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Monthly Archives: April 2010

Grieving the Loss of a Pet: An Overlooked Employee Absence Issue?

Employers often provide time off from work — even a leave of absence — for the death of a family member. But what if that lost family member is a dog or a cat?

While it may not be a recognized condition for FMLA, for many employees, losing Fido or Fluffy can be a source of surprisingly strong grief.

For many people, pets are beloved family members, and their passing can cause a grief response similar to the death of a person, only in that case, it’s grief with little outlet as the employee often correctly assumes that coworkers and supervisors will not understand or sympathize.

On the job, that grief with no outlet can cause presenteeism and even absence due to unexplained depression.

According to a recent article in the New York Times, researchers at the University of Hawaii who conducted a study to determine the level of grief and stress that pet owners experience after a pet dies found that 30 percent of the study subjects reported grief that lasted six months or longer. Severe grief that resulted in a major life disruption was as high as 12 percent of study participants.

Case managers who are helping employees with depression or other behavioral health issues should be aware of the following:

  • Grieving for a lost pet can have a surprisingly profound effect on employees.
  • Employees who are suffering from pet-loss grief may be extremely reluctant to admit the issue.
  • There are many behavioral health resources — such as support groups — that employees can be referred to as part of case management.
  • When dealing with grieving employees, case managers should focus on the physical or mental restrictions/limitations.
  • Employees may qualify for FMLA if depression is certified by a qualified physician.
  • The Humane Society’s website offers suggestions on where and how to help employees who are coping with an exceptionally strong response to the loss of a pet.

Clearly, adding a health advocacy role to intake as part of the employer’s health and productivity initiative can provide support for the grief process, regardless of whether the loss was a person, a pet or other grief-inducing loss.

Want Healthier Workers? Help Them Stand and Walk

A simple thing employers can do to help desk-bound employees with chronic back pain and perhaps even to reduce obesity levels among employees may be as simple as a change of office furniture.

Replacing the standard sitting desk with higher and height-adjustable desks that allow employees to comfortably stand while they work may offer substantial health benefits.

Standing May Help Prevent/Reduce Obesity

A recent health story in the New York Times by Gretchen Reynolds quotes Barry Braun, an associate professor of kinesiology at the University of Massachusetts at Amherst.

“Emerging evidence suggests that unlike bouts of moderate-vigorous activity, low-intensity ambulation, standing, etc., may contribute to daily energy expenditure without triggering the caloric compensation effect,” Braun wrote in the American College of Sports Medicine newsletter.”

“In a completed but unpublished study conducted in his energy-metabolism lab, Braun and his colleagues had a group of volunteers spend an entire day sitting. If they needed to visit the bathroom or any other location, they spun over in a wheelchair. Meanwhile, in a second session, the same volunteers stood all day, “not doing anything in particular,” Braun says, “just standing.” The difference in energy expenditure was remarkable, representing “hundreds of calories,” Braun says, but with no increase among the upright in their blood levels of ghrelin or other appetite hormones. Standing, for both men and women, burned multiple calories but did not ignite hunger. One thing is going to become clear in the coming years, Braun says: if you want to lose weight, you don’t necessarily have to go for a long run. “Just get rid of your chair.”

Reed Group’s Vice President of Account Services Vicki Schweitzer says: “Some may say there is cost involved with modifying work stations, but it is a great idea to have an ergonomic evaluation and options for sitting/standing.”

“Another low-cost alternative,” she says, “is to get employees on their feet more is to put the parking lot a mile away and let employees have 10 minutes to walk into work in the morning.  They are also then in the position of walking back, and two miles a day is a really good thing!”

Chronic Back Pain and Return to Work

For employees who suffer chronic low back pain, MDGuidelines Return-to-Work recommendations say that prolonged sitting should be avoided.

Heavy or unassisted lifting; repetitive rotation of the back; carrying, pushing, or pulling heavy objects; vibrational stresses; overhead work; and prolonged sitting are to be avoided early on. Prolonged standing should be evaluated for aggravation of the pain. Rest periods are an important part of both treatment and prevention. Some health care providers may recommend wearing a lumbosacral support. Use of medications such as pain relievers (analgesics) and muscle relaxants will necessitate review of safety issues and drug-testing policies. Recurrence of back pain is common, and education regarding safer work practices for lifting, carrying, pushing, pulling, and sitting can help decrease or prevent recurrence.

For more information on low back pain, visit www.mdguidelines.com.

An Employee Health Investment that’s Worth Considering

Spending a few hundred dollars per employee on adjustable standing desks, along with higher chairs that encourage employees to switch between standing and sitting, may be a wise investment that saves employers health care and disability dollars down the road.

Medical Marijuana: A Smoking Hot Topic for STD, LTD and Workers’ Comp

Medical marijuana is all over the news these days as more states seek to decriminalize it and end up grappling with resulting employment issues. Here are a few recent stories:

* New Jersey Compassionate Use Medical Marijuana Act takes effect July 2010, making New Jersey the 14th state to legalize medical marijuana. (Matthew Stoloff’s blog).

* In April the Oregon Supreme Court ruled that Oregon law does not require employers to accommodate medical marijuana that is otherwise allowed under state law. (Jackson Lewis blog).

* California voters will decide in November whether to legalize it. (Associated Press)

* Joshua Clifton wrote an excellent article in Risk Management about the effect of the Oregon decision for workers’ comp and hiring law. (Risk & Insurance)

In these states and many others, employers are beginning to wrestle with issues of prescribed medical marijuana use by employees on STD, LTD, and Workers’ Comp. It’s only a matter of time before its use as a treatment modality becomes a significant return-to-work issue.

If you’re an employer, insurer, TPA or case manager, consider the following:

* Case managers should be aware that employees on short-term and long-term disability in many states may be prescribed medical marijuana, particularly for chronic conditions where more standard treatments have failed. In these cases, the employee may or may not inform the case manager of this.

* While the use of medical marijuana is an alternate treatment, and typically not an approved treatment method covered by insurance, case managers should be aware of the possibility and its potential effects on recovery, return-to-work durations, and especially, the potential for ongoing usage after the employee goes back on the job.

* Disability plan language typically states that the claimant must be under the care of a physician and be complying with the “approved” treatment plan. Medical marijuana is typically not an “approved” treatment.

* Medical marijuana use has the potential to become an addiction that may end up being a co-morbid condition in the case of some disabilities, requiring behavioral intervention and treatment. Critics of medical marijuana would argue that many patients taking the prescription are, in fact, recreational or addicted users of the drug and, as such, should be considered as having a medical co-morbidity when analyzing the return-to-work case.

* Employees who are being slowly transitioned with part-time or light duty work — and who are on medical marijuana treatment with or without employer’s knowledge or approval — could conceivably continue medical marijuana treatment during the transition phase and this needs to be dealt with according to legal and company policy.

* Employers should examine their drug testing policy to ensure that they are appropriately covering employees returning from STD, LTD and workers’ comp leave who may have been prescribed medical marijuana, especially in situations where potential mental impairment can endanger lives and/or increases the changes of relapse for the original condition.

Reduce Your Risk with Absence Management

One thing is certain, we are only at this point seeing the tip of the iceberg with absence management and medical marijuana. The sooner employers and RTW experts get on top of it with good policy and case management, the less potential for damage.

For more information on marijuana dependence and abuse, see our topic at www.mdguidelines.com.