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Counter the Top Triggers of Short-Term Disability

Employer actions can help employees stay healthy and return to work sooner

May 14, 2014 | Stephen Miller, CEBS

An analysis of 20 years of Cigna's short-term disability claims shows that absences related to obesity, treatment for skin cancer and herniated disc surgery increased significantly from 1993 to 2012, while a reduction in absences related to depression coupled with an increase in prescribed antidepressants may signal a hidden problem.

Understanding disability leave trends can help employers structure a wellness and absence management program to improve workforce productivity, analysis of the findings suggests.

“Though medical advances have helped improve the quality of life for many people, lifestyle and behavioral factors remain key drivers of absence,” said Dr. Robert Anfield, chief medical officer for Cigna's disability insurance unit. “Employers must address these triggers with earlier intervention, vocational rehabilitation services and wellness programs.”

Shift in Disability Causes

According to the data, the most frequently approved short-term disability claims—both 20 years ago and today—remain musculoskeletal disorders, which make up 25 percent of all non-maternity absences. While some conditions in this group have decreased due to medical advances, others are increasing as workplace demographics change.

“The aging workforce and a trend towards growing waistlines has made some medical conditions more dominant factors for short-term disabilities than they were 20 years ago,” said Anfield. “For example, arthritis and tendonitis-related absences have both increased more than 50 percent since 1993.”

Below are some of the leading triggers of short-term disability, along with recommended employer actions to help employees stay healthy and return to work sooner:

Herniated discs. As new techniques have improved the efficacy of back surgery, the number of procedures has gone up and the average amount of time out of work has decreased. Simultaneously, these medical advances led to an increase in the number of eligible candidates for surgery and an overall net increase in lost productivity time.

Cigna’s data show a 45 percent increase in work absence for this condition, which represents the most significant increase in short-term disability claims among sedentary occupations over the 1993 to 2012 period.

Recommendation: Employers should consider putting in place programs that target specific conditions. For those who may not need surgery, employers may want to take a fresh look at the employee’s workstation and other factors that may contribute to back and muscle issues. For those who require surgery, vocational rehabilitation programs are designed to help individuals successfully re-enter the workforce.

Obesity. Over the last 20 years, the number of obese Americans has doubled. At the same time, short-term disability claims related to obesity have increased by 3,300 percent, excluding obesity-linked chronic conditions such as diabetes and some musculoskeletal conditions, according to the study. Many of these absences are attributed to the increasing popularity of bariatric surgeries.

Recommendation: Although bariatric surgery has improved the lives of many people, it can only be as effective as the healthy life changes the individual adopts after surgery. Employers that provide resources and coaching, such as employee assistance programs (EAPs) and vocational rehabilitation services, can help workers become more productive and enjoy long-lasting health.

Cancer. According to the American Cancer Society, this year there will be an estimated 1.7 million new cancer cases diagnosed. Among different types of cancers affecting short-term disabilities, the biggest spike over 20 years was due to skin cancer—now five times more prevalent than in 1993. Employers should also anticipate that caregivers who look after family members with cancer will require leave under the Family and Medical Leave Act (FMLA).

Recommendation: Employers should implement absence management strategies that integrate wellness programs, disease management programs and vocational rehabilitation services to meet the needs of cancer patients. Getting a head start on engaging employees who are on FMLA leave can lead to nearly seven fewer days away from work when an integrated disability and FMLA administration strategy is in place.

Depression. Twenty years ago, depression was the third leading cause of short-term disability. Today, it is the fifth leading cause. Still, more than one-fourth of Americans ages 18 and older suffer from a diagnosable mental disorder in a given year, and the use of antidepressant medications prescribed by physicians has surged. Despite pharmaceutical advances, the use of antidepressants, particularly without counseling, could indicate a problem with presenteeism, defined as sick or distracted employees at the worksite with markedly lower productivity.

Recommendation: The longer a person fails to seek mental health treatment, the longer and more deeply depression can have an impact, both on an individual’s wellbeing and an employer’s workforce. This underscores the importance of an EAP to help people with behavioral health needs access early care.

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.