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Life Health > Health Insurance

Managing Psychiatric Claims Effectively

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Laura is a 33-year-old customer service representative working in a large call center. Shes struggling under pressures of the job and feeling a general sense of stress and anxiety because of long hours, a rigid work environment and pressures at home. Without access to a mental health professional, Laura may be at risk for developing a stress-related disability.

Lauras situation is not unique. Today, psychiatric conditions account for about 7% of short-term and 11% of long-term MetLife group disability claims. In stressful work environments such as call centers, the percentage of psychiatric claims can nearly double.

Depression, stress and anxiety also account for a significant amount of co-morbidity in other short- and long-term disability claims. As a result, employees suffering from conditions such as cancer, pregnancy, cardiac disease and lower back conditions often experience prolonged disability duration because of psychiatric co-morbidity.

These are frightening statistics for employers and employees alike. Disability-related absences can be enormously expensive for employers, exacting a toll on productivity and revenue. As staffing at many companies continues to shrink, employers need help managing disability-related absences now more than ever.

First, employers need to understand what drives mental health claims. One common culprit is job stress and/or dissatisfaction. Job settings that have higher levels of stress or higher levels of conflict (such as companies with rigid controls or pending layoffs) witness spikes in psychiatric-related STD claims overall. Claims are typically more prevalent among businesses in the service sector than in manufacturing.

The peak age group at risk for these claims is 35 to 55 years of age. White-collar workers are far more prone to these claims than blue-collar workers. Psychiatric-related STD claims are no more common in women than in men.

Psychiatric LTD claims, likewise, are more prevalent in service sector businesses, and among white-collar workers and those in the 35 to 55 year old range. More than half of these claims are linked to depression, with an additional 30% of claims accounted for by stress and anxiety.

Employers also need help minimizing the impact of mental health claims–and the productivity losses associated with them. One of the better ways to do this is through effective absence management strategies.

Often, a key ingredient in such strategies is medical intervention. Employees need access to good medical care. They also need access to prescription drug and psychotherapy benefits that directly improve their mental health.

Unfortunately, due to cost pressures, many employers have cut medical benefits, reducing employee access to such services. The result has been the rising cost of lost productivity in the workplace.

To help reduce the productivity losses associated with STD and LTD mental health claims, insurers, brokers and employers need to work together. Brokers need to identify disability insurers with a strong track record for getting employees healthy and back to work. Insurers need to implement effective absence management programs that help employees and, as a result, improve their customers bottom lines. And, employers need to help reduce workplace stress by creating healthy, productive working environments and work to facilitate claimants return-to-work on a full- or part-time basis. Equally important, employers and insurers need to work together to understand the relationship between group health and group disability benefits.

American businesses are fast recognizing the growing impact that depression, stress and anxiety have on workforce productivity. As a result, insurers and brokers are faced with a tremendous opportunity: helping employers develop solutions designed to minimize the impact of mental illness in the workplace.

Dr. is National Medical Director, MetLife Disability.

Reproduced from National Underwriter Life & Health/Financial Services Edition, July 29, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


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