Disability Case Management Guideline

Purpose

To coordinate short-term disability, long-term disability, and workers' compensation cases consistently — reducing unnecessary cost, supporting a prompt and safe return to work, and ensuring compliance with the ADA and related law.

Objectives

1. Ensure employees with a work-related or non-work-related illness/injury get prompt, appropriate medical treatment.
2. Support the employee's return to their regular role, or a suitable alternate role, as quickly as medically appropriate.
3. Contain medical, indemnity, administrative, and rehabilitative costs.
4. Reduce the personal impact of disability on the employee.
5. Ensure compliance with the ADA and other applicable disability-related law.
6. Support a healthier, more productive workforce by reducing the frequency and impact of disability events.

Program components

• A designated case manager (an occupational health professional or HR-designated equivalent) who coordinates each case from report through resolution.
• A disability management team, drawn as needed from the employee's manager, HR, safety, the claims administrator, and diversity/accommodations specialists.
• Standard forms: a treating-physician statement, a job requirements/demands profile for the role, and a job-accommodation request form.
• Established working relationships with treatment providers, claims administrators, and accommodation resources.
• Flexible return-to-work options (for example, modified duty, reduced schedule, or a temporary alternate assignment).

Everyone involved should apply consistent diligence to guard against misuse of disability programs, while treating each case with genuine concern for the employee's recovery.

Case manager responsibilities

1. Review required paperwork and confirm the disability is properly certified.
2. Help determine whether the condition is work-related (which routes the case to workers' compensation instead of STD/LTD).
3. Refer the employee to appropriate medical providers and treatment resources.
4. Help the employee navigate the health-care and claims process.
5. Coordinate with the treating physician toward an appropriate return-to-work plan.
6. Assess whether the treatment plan and the employee's progress are on track.
7. Maintain regular contact with the employee throughout the case.
8. Monitor the case and keep relevant parties (manager, HR) informed.
9. Provide periodic status reports.
10. Where feasible, coordinate an alternate work assignment with HR and the manager, consistent with ADA obligations.
11. Establish an expected return-to-work date in consultation with the treating provider.
12. Work with the manager to plan for the employee's return.
13. Bring the case to resolution, supporting recovery and reintegration to work.
14. Where initial return-to-work options don't work out, propose alternatives.
15. Escalate complex cases for outside assistance (for example, an independent medical examination) as needed.
16. Check in on the employee's medical progress after they return to work.

Manager responsibilities

1. Notify the case manager and HR promptly of any injury, illness, or disability event.
2. Maintain a supportive, respectful relationship with the affected employee.
3. Stay in regular, appropriate contact with the employee during the absence.
4. Keep an up-to-date job requirements/demands profile on file for the role.
5. Look for reasonable alternate work assignments where the employee cannot yet return to their full prior duties.
6. Communicate the intent and process of the company's disability programs to the team.
7. Work cooperatively with the case manager to resolve cases fairly and avoid misuse.

HR responsibilities

• Provide consultation and guidance to managers throughout each case.
• Coordinate workforce planning implications (coverage, backfill, accommodation logistics).
• Ensure accommodation requests are routed for proper ADA interactive-process review.

Safety responsibilities

• Investigate work-related injuries and recommend workplace modifications to prevent recurrence.
• Educate managers on accident and illness prevention.

Related policies

• Short-Term Disability Policy
• Long-Term Disability Policy
• Workers' Compensation Policy
• Reasonable Accommodation Policy