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4 Myths of Disability Management with Dr. Roger Hodkinson

September 26, 2016 from Canadian HRReporter

In an article published by the Canadian HR Reporter, Western Medical Assessment’s CEO and Medical Director, Dr. Roger Hodkinson, covers the murky and often confusing industry of disability management. Unnecessary treatments are a significant cost for Canadian companies managing disability benefits, largely due to the myths and vested interests which impact case managers.

Myth 1: Treatment is always beneficial.

In reality, unnecessary or excessive treatment can harm healthy employees by making them believe they are disabled. This uneccesary treatment may involve prescribing narcotics inappropriately without sufficient evidence-based support due to financial motivations.

Some of these industries issuing treatment include massage, passive physiotherapy, acupuncture, naturopathic, and chiropractic. Treatment in these areas can be very beneficial if it is medically appropriated and evidence-based. Dr. Hodkinson emphasizes the importance of ensuring treatment is appropriate, stating that “unnecessary or excessive

treatment is not just a waste of money – it can actually harm otherwise healthy employees by medicalizing them into believing they are truly disabled and unfit to return to their normal life, including work.”.

Myth 2: Disability is primarily an insurance matter.

Although insurance carriers are crucial partners in disability management, the claims themselves are a medical issue. Timely and medically effective treatment based on a well-supported medical diagnosis can reduce long-term claims and decrease insurance carriers’ premiums. According to Dr. Hodkinson, this is the optimal strategy for a safe return to work which also preserves the employee’s self-esteem and minimizes costs associated with retraining.

Myth 3: A note from a family doctor is sacred.

Family physicians may be asked for disability notes before necessary diagnostic investigations or specialist referrals are completed, leading to vague disability notes. Vague disability notes – or as Dr. Hodkinson calls them, “Elephant-in-the-room syndrome” – are identified as the greatest contributor to the high cost of disability in Canada. Case managers often aren’t aware that they have the right to challenge unsupported GP opinions and have the right to ask for additional information.

Doctors may also be not fully informed of their obligations regarding information sharing. If a family doctor and a specialist disagree on diagnosis, treatment, or causation, an independent  opinion from a specialist who is able to speak on the scope of the disability would generally take precendence.

Myth 4: Case Managers Have No Power.

Outsourced disability case management companies are described as “case-monitoring” companies who pass information between employers, family doctors, treatment providers, and insurance carriers. Employers who may not be privy to all the details of the case often accept increases in their insurance premium, unaware that they could have taken measures to avoid this rising cost.

Case managers have a right to ask an employee’s general practitioner for further information regarding the disability (within the limits of privacy legislation) if the note written does nto seem satisfactory. This applies even if the insurance carrier has accepted the case for disability coverage already.

In situations where the information provided is still insufficient, case managers can request an IME to challenge the medical authenticity of the disability claim. A major Canadian city reportedly reduced long-term disability claims by 38% over a few years by adopting a diligent management philosophy requiring medical substantiation for each case.

Although disability management in Canada may appear to be functioning efficiently, vested interests benefit inappropriately from the disability management industry, including general practitioners, treatment providers, and outsourced case management companies.

Dr. Hodkinson states that he has the highest regard for in-house case managers and emphasizes their focus on safely and efficiently getting employees back to work.

He also calls for constant vigilance by disability case managers to identify claims that may not appear reasonable and emphasizes the importance of positive, timely intervention.


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