3 fast-rising disability claims
February 20, 2009 by Bill MeltzerPosted in: Disability, In this week's e-newsletter, Latest News & Views
Advances in medical diagnosis and treatment can have an unexpected impact on your health costs. Conditions that rarely showed up in past claims become important cost-drivers.
The best defense for management: staying on top of the trends. Here are three medical conditions that have been showing up with ever-increasing frequency in recent years. The conditions themselves aren’t disabling but increase employees’ risk of future long-term disability claims.
1. Metabolic syndrome
According to a Milliman Benefits study, four of the seven biggest U.S. insurers report an upswing in applicants with the condition, often tied to disabling heart attacks. Common risk factors include obesity, high cholesterol, diabetes and/or high blood pressure.
Every carrier considers metabolic syndrome a significant factor in raising an employee’s disability risk. This results in higher premiums, but early diagnosis and treatment (especially through disease management programs) can reduce the chance of future disability claims.
2. Obstructive sleep apnea (OSA)
Five of seven carriers have seen upticks in OSA cases. The condition can lead to chronic fatigue, mood and anxiety disorders and workplace or off-site accidents, among other issues.
Obese employees are at much higher risk of OSA than the general population. All seven insurers say OSA increases an employee’s disability risk.
3. Restless leg syndrome (RLS)
Four of seven carriers have seen RLS increases. Six of the seven insurers consider RLS a condition that increases disability risk. This is especially true for employees who work night shifts and/or desk jobs.
Cutting the risk
Best practices for cutting employees’ risks (and your long-term health and disability plan premiums) include:
- disease management programs, especially for obesity and diabetes
- preventive care – the aforementioned conditions, especially RLS, are most commonly recognized first by an employee’s primary-care physician, and
- employee education on proper prescription-drug use to keep conditions under control.
September 12th, 2008 at 11:15 am
If an employee is on medical leave does the physicisan need to put a diagnosis on the order? Or is employee will be off for the next 2 weeks and be re-evalauted at that time enough?
February 26th, 2009 at 3:07 pm
If they are on FMLA the doctor needs to put the medical condition on the form.
February 26th, 2009 at 4:06 pm
FMLA requires the statement, but in CA we still cannot because FEHA and CFRA do not allow that info to be supplied to the employer.
March 5th, 2009 at 8:43 pm
I am a California employer. We have an employee out on Family Medical Leave for a premature baby who has still been hospitalized for months. I understand Intermittant Leave, but it is very difficult for us. She will work one day, off for two, back for a shortened day, back off for the rest of the week, and then works a few days.
Can you explain to me, as the employer, do we add up all the hours she works and figure out whether that adds up to a total of 12 weeks, hour by hour? Please advise
March 9th, 2009 at 9:53 am
Yes, total the hours as she goes along and document, document, document. 12 weeks at 40 hrs per week is 480 hours. If the employee worked part-time it would be pro-rated. Use caution though – keep her updated as to how many hours she has remaining. Also, make sure you are calculating the hours the same way for any other employees. Everyone must be treated equally.
March 18th, 2009 at 3:32 pm
Janice, Also make sure you use the same FMLA year for everyone. We use the date event began as our FMLA year. I put all my FMLA events on a spread sheet and track that way. It is pretty easy with auto sum. Can anyone tell me, when determining eligibility of an employee (working 1250 hours the previous year) does FLMA leave count as time worked, or not worked? I know you don’t ca=ount vacation or holidays as time worked.