Psychosocial Factors and Disability Claims Management

Editor’s Note: The Council for Disability Awareness’ research consultant Fred Schott recently completed a third stint as host of The CDA’s Financial Health and Income Network podcast. This time, his guest was Ian Bridgman, executive director of The Claim Lab and a member of The CDA’s Board of Directors. Their topic was psychosocial factors and their role in disability claims management.

~ What follows is an annotated and abbreviated transcript drawn from the original podcast. You can listen to the full podcast here. ~

The Evolution of Disability Duration Guidelines

[1:49] Schott opened the discussion by sharing a story about coming across an old two-volume print edition of disability duration guidelines from the early 2000’s. He noted that getting people back to work safely and on a timely basis after a disability episode has evolved into an accepted best practice. As part of this process, modern duration guidelines broadened to take into account a variety of variables beyond the physical exertion requirements of a person’s job. Foremost among these variables are psychosocial factors, including mental health and workplace culture.

[5:14] Bridgman discussed how his company developed an application to measure psychosocial factors at work within the context of disability claims. They saw duration of claims being driven by underlying levels of anxiety or depression – while the claim itself was for a physical diagnosis.

Bridgman: “It’s something like an undocumented mental health episode. And why should people not tell us that they’re depressed or anxious? Well, it’s all in that workplace situation issue.

“The fact is these short- and long-term disability policies are often paid for by an employer. [Note: Bridgman works mainly with group insurers.] So why would [an employee] turn around and say: “Actually, I can’t work anymore because I’m feeling really depressed. I hate my job. I hate my boss. I’m very anxious.” when it’s perhaps easier to say: “Actually, I sprained my back during the weekend and it’s—I don’t want to talk about it—it’s very sore, you know?”

The top three psychosocial measures Bridgman follows are mental health, workplace issues, and individual motivation.

[10:09] Schott and Bridgman discussed how this is the kind of information employers need to gather in order to “take the temperature of the workforce.”

The Impact of the Pandemic on Disability Claims

[11:26] Bridgman has been seeing an increase in claim severity scores since the start of the pandemic with scores continuing at that higher level over the following twelve months.

Bridgman: “Imagine this scenario: You get someone who goes off work with the infamous rotator cuff injury, but now we’re in the pandemic. So, whereas perhaps before they may have had some sort of motivation to get back to work, and everything was good.

“But now, they’ve got these other things working on them. So perhaps they’ve got an employer who isn’t taking proper precautions with masks and so forth. Perhaps they’ve got elderly parents they’re trying to support. Maybe those factors just make people less inclined to want to go back to work.

“People say don’t over-medicalize claims . . . but you’ve got to look wider than the medical diagnosis because we can see those wider influences really have a dramatic effect on claim duration.”

Disability as a Life-Work Disruption Event

[15:43] What kinds of tools can disability claims managers (disability insurers or third-party administrators) provide to manage a disruption event?

Bridgman does a lot of work in Canada where, because of different employment laws and legislation regarding how to treat disability, claims managers have to go further down the road. The Canadians provide a fuller return-to-work service and Bridgman believes U.S. insurers – especially after the pandemic – will wind up doing likewise.

Are We Entering the Endemic Phase of Covid-19?

[20:16] Here is how Bridgman’s indicators are trending regarding an endemic:

Bridgman: “All the indicators are, fortunately, trending downward.”

Schott: “So, are we returning to normal?”

Bridgman: “You know, I’m not quite sure what “normal” means these days. I don’t know about you personally, but I’ve been working now for three years from home and have lost all my desire to climb in an airplane and travel anywhere — to conferences or business appointments or whatever.

“We’ve survived for three years without going anywhere, so why should I put myself through that indignity of traveling on an airplane and waste all that time? I used to have a suitcase in my bedroom ready to go, and I don’t have that anymore. I’m going on a trip on Sunday and I’m dreading it; I have to pack my case from scratch!

“It’s going to take a while to get us back there. If we ever get back to the same place.

“We’re, perhaps. in some sort of post-pandemic PTSD phase.”

Bridgman’s last statement prompted Schott to mention how a former colleague commented on one of his recent LinkedIn posts, indicating that we may be in the midst of a “societal adjustment reaction disorder with mixed emotional features.” And, yes, there’s a diagnostic code for that.

[25:04] The Cost of Ignoring Psychosocial Issues

Bridgman: “I’m not saying for one moment that we can eliminate the effect that the psychosocial has on recovery [from disability]. But what we can do is become more aware of it and make our [claims] process and our return-to-work plan for those individuals [affected by psychosocial issues] more sophisticated.

“You can approach [a disability claim with many psychosocial issues] in two ways:

1. 1. 1. You can either say: “We know this is going to be a complex claim; let’s put down a high-touch process to make sure we cover all of these complicating factors.”
    2. Or else, if we just ignore it, we turn around and we’re left surprised : “Oh, why did this claim last so long?”

~ You can listen to the full podcast here. ~