Enabling Physician

Client
Mid-size Washington, D.C., engineering consulting company with small groups of employees in 35 states with total salary continuation for short-term disability (STD).

Situation
An employee was out of work for four weeks due to a psychological disability. She returned for three weeks. During that time, she was formally counseled by her supervisor about her poor job performance. She then was out-of-work again for psychological reasons. Her employer suspected the second STD episode was related to the counseling session. He asked Work & Well to look into it.

Action Taken
Work & Well reviewed the employee’s medical record. It showed that her psychological problems were being controlled by medication. The employee was 100% functional and able to perform her job.

The record also revealed something else. The employee had told her psychologist she feared being terminated due to poor job performance. The psychologist told the employee to retain a lawyer. He also agreed to keep her out of work for another 30 days and assured her he would support her in any job action she would take against her employer.

Because there was no medical substantiation, Work & Well recommended the employer deny payment of STD benefits from the date she went out on the current disability.

Results
The employee’s diagnosis and disability paperwork fell well within the “canned” guidelines used by most disability management companies. The guideline easily qualified her for additional time out of work. However, Work & Well’s thorough and expert medical review proved much more effective than these boilerplate guidelines. Once the employer went along with Work & Well’s recommendation to deny further benefit payments, the employee immediately returned to work.

Savings
Through aggressive clinical case management, Work & Well was able to reduce unnecessary disability time and mitigate potential employment action.