Part V. The management of absenteeism: a continuing strategy
Absenteeism is a phenomenon that every employer has to deal with sooner or later. The experts all agree that it must be managed proactively in order to reduce the financial and human costs. As we shall see, it is important for an employer to act at various levels, including prevention and the management of disability while the employee is absent, and upon their return to work.101 While each absence must be individually assessed and the means adopted to alleviate its consequences will unquestionably vary from case to case, it is possible to identify some general principles that apply in all situations and can facilitate the overall management of absenteeism.
Sound management of absenteeism will enable an employer to exercise its right to manage, while respecting the fundamental rights of its employees. For example, effective management of disability may allow a business to retain experienced employees who become disabled, and make substantial savings in terms of health, time and insurance costs.102 In this part, we shall look at a series of measures employers may adopt. Naturally, selection will depend on the size, nature and capacity of the business.
5.1 A workplace disability management program
It is important for both employer and employee to take a broad view of the absenteeism issue when problems arise. It is essential, in fact, that they be aware of their rights and responsibilities and know how to proceed in cases of long-term absence.103 A workplace disability management program can greatly facilitate the reintegration of employees affected by a work accident, a psychological illness or a dependence problem, or who are returning to work after a prolonged absence. A program developed in cooperation with all concerned can produce a joint strategy that meets the needs of the organization and defines the rights and responsibilities of each party. It can also set out a procedure to be followed in cases of conflict and coordinate the services provided by existing structures, such as health and safety committees and employee assistance programs. Such a program allows a comprehensive approach to absenteeism and the planning of measures to deal with it, ranging from prevention to the reintegration of employees affected by a disability. The process of developing a program to manage absenteeism also offers a good opportunity to review existing policies and ensure that they respect employees’ fundamental rights.104
A growing number of professionals and other resources are available to businesses wishing to set up such programs.105 Moreover, Canada was the first country in the world to develop a Code of Practice for Disability Management, which the International Labour Office made extensive use of in its 2001 Code of Practice on Managing Disability in the Workplace.106 These publications can be very helpful to anyone wishing to put in place mechanisms for the management of absenteeism due to disability.
5.2 Cooperation and dialogue
The literature as a whole indicates that the most efficient practices for managing an employee’ s return to work are those based on cooperation among all concerned, in particular the employee, managers, supervisors, union representatives, co-workers, health professionals, the return-to-work coordinator and benefit providers.107 According to a 2000 study by the School of Industrial Relations at Cornell University, workplace management of disability is an area in which it is possible to develop a valuable consensus between employees and management.108
As we have seen, the individual right not to be discriminated against often conflicts with collective rights enshrined in collective agreements: seniority rights, for example. This often causes disputes between the union and the employer, and among employees within the same bargaining unit.109 However, cooperation between employee representatives and the employer is absolutely vital in reconciling the interests of all, and avoiding conflicts that can land them in court. In this connection, the striking of a parity committee to manage the implementation of a disability management program has been recommended by a number of experts in the field.110
Effective and positive communication between employee and supervisor is essential to success in accommodation and the return to work.111 As we have seen, however, the disclosure of personal data in such circumstances must respect the privacy of the employee. Apart from cases in which accommodation absolutely requires the disclosure of medical information containing a diagnosis, an employee may choose whether to disclose the nature of the disability to the supervisor or co-workers.
While it is fairly rare for an employee an employee to be compelled to reveal the nature of his or her disability, there are sometimes advantages in doing so. Most respondents surveyed for a recent study by the Canadian Mental Health Association reported that being able to discuss their condition openly with their employer had been a key factor in keeping their job.112 In particular, disclosure can reduce tension and anxiety about eventual discovery, facilitate requests for support within the workplace, and make it possible to develop strategies to help co-workers react appropriately in a crisis.113
However, disclosing a psychological disability or some other disease that often leads to extensive prejudice, such as HIV/AIDS, is not an easy decision. Those affected by such disabilities may be ostracized or treated differently when their problem is disclosed. An open environment where differences are respected makes such a disclosure easier. An established policy, familiar to all, spelling out how people are to be treated after disclosure can help those who wish to do so to share their situation.
5.3 Working conditions that promote the physical and mental health of employees
Employers can help prevent some diseases or accidents by promoting health and safety in the workplace. Workplace health and safety legislation contains a number of provisions with which employer and employee are obliged to comply, particularly with respect to clothing, equipment and hazardous materials.114 Other measures not covered in the legislation may also be adopted, in particular to reduce the risk of the development of job-stress-related diseases.
There are a number of studies showing connections between stressful working conditions and such diseases as depression and anxiety, cardiovascular disease, back pain and alcohol dependence.115 A situation in which an employee has little control, combined with very high requirements, is harmful to his or her health. It seems that organizational fairness also affects employee well-being.116 Clarification of duties and expectations, the training of supervisors to recognize good work, the opportunity to express an opinion on the duties assigned, and a clear and transparent decision-making process are all elements that can improve the quality of life at work.117 In order to reduce the incidence of psychological and stress-related diseases, therefore, it is necessary to invest in the quality of the work experience, to focus on human factors and to devise strategies based on the development of a feeling of well-being.118
Since psychological illness is one of the main causes of disability, employers should pay special attention to the mental health of their employees.119 The organization can develop, among other things, mechanisms to detect early signs of psychological illness or dependence in its employees. Episodes of mental illness are often preceded by a period of psychological distress marked by, for example: chronic fatigue, loss of energy, poor concentration, lowered motivation, mood swings, argumentative attitudes, a tendency to seek solitude, the appearance of scattered absences, reduction in the quantity or quality of work, or unusual enthusiasm.120 The organization can then intervene and encourage the employee to take a step back, refer him or her to a helping professional, or suggest sick leave, in order to prevent the situation from degenerating and leading to a prolonged absence. Early access to services and treatment has proved very cost-effective for some companies.121
Reducing the risk of mental illness at work is a significant complement to clinical casework in lessening the burden of depression and anxiety in the workplace.122 If a poisoned environment has contributed to a bout of depression, treatment will be compromised if nothing has changed when the employee returns to work.123 As Dr. Dan Bilsker explains, a bridge must be built between the health care system and the workplace, in order to manage mental illness properly:
"It has been observed that the worlds of mental health and work have elaborated two cultural traditions, speak different languages, are philosophically distinct… Bridging the domains of mental health care and the workplace is a critical task if we want to effectively manage common mental disorders."124
Employee assistance programs (EAPs) can also be used to help employees cope with problems of stress, drugs or alcohol, and with marital or financial difficulties. Such programs can also promote physical fitness and healthy living habits. In addition to showing that a company cares about its employees and creating a feeling of belonging, they can help prevent absenteeism at the source.125 EAPs must be confidential and easily accessible. Support programs can play a key role in keeping employees on the job. For example, a mental health study has shown that the individuals with the highest job retention rates had continued to receive formal or informal help after going back to work.126
Small businesses often lack the resources to develop an EAP. Nevertheless, they can refer their employees to services available in the community. With a small contribution, they can also develop group resources in partnership with other small businesses.127
5.4 Training and education
Employees and managers, beginning with the most senior, can benefit considerably from training designed to raise their awareness of the myths and the stigma surrounding disability, and specific forms of disability.128 Complaints of discrimination brought before tribunals by employees who are sick often results from stereotypes and preconceived ideas. For example, people suffering from mental illness face an intense stigma in the workplace. Many employers and employees express unwarranted fears and see such people as incompetent, unproductive, violent or unable to deal with pressure on the job. 129 Interestingly, discrimination sometimes results from a mistaken belief on the part of the employer that accommodation is needed, when all that is needed is for the organization to lose its misperceptions about persons with disabilities.130 Education about prejudice and stereotypes about certain disabilities can be much improved by consulting specialized agencies.131
All employees and managers should also receive clear information on the company’s disability management strategy. They should be informed of their rights and responsibilities and the measures or programs available. Training should include information about accommodation that may be needed in cases of disability. Providing details about the underlying reasons for accommodation helps employees who require it to feel included, and avoid any feelings among their co-workers that they are receiving preferential treatment. Co-workers can also draw comfort from the thought that such measures would also be available to them if needed.132
The employer must demonstrate that it encourages its employees to avail themselves of the programs and measures available in the workplace, and that they will not suffer any negative consequences for taking advantage of them. For example, it has been shown that participation in workplace family-friendly programs was sometimes surprisingly low.133 There is apparent reluctance on the part of employees to make use of such programs in the belief that it may create negative perceptions about their commitment to their job and their career and have long-term consequences. Employees tend to be less distrustful if their representatives are involved in developing and promoting such programs.
5.5 Planning the return to work
Planning the return to work after a prolonged absence is the core of any absenteeism management strategy. Some experts feel that the key to managing workplace disability is to maintain the connection between the sick or injured employee and his or her work environment.134 Early cooperation among all concerned can speed an employee’s return. Once health permits, it is important to plan for an early return, well in advance of complete recovery. The longer the absence, the poorer the chances of reintegration.135 An employee who is absent from work for a long time will tend to suffer some psychological fragility. The less contact he or she has with the work environment, the greater the fear of relapse or of having lost one’s touch.136
In some cases, the organization will have to make temporary or permanent changes in the environment to enable a disabled employee to return to work. It must be able to identify and coordinate the opportunities for productive employment the workplace offers to that end. An employment possibility will be assessed on the basis of the limitations of the person and the risks a job presents for him or her. Research has shown that the possibilities for a return to work after an accident or illness increase considerably when workplace disability management programs are in place.137
Once accommodation measures have been taken, it is important to evaluate them periodically to avoid any risk of injury or of aggravating the disability. When such measures are temporary, evaluation must be carried out regularly so as to monitor the employee’s condition closely and make any changes needed. In the case of permanent or long-term disability, the arrangements can be permanent, designed to be used at any time, or available if the disability returns.138 It may be that the return to work carries no restrictions, as after maternity leave. In such cases, it is important to ensure that the employee’s knowledge is updated so that she can resume productive work and enjoy the same employment and advancement opportunities as her co-workers.
It is essential that the absence of an employee, and planning for the return to work, do not generate an excessive workload for his or her co-workers. While they may be understanding initially, they will often become eventually hostile towards the employee if the extra workload is prolonged or becomes too heavy.139 In such cases, solutions may involve a gradual return, with spare human resources or the designation of a sponsor to accompany the returning employee in resuming duties and swiftly relieve any tension that may develop. When accommodation creates more work for others, the employer can also try to obtain union support by raising the pay of those who have more to do, or by having the accommodated employee perform tasks he or she is reasonably able to do and which are normally performed by these same co-workers. Such measures may eliminate some of the negative effects and dissipate any feeling of unfairness.140 In every case, planning for the return to work can certainly be facilitated by a return-to-work coordinator or a specialist in workplace disability management, and by the parity committee, if there is one.141