Untangling the mysteries of employee performance: the eventual goal of catching employees before their breaking point is on hiatus while disability managers grapple with the ever-changing field of behavioral risk management

Risk & Insurance, May, 2007 by Peter Rousmaniere

Summary

* Disability managers are fully occupied with returning employees to work and aren't able to intervene before an employee currently at work "flips."

* A "coach" can be helpful to mitigate an employee's anxiety as a return-to-work date approaches.

* A returning employee's supervisor must also be coached to avoid exacerbating a delicate situation with judgmental comments and jeopardizing the employee's work status.

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Deborah Jacobs' persistent dream is to get to people before they "flip."

The director of Southern California Edison's disability unit says that at present she almost always learns too late after an employee's performance "flips and she or he goes onto disability." Keeping people out of disability means clueing into turbulence at home or work before it begins to overwhelm the employee, an arduous task at the least, she says with a veteran's perspective.

"That is probably not going to happen for a while because we are so busy getting those already off work back to work," says Jacobs, 41.

Jacobs has worked at the company for 17 years, much of those years invested in guiding people back to work. Reality to her is a work force of 17,000, one-tenth of which is out on medical or other leave at any given time.

Beyond her employer is her professional world, where behavioral science intersects with corporate America. It is peopled by teams of disability managers, employee assistance programs, mental health professionals and claims adjusters--and especially midlevel corporate managers who run part of or, as Jacobs does, an entire integrated disability management program.

Jacobs stands in the midst of a vastly growing professional field as represented by the phenomenal growth of the professional association in which she is an active member, the Disability Management Employer Coalition. In the last 12 years, DMEC's membership has gone from 35 to 1,500 members. Jacobs has been president of its Southern California chapter for several years and might arguably serve as the organization's role model.

Employers, especially large ones like SCE, are driven by a sense of urgency to address employee behavioral problems and are nailing together planks for a new foundation for worker productivity. Listening to Jacobs, one can imagine her hammering away, nails clenched between her teeth, as she recounts an episode that opened her eyes.

"In about 2004, a man made some threats toward his supervisor and went out on disability," recalls Jacobs. "He got a certificate for stress, but not a proper mental health diagnosis. When I got this case, wow--he and his supervisor had had a falling out, and here it was a year and a half later. He was capable of doing his job. What a waste. I worked with the EAP to talk with him and the supervisor separately to ask can he go with a clean slate going forward.

"A month after he came back, he called to thank me for getting him back to work and asked me to lunch," she says.

That's basically what she and her crew of 13 do, handling all leaves from work except workers' compensation. They operate out of a first-floor suite in a SCE office park located in Rosemead, Calif., a culturally diverse city of 50,000 east of Los Angeles. She has been managing the unit for seven years.

In the same office complex is Jacobs' boss, Susan Heller, a physician and corporate medical director with an M.B.A. and engineering degrees. "We're both working moms," says Jacobs proudly. Jacobs is married with two young children; they live a mile from Disneyland. Heller runs occupational health clinics, fitness centers and preventive health programs, and oversees Jacobs' operation. Jacobs also reports to the corporate benefits department.

SCE's investment in what could be called employee behavioral risk management is complicated, perhaps inevitably as the field is changing rapidly. It retains Sedgwick CMS, the third-party administrator, to manage disability claims. The Horizon Health Employee Assistance Program was engaged a few years ago to deliver EAP services. Horizon Health's counselors are all offsite except for a part-time counselor at an SCE nuclear facility to meet, according to Jacobs, nuclear regulatory standards.

Jacobs' unit collaborates with both Sedgwick and Horizon, but the arrangement, when she talks about it, seems a very provisional work in progress.

For one, Horizon is delivering both a classic EAP service and a boatload of other helping tools for families.

This, according to Jacobs, is in contrast with a more traditional EAP model delivered internally before SCE outsourced the function earlier in this decade.

According to the traditional model, an EAP concentrates on mental health and substance-abuse problems, primarily for the employee. Because of that, says Jacobs, the company's EAP had a stigmatizing image that kept utilization down.

The EAP now offers financial counseling, legal services, life-care planning and disease management services for all family members, including an elderly parent living remote from their adult children who are SCE employees.