Are you prepared for the coming deluge of disability claims?

Despite some supply chain challenges, vaccination plans are coming together across Canada, and employers are beginning to look ahead to new ways of working. Now is a great time for benefits managers and administrators to start incorporating some of the lessons from the past year and to look ahead at what awaits when Canadians begin to return to work, school and social activities.

For example, the past year has seen big growth in employees accessing virtual care from family physicians, specialists and paramedical practitioners, as well as looking to employee assistance programs for help with healthier living, balancing work and family and managing isolation-related mental wellness challenges. But Canadians have also spent much of the year contending with rolling lockdowns, financial uncertainty and new pressures on their health.

With these changes your benefits plan may need some finetuning for 2021 and beyond. One trend, in particular should be on your radar, and that’s the looming rise in long term disability (LTD) and short term disability (STD) claims.

Mental health disability on the rise.

Prior to the pandemic, the top drivers of disability claims were mental health issues and musculoskeletal concerns such as sprains and strains. It’s certainly no secret that COVID-19 took a big toll on mental health, with more than half of Canadians (56%) reporting a negative impact due to the pandemic. About two-thirds of Canadians say isolation has been the primary reason for their decline in mental wellness, and 60% say they are not receiving any support to work through their challenges.

There is also evidence that many Canadians either couldn’t or chose not to get help for non-COVID-19 related mental health concerns, either because their practitioners were not available or because they were afraid to visit a healthcare facility. One study finds just 11% of Canadians are accessing virtual mental health services, and another study finds emergency room visits, home care screening visits and elective surgeries were down substantially in 2020.

These two trends mean there is a very large cohort of patients with undiagnosed, under-treated or entirely untreated mental health concerns, and this is likely to show up in a spike in related disability claims later this year.

Physical disability has old and new causes.

While injury claims due to accidents were down, this trend will be short lived as we begin to see the physical toll of working from home, in the form of injuries due to poor ergonomics in makeshift offices and the overall general decline in physical activity. Employees who were facing physical ailments in early 2020 may also have had to postpone or reduce treatment as surgeons, specialists, physiotherapists, and other paramedical offices were forced close.

As the toll of home office work and the pent up demand for treatment join forces, we will almost certainly see case managers boards filling with disability claims. Of course, once we get back to our pre-pandemic habits, we can expect another uptick in sprains, fractures and sore joints as employees return to more active lifestyles.

Treatment delays extend across the healthcare system, particularly when it comes to elective surgeries. Some estimates suggest it will take more than 18 months to clear the backlog in certain provinces such as Ontario and Quebec, which means employees waiting for new joints, pacemakers or other interventions may become sicker as time goes on. This means longer recovery times, more pharmaceutical and non-pharmaceutical interventions and additional people needing disability leave.

Delayed treatment will have an impact.

The backlog in treatments isn’t just surgical; more than two-thirds of the Canadian workforce is living with some form of chronic illness, such as diabetes, auto-immune condition or cardiovascular disease. For these employees, a year of reduced or missed specialist support may leave them unable to work and needing longer to recover.

One final pressure on our disability benefits may be the so-called COVID-19 long haulers. Even though 90% of Canadians who have been infected with the virus to date have recovered, there are many who continue to experience severe symptoms for months afterward. It’ s not known how long lingering respiratory issues, cognitive impairment (brain fog) and fatigue will last. Some research shows that about one-quarter of infected adults still have at least one symptom 90 days after they are virus-free.

With infection rates still on the rise in most areas in Canada, this could mean tens of thousands of Canadians will remain off work, either recovering or caring for long-haulers in their families, even when vaccinations are widespread.

Work with your carrier.

While there is little we can do to halt these trends, we can make sure our benefits plans are ready to support our employees and their families when the time comes. “The key to assessing our plans is to make evidence-based decisions,” says Shawn O’Brien, Principal, Data Enablement with TELUS Health. “By analyzing your claims now and looking for gaps in coverage and early trends, benefits administrators and managers can make sure employees are protected, and can find opportunities to help flatten that coming spike in disability claims.”

The first step is to ask your carrier to do a claims analysis. Using powerful, interactive business intelligence technology, you and your carrier can assess if there are areas where coverage needs to be added or modified to prepare for new kinds of disability claims. You may also find opportunities to offer pre-emptive benefits that could help some employees avoid disability claims all together. For example, adding an on-demand virtual care solution, such as Akira by TELUS Health can connect employees and their families to specialists who can address chronic and acute mental and physical health concerns.

If you are seeing some plan limitations, O’Brien recommends looking at healthcare spending accounts. “These are a great, and tax effective, way to help employees access the specialty paramedical services that may help them avoid having to miss work.”

The final element you can look at is your employee assistance program (EAP). Prior to the pandemic, most EAPs were woefully underutilized. While they have seen great use in the past year, it never hurts to make sure your employees understand the preventive and early intervention support these resources can offer. While you’re at it, make sure the EAP offering is robust enough to support the changing needs of your workforce.

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