When it comes to chronic conditions, there’s a difference in understanding and appreciating — “and this difference goes a long way in helping employers navigate their disability claims and accommodations,” said Yvonne Murphy, director of disability claims and group benefits at Sun Life Financial Inc., during a session at Benefits Canada’s 2023 Chronic Disease at Work conference.
Chronic conditions in the workplace are higher than ever before because of new advances and treatments that allow individuals who are diagnosed with these conditions to manage their symptoms and remain functional in the workplace, she noted. “Individuals faced with a lifetime condition want to remain at work and be productive, work with a purpose and have financial security. And with the right leadership, support and accommodation, living with chronic conditions isn’t only possible — it’s actually preferable.”
More than half of the Canadian workforce lives with at least one chronic illness, said Murphy, and even if an employee doesn’t have a chronic condition, they might be a caregiver for somebody living with one. “You want to keep that in mind. These are valued employees we want to keep productive and in the workforce. So be sure you’re focusing on this, as it will go a long way in supporting these individuals and managing your disability costs.”
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Many factors contribute to the complexity of a condition — the plan member, their personality, culture, family, resilience, coping skills or whether they’ve had a previous medical condition, she said, noting other factors include the presence of concurrent conditions, access to care, family and community support, financial stability and benefits plans.
The workplace plays a huge part here, said Murphy. For instance, if someone has depression and their employer has a strong culture of support and accommodation, this condition won’t necessarily be a barrier. On the other hand, if someone fractures their leg and has limited extended health coverage, financial difficulties and an unsupportive boss, this can turn a simple condition to a chronic one.
“Everyone has their own story. That story is shaped by factors and will determine how we move through our recovery journey.”
It’s no surprise that mental-health claims have steadily increased over the past decade and continue to drive overall volume, she noted. “Younger plan members have a higher proportion of these claims, as these young adults have grown up with an increased awareness of mental health and anti-stigma campaigns, meaning they’re more likely to seek treatment early, compared to their older counterparts.”
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Depression still dominates mental-health claims, she added, but anxiety- and stress-related disorders are increasing — most likely due to uncertainty posed by the coronavirus pandemic. In fact, the proportion of Canadians reporting a diagnosis of depression or anxiety has increased 30 per cent since the pandemic, with three in 10 individuals reporting they’ve had a mental-health disorder diagnosis.
“From a disability perspective, mental-health claims represent 30 per cent of all claims. However, they represent 45 per cent of the costs and take 25 per cent longer for case managers to handle.”
Since the onset of the pandemic, life pressures have reached a peak, said Murphy, noting research shows that, during a crisis, the volume of disability claims lag. When faced with a crisis, people are able to function for a short period, but as the crisis subsides, many employees are left depleted or burnt out, she added. This is what’s being seen in disability claims now — significant access-to-care issues that started pre-pandemic have escalated and are coming back with huge waitlists.
“Individuals who’ve been waiting for a chronic disease screening or treatment are more delayed, meaning that when they do get diagnosed, they’re further down the chronic disease path.”
Employees want robust benefits plans, with the increasing cost of disability plans and the cost to manage chronic and complex conditions both rising concerns, she added. “Without the right workplace supports, these claims are likely to end up as permanent disability claims, causing overall premiums to rise.”
Supporting plan members is a collective responsibility shared by employers, employees, advisors, health-care teams and group benefits providers, said Murphy. Indeed, the rising costs of benefits plans have led to more partnerships between these parties and the use of data to find solutions. “The only way we’re going to bring costs down — ensuring we keep valuable employees in the workplace, continue being employers of choice and navigate our new normal — is a partnership.”
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Murphy suggested that insurers develop innovative solutions and product offerings, provide employers with the tools to assess their organization and develop strategic plans to address the factors driving group benefits experience. In addition, she said benefits plan sponsors need to take the time to review their offerings and compare those to their employee population and data.
“By supporting employees living with chronic or complex health conditions, you ensure a healthier future for your employees, which increases productivity, reinforces commitment to your organization and helps to manage your benefits costs.”
Read more coverage of the 2023 Chronic Disease at Work conference.