Conducting a disability audit

Made-in-Canada tool gains worldwide acceptance

As a manager of consulting services at the Saskatchewan Association of Health Organizations, Leanne Hamm has long been training health administrators across the province on such issues as return to work, disability management and case management.

Now, she hopes to be able to provide another service: a disability management audit that would help organizations identify what they’re good at and what they need to work on. The association provides its 160 members, including regional health authorities, hospitals and special care homes, with a range of support services in payroll, collective bargaining, benefit programs, professional development and health and safety.

The audit tool Hamm will be using is the Consensus Based Disability Management Audit, developed by the National Institute of Disability Management and Research (NIDMAR), a Victoria-based non-profit education, training and research organization. To conduct a disability audit, Hamm would typically spend five days poring through policies and procedures, committee minutes and individual case files, both open and closed, to find out how they were handled. She would then sit down with representatives of both management and employees to determine a score for each of the audit’s 84 questions. Both parties will have to agree on the score for each question. If they don’t, it’s the lower score that’s registered.

Then she would verify those scores against employee perception by conducting a survey of the general employee population. She would select a random sample representing five or 10 per cent of the workforce, depending on the size of the organization. Whereas the employee representative helping her score the questions would be well-versed in how the program works, the workers participating in this part of the audit will help give her a sense of what the employee population at large knows of the program.

If she’s auditing a regional health authority, her work would take her to each of the authority’s major facilities to get a good understanding of how things work at each site.

“It’s a lot of work, but it will be worth it,” said Hamm, who works out of the association’s workplace health, safety and education services department in Regina. “I don’t know of any other audit that’s that complete, where you’re looking at evidence and surveying employees and bringing together all the parties to answer the questions.”

Hamm said the cost of doing such an audit typically runs $8,500 to $10,000, but the association has yet to determine a price structure for the member organizations.

The audit tool has come a long way since it was created by NIDMAR in 1996 and is gaining acceptance around the world. Late last year, the United Kingdom subsidiary of UnumProvident, one of the largest disability insurance providers in the country, adopted the tool. It began training nine of its vocational rehabilitation employees to be certified to carry out the audit.

Joy Redmund, head of vocational rehabilitation services for UnumProvident in the U.K., said she sees it as another service the insurer can provide to its larger client companies.

“We see the NIDMAR assessment as having great potential to assist employers in this area by giving them a standardized benchmark. This will help them see how they compare with their industry competitors; a starting point, so that they can see how they change over time; a confirmation that they are employing best practices in this area; and an analysis not only of their strengths but also their weaknesses, with recommendations for how they can improve,” said Redmund.

In Australia, the audit tool is being licensed by Employers Mutual, a workers’ compensation insurance provider in the states of New South Wales, South Australia and Victoria. A not-for-profit organization for workers with disabilities in Ireland is also using the audit tool to help employers improve their return to work and disability management programs.

For Wolfgang Zimmerman, executive director of NIDMAR, the biggest accolades came when the audit tool, the curriculum and the professional designations of certified disability management professional and certified return to work co-ordinator were adopted by the German Federation of Institutions for Statutory Accident Insurance and Prevention (HVBG), the umbrella group representing all 35 of Germany’s insurance providers for workplace accidents and injuries.

Noting that Germany is the country where the workers’ compensation board (WCB) system was created, Zimmerman said he once asked Joachim Breuer, the director general of the federation, why “the oldest and largest WCB in the world” would use a Canadian protocol as a standard for its 3,500 return-to-work and case management professionals.

“The answer he gave was, ‘We never had these standards,’ and ‘What I’m doing is no different than what leading organizations do,’ which is to continuously scour the world for innovative products,” said Zimmerman.

Part of the appeal of the audit tool is its grounding in research. Zimmerman said the tool draws on the key principles identified in a 1998 research project by the International Labour Organization, a United Nations agency.

The International Research Project on Job Retention and Return to Work Strategies for Disabled Workers examined and evaluated return-to-work policies in eight countries and found a number of universal success factors. These include a safety program, a health promotion program, transitional work options and early intervention as part of a formal return-to-work program. Key factors also include policies and procedures that are jointly endorsed by labour and management, strong internal and external communications systems and a supportive enterprise culture. And, not least, successful disability management programs are those run or co-ordinated by someone who’s well-versed in return to work and accommodation.

It’s with the goal of setting professional standards in this line of work that NIDMAR has made it mandatory that anyone using the tool be certified as an auditor. Last month, Zimmerman came to Toronto to take part in the launch of a new organization, the Canadian Society of Professionals in Disability Management, which has 100 members. An international association of these professionals is being launched March 22 in Berlin.

“If I get injured at work, it’s the skill set of the person co-ordinating the return to work that is pivotal to whether or not I’ll have an income and a future, or just join the ranks of those sitting at home,” said Zimmerman.

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