The role of plan sponsors in effective disability case management

The role of the plan sponsor in the disability management process has changed and evolved over the last number of years to become more of a collaborator and strategic problem-solver. The sponsor’s role doesn’t end with the submission of a claim form; their active involvement is a key component in an employee’s successful return to work.

Initial evaluation of a disability claim

During the initial evaluation of a disability claim, the case manager will contact the sponsor to obtain information about an employee’s coverage and eligibility, regular job duties, as well as observations prior to the absence (including any job performance issues).  Details about employment history and an expected return to work date are also obtained. This initial conversation helps the case manager understand the employee’s functional abilities and if any modified work is available. It’s an opportunity for the case manager to provide updates on the status of the application and highlight any contractual issues which may require further investigation.  This meeting is essential in developing an outcome-focused plan.

Return to work opportunities

Provided the disability application is approved, collaboration between the case manager and the plan sponsor is essential to plan and co-ordinate the member’s return to work. This includes a joint effort to look for opportunities for accommodation through modified work or alternate duties for the employee. Collaboration with the sponsor may require the focused assistance of a rehabilitation specialist, who can create customized plans and address potential barriers affecting a return to work. A rehabilitation specialist also follows up with the sponsor to ensure the employee’s return is  successful.

Things to consider

It’s important to consider a wide variety of details that can affect a claim, including a change in a member’s earnings or employment status, as well as income paid – such as part-time earnings and vacation pay – and offsets such as Canada Pension Plan disability benefits. When communication lines are open, sponsors may contact the case manager to discuss absences or incidents which may affect a recurrent disability.

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