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Life Health > Health Insurance > Health Insurance

Which STD claims turn into LTD claims?

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Some workers who take federal Family and Medical Leave Act (FMLA) leave are much more likely to file short-term disability (STD) claims than others, and some workers who file STD claims are much more likely to file long-term disability (STD) claims than others.

Analysts at the Integrated Benefits Institute (IBI) look at the correlations in a new report based on survey data from 161 employers with about 520,000 employees. The data included covered the period from 2007 to 2011.

The IBI represents employers, health insurers, disability insurers, benefits consulting firms, health care products and services providers, and other organizations with an interest in the links between health and productivity.

The FMLA is a 20-year-old federal law that gives eligible workers access to up to 12 weeks of job-protected, unpaid time off work. A worker can use FMLA leave to handle the worker’s own serious health condition or the serious health condition of a family member.

Some of the topics the IBI cover in the new report include how likely health-related absence cases are to evolve from one level of severity to the next.

The analysts, found, for example, that, over the five-year study period, 24 percent of all workers included took FMLA leave, 14 percent filed an STD claim and fewer than 1 percent filed an LTD claim.

In any given year, workers who had taken FMLA leave due to their own health problems were twice as likely to file STD claims as other workers.

STD claimants who had also used FMLA leave were twice as likely to filing LTD claims as STD claimants who had not used FMLA leave.

The IBI analysts also looked at the likelihood that a worker who had filed an STD claim resulting from a particular condition would end up filing an LTD claim.

“Neoplasms,” or tumors, topped the list, with 6.8 percent of the STD claimants with neoplasms eventually filing LTD claims.

The other conditions with an STD-to-LTD progression rate greater than 5 percent were disorders of the nervous system and sense organs, circulatory system problems, mental disorders, and problems with the muscles, skeleton or connective tissue. 

Intermittent leave
IBI members also have taken an interest in horror stories about workers’ use of “intermittent FMLA leave” — taking two or more periods of FMLA leave for the same reason.

Some FMLA compliance specialists have talked at conferences about unhappy airline employees using ordinary illnesses to qualify for FMLA leave, and then using intermittent FMLA leave as a way to get to come in a few minutes late to work every day, or to take off on Fridays and Mondays and give themselves instant long weekends.

Analysts at Abt Associates recently concluded in a report commissioned by the U.S. Labor Department that use of intermittent” FMLA leave was annoying some large employers but not causing them or other employers much noticeable harm.

The IBI analysts found that the corporate benefits managers they interviewed “described ‘unscheduled intermittent leaves’ almost unanimously as their biggest FMLA headache.”

But an IBI analysis of about 920,000 intermittent leave episodes failed to show that many workers have been using intermittent leave to give themselves long weekends or abusing intermittent leave in other obvious, easy-to-detect ways.

“Intermittent leave episodes were roughly proportional to the days of the week on which work typically occurs,” the analysts said.

Workers were no more likely to take intermittent leave on a Monday or Friday than they were on a Tuesday, Wednesday or Thursday, the analysts said.

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