Disability Accommodation

Overcoming Employment Barriers for the Disabled

Fear of losing benefits is keeping the disabled from rejoining the workforce.
By: | February 7, 2014 • 4 min read

A contingent of California’s workers with permanent disabilities would prefer to work, according to the head of a panel seeking to increase employment among persons with disabilities. Due in large part to barriers about health care coverage and messages from some health care providers, they remain out of the workforce, taking a human and financial toll.

Advocates hope that their stepped up efforts — along with a presidential order, a new requirement for employers with federal contracts, and the Affordable Care Act — will spur an increase in the percentage of employees with disabilities.

“Many people with disabilities on Social Security disability can work and want to work but choose not to work for fear of losing their health benefits,” said Sarah Triano, executive officer of the California Committee on Employment of People with Disabilities. “Surveys show that 40 percent of Social Security disability beneficiaries are interested in working, but 20.1 percent cited fear of losing health insurance or Medicaid as their primary reason for not looking for work.”


Triano, who identifies herself as a person with a disability, was appointed by Gov. Jerry Brown to staff the committee charged with recommending policies to increase the number of people with disabilities working in California. She estimates about 20 percent of California’s workers with disabilities might be willing to work if they were not at risk of losing their health insurance, which is costing the state approximately $3 billion annually.

“California ranks last in the nation in terms of the labor force participation rate of people with disabilities,” she said. “Gov. Brown has made a proactive effort and a commitment to turn that around.”

Persons with disabilities have lower rates of absenteeism and higher rates of productivity, advocates say. Additionally, a 2010 presidential order set a goal for federal agencies to step up hiring of people with disabilities. Last summer, the U.S. Department of Labor issued rules for federal contractors and subcontractors to increase the number of employees with disabilities.

“The federal regulations could light a fire under folks,” Triano said. “Employing people with disabilities is no longer just a good thing that is morally right, it’s now a benchmark that federal contractors are being judged against. People are paying attention.”

The Committee

The California Committee on Employment of People with Disabilities is first focusing on the state workforce then the private sector. First on tap is the health care sector.

Triano said the hope is that targeting that industry might eliminate one of the reasons people stay on the disability rolls. Many people with disabilities, she said, are under the false impression they cannot work.

“A study out of the University of California at San Francisco asked, ‘why do you think you can’t work?’ An answer was ‘because somebody told me I couldn’t,'” Triano said. “In response to ‘who said that,’ 97 percent said ‘my doctor.'”

By increasing the percentage of workers with disabilities in the health care sector, medical providers will be more inclined to see and be working side-by-side with a person with a disability.

WCForum Feb.indd“The representation of people with disabilities in California’s health workforce is currently 3.7 percent which means that most health professionals and paraprofessionals interact with people with disabilities as the recipients or consumers of health care but rarely as a colleague or health care provider,” Triano said. “We talk about culturally competent care all the time, but what would it look like if the health workforce in our state was actually reflective of the patients served?”

Advocates are also hoping the Affordable Care Act may provide more opportunity for persons with disabilities to have access to health insurance. Prior to its passage, one of the only options for people with disabilities who were denied health coverage on the basis of a preexisting condition in the private health insurance marketplace was to apply for public health insurance.

“Due to the nationwide expansion of health care and the corresponding end of preexisting condition exclusions, people with disabilities no longer have to go on welfare to get health care,” Triano said. “Californians with disabilities have access to affordable, quality health coverage without having to say that their disabilities prevent them from working.”

Overcoming Barriers

One of the biggest challenges to increasing the percentage of persons with disabilities in the workforce is overcoming employers’ fears. “What we are really seeing is fear over whether [the person with a disability] can do the job, and number two [the] cost,” Triano said.

A study by the Job Accommodation Network showed more than half of employers who called about accommodation information and solutions would have no cost for the accommodation needed. Of those accommodations that did have a cost, there was typically a one-time expenditure of $500.

“In fact, the majority of reasonable accommodations are less than $500, especially with new technology,” Triano said. “However, the minority of situations that require higher expenses to accommodate a worker with a disability are admittedly a concern for many employers.”

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]