HR has pivotal role in episodic disabilities

Workers with certain diseases have much to offer employers – but they need a little help

Permanent loss of vision, hearing or mobility — these are what most people think of as disabilities.

But what about cancer, arthritis, mental illnesses, multiple sclerosis, HIV, lupus and hepatitis C? Many people think of these as diseases, but they too can be considered disabilities. HR professionals can play a pivotal role in helping employees living with such “episodic disabilities” to maximize their work potential.

An episodic disability is a physical or mental illness that is unpredictably recurrent. This affects a person’s ability to work — an employee recovering from a round of chemotherapy or suffering symptoms of arthritis are just two examples.

Awareness lacking: Survey

HR professionals are often the lynchpin between employees with episodic disabilities, the employer, the insurance carrier and rehabilitation professionals. So what do HR professionals need to know about episodic disabilities? What’s their level of knowledge about these disabilities and how can they address the gaps?

These are just some of the questions answered in a report by the Canadian Working Group on HIV and Rehabilitation (CWGHR), a national non-governmental organization. Based on a survey designed and disseminated in partnership with the Canadian Council of Human Resources Associations, the report analyses the responses from about 500 HR professionals across Canada.

It shows HR professionals lack information and strategies to help employees. Among the key findings:

• more than 60 per cent of respondents said they have little to no knowledge on approaches to managing cases of episodic disabilities;

• almost 70 per cent said they are unable to statistically identify cases of episodic disabilities in their caseloads;

• more than 80 per cent said their organization’s current return-to-work policy does not address the implications of episodic disabilities;

• more than 50 per cent said their current training was not useful with respect to episodic disabilities; and

• the majority (56 per cent) expressed interest in receiving training specific to episodic disability issues.

This means most HR professionals are only familiar with:

• a disability income-security model based on a severe and prolonged disability;

• a definition of disability that does not include the capacity to work; and

• benefit reductions and disqualifications if there is participation in work.

There are examples of progressive responses within disability support programs, such as rehabilitation plans for some long-term disability benefit recipients and maintenance of extended health-care benefits for Ontario Disability Support Program recipients who engage in paid employment until covered by an employer. However, none of these programs recognizes partial work with partial disability income support for the episodes when employees are unable to work. Yet employees with episodic disabilities have varying capacities to work over time.

Workplace evolving

The workplace has evolved from labour-intensive to technically supported and is increasingly non-physical, favouring the inclusion of persons with disabilities. Supported by medical and treatment (including rehabilitation) advances and assistive devices, greater labour force participation for people with episodic disabilities is feasible. Key diseases with disabilities where there are significant breakthroughs include arthritis, multiple sclerosis and HIV/AIDS. In addition, Canadians now believe people with disabilities should be included in work.

Employees receiving disability income benefits lose their income and, in some cases, health benefits, when they attempt to rejoin the labour force. The problem is that current income security programs, such as the Canada Pension Plan Disability Program, do not respond to the episodic nature of disabilities.

However, employees with disabilities that are unpredictably episodic are in need of disability income when they are unable to earn income and health benefits, whether or not they are employed. For example, if able to work part time and earn income, a person living with an episodic disability would need disability income support for the period when he is not able to work. However, by engaging in part-time, paid employment, his disability status, and the related income and benefit support, is at risk. Unsure of when he may be unable to work again, this risk or cost of taking paid employment is often too high.

Yet no one is ahead because:

• the insurance carrier (whether public or private) is paying full disability benefits when the recipient is capable of and eager to work during periods of wellness;

• the employer is without the skills and experience of the employee; and

• the employee remains on disability benefits when he is able to work, thus interrupting, if not ending, his contributions to his employer and the economy.

Bolstering inclusiveness

It stands to reason more flexible policies can help people living with episodic disabilities to:

• increase their ability to live a satisfying, productive and meaningful life;

• stay healthier for longer and improve their overall quality of life;

• lessen isolation, thereby improving mental health;

• promote social integration;

• reduce health-care costs;

• contribute to the economy;

• stay active, both at home and at work; and

• access medications and rehabilitation.

Within its episodic disabilities initiatives, CWGHR has reviewed disability income and employment issues internationally and conducted a cost-benefit analysis of a hypothetical disability income support model with increased flexibility — partial income support for those recipients of full benefits who were able to return to work part time.

Preliminary results suggest potential financial benefits for the insurer; however, the overall impact on the health and social inclusion of Canadians with episodic disabilities is unknown. More work is needed.

Eileen McKee is manager of episodic disabilities initiatives at the Toronto-based Canadian Working Group on HIV and Rehabilitation. She can be reached at [email protected]. For more information, visit

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