David West was well-established as a senior executive at Mercer in Toronto when his arthritis became severe, threatening to derail his career.
“I worked through the pain for more than two years,” he says. “I couldn’t function at my usual standard but I was afraid if I stopped working, I’d never come back.”
West was fortunate — his colleagues recognized he was dealing with a crippling condition so they worked to accommodate him while he found a course of treatment and lifestyle changes that now keep his arthritis in check.
“There’s such a stigma around missing work,” he says. “I was lucky. I didn’t have to go on disability (leave) and, as a senior employee in a professional consulting firm, they had a lot invested in me. People in different roles or different industries might not get the same support.”
More than 4.6 million Canadians cope with pain and disability from the 100-plus different conditions characterized as arthritis, and about 60 per cent of those are of working age, according to the Public Health Agency of Canada.
Chronic pain due to arthritis is the leading cause of long-term disability in Canada — and that means big costs for employers. A recent study from the Arthritis Alliance of Canada pegged Canada’s annual economic impact of treatment and lost productivity due to arthritis at $33 billion — and that number is expected to double over the next 30 years.
It’s a small wonder employers are trying to get a handle on what arthritis means in the workplace. But just what is an employer’s role? It may be relatively straightforward to identify an employee who has special accessibility needs such as ramps or parking spaces — it’s much more difficult to identify someone dealing with chronic pain.
As many as 51 per cent of workers suffering from arthritis keep it a secret from co-workers, according to a study released by the Arthritis Society in Toronto. Employees are understandably afraid that admitting to their disability will limit their opportunities at work, invite criticism from colleagues or even lead to termination.
Fortunately, there’s a lot employers can do to help staff work well with arthritis, says Monique Gignac, senior scientist at the Institute for Work and Health in Toronto.
“Many of the techniques for managing chronic pain actually benefit healthy workers as well, from the office to the shop floor.”
Understand the problem: Arthritis symptoms such as pain and fatigue can affect people at work, regardless of their job. People may be unable to work to full capacity or be risking burnout or making sacrifices in their personal lives in order to keep working.
General awareness and education initiatives — for both management and staff — can help people at an organization better understand the challenges of chronic pain, whether it’s their own or their colleagues’, and combining that with a positive example from leadership can help alleviate some of the stigma.
Extend the barrier-free workplace: Heavy doors, fixed desks, phone handsets and extended standing can all lead to or exacerbate arthritis symptoms and can prevent many arthritis sufferers from performing at an optimal level.
Conducting a comprehensive ergonomic work and movement evaluation is always a good idea, particularly if there are higher-than-expected levels of worker discomfort. Solutions don’t always have to be expensive — putting a phone book under a person’s feet when working at a desk can help alleviate strain on her hips and knees, and a rubberized mat can reduce strain from standing.
Take the pain out of commuting: For some employees, even getting to work is a barrier — a long commute or lots of stairs can increase the risks of strain and injury.
Flexible work hours and occasional work-from-home options can reduce flare-ups and help employees arrive fresher, healthier and ready to work.
Promote self-management: Free programs such as the Arthritis Society’s Joint Health in the Workplace workshop can help educate employees about how to perform their work in a way that reduces strain.
Simple tactics such as regular stretching, wearing appropriate footwear and planning your work to allow for brief breaks from repetitive tasks can greatly reduce joint wear-and-tear.
Equipping employees with the tools to self-manage their pain is a good way to reach out even to those who choose not to self-identify.
Most importantly, be proactive, says Gignac.
“Most conditions can be mitigated if identified and addressed early, but employees and employers both tend to wait until a problem reaches a crisis point before they begin to address it. Tackling potential issues early can help avoid crises in the workplace and people’s personal lives.”
Building the plan
While these approaches can have a positive impact on employee health, there will likely still be times when arthritis symptoms become too severe to manage just through stretching and sensible shoes. This is when an employee needs to be able to turn to a health benefits program.
Effective health coverage needs to be built around flexibility, says Winnipeg’s Tara Besant, director of pharmacy benefits at Great-West Life.
“It can be difficult to design a plan for a specific condition, but plans can be designed with the flexibility to help employees with a variety of conditions.”
Flex benefits: Health spending accounts (HSAs) and health and wellness initiatives enable employees to tailor their benefits’ usage to their unique needs without overburdening the program with excessive coverage.
Advanced drug coverage: In some cases, employees are dependent on advanced pain medication to cope with severe arthritis. But a 20 per cent co-pay on a prescription for a new biologic medication can still leave her on the hook for $10,000 or more, a price tag that can put pain management well out of most people’s reach.
A one-size-fits-all drug plan simply doesn’t work in these cases, so employers need to be aware of and prepared to address those concerns, just as they would for employees with cancer or other complex diseases.
Plan provider as resource: Plan providers can be a valuable resource for plan members and plan sponsors. Members can receive information, tools and even case management support.
Plan sponsors can work with their provider to better understand the conditions at their workplace and in their industry and develop tailored plans that best address those concerns.
This is in the best interest of all parties — an employer can only manage the costs of a plan down so far, it also needs to “manage up” the health outcomes of plan members to reduce long-term reliance on disability coverage.
“Perhaps the most important thing is that plan members need to understand the benefits they have,” says Besant. “Too often, employees suffer in silence because they don’t know about the coverage available to them — and they’re too afraid to ask.”
Creating an arthritis-friendly workplace spins out substantial benefits for employers, reducing the disruptions and costs associated with long-term disability and adding greatly to the potential talent pool.
The benefit for employees is just as important: The overwhelming majority of people with arthritis want to work, to feel the sense of fulfillment and satisfaction that comes from a job well done.
With a little accommodation from an understanding and supportive employer, they can be positive and productive members of a workforce.
Douglas Emerson is national manager of communications at the Arthritis Society in Toronto. For more information, call (800) 321-1433 or visit www.arthritis.ca.