may get worse before there is a slow crawling improvement helped by a vaccine sometime next year? We need to do something to help us cope with the potential claim tail of this pandemic.

Maybe this is the right moment to get organized; ask ourselves how we can better manage these short-term mental health claims; and get ready for some of them transitioning to long-term disability claims.

Getting Serious About Mental Health

What can we do to get ready for the tsunami? We need to use smarter tools, improve our processes, and implement those changes that we never quite got around to putting in place.

Early intervention is critical in managing mental health claims, and early intervention needs early detection – particularly of those individuals who are in denial. Smarter ways of working are available to us so we can help individuals recover from mental health issues.

Treating COVID-19 Depression and Anxiety

The Claim Lab is currently conducting a trial in Canada where we help identify ‘at risk’ mental health claimants at a very early stage in the claim process, and then apply a cost-effective intervention.

We start with our psychosocial questionnaires and then go one step further. Rather than simply stop at using data and statistical models to identify claims where a mental health intervention is required, we now look to assist in the application of the most appropriate treatment for all claimants impacted by depression and anxiety disorders.

Our questionnaire data has indicated for some time that there is a great deal of untreated depression and anxiety in claims where a mental health condition is not the primary diagnosis. But now this factor has been multiplied by COVID-19 and the associated pandemic.

Typically claims operations have an intervention path for the most severe mental health claims, but many claimants are still functioning and are not yet severely impaired. However, they do need some support to get through their depression or anxiety, or this condition could significantly prolong the duration of the claim.

The traditional cognitive-behavioral-therapy process is still highly appropriate for the most severe cases of depression and anxiety, but there is a need for an alternative – online cognitive-behavioral-therapy sessions.

Why is it so important to address depression and anxiety?

I have been lucky enough to have been given a preview of a new peer-reviewed paper, through our work with The Council for Disability Awareness, which looks at the effects of a mental health condition on short-term-disability claim durations.

I suspect it would come as no surprise to claim professionals that any mental health condition will lengthen recovery time, but by how much? This paper, which appears in the Journal of Occupational and Environmental Medicine, was written by a team of individuals led by Fraser Gaspar, director of data science and analytics, at MDGuidelines. The research finds that a co-morbidity of a mental health condition doubles the duration of a disability claim.

We need to get better at helping claimants with primary or secondary mental health challenges. Mental health was a rising-tide problem before the coronavirus hit. Now it’s about to grow into a full storm from “pandemic fallout.” Hiding behind a 24-month limitation on long-term disability mental health claims in the US will no longer work. In Canada and Australia (where there is no limitation) it is already a huge problem.

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