The real problem with disability management is not intent but execution, says Medavie’s Gillian Grossman
Disability insurance is “one of the unsexy components of group insurance that no one really likes to talk about and no one really wants to pay into,” says Gillian Grossman, senior product specialist at Medavie Blue Cross.
After all, it lacks the flash of wellness apps or the headline appeal of pharmacare debates. But when an employee is off work with a complex condition, it is the disability management program - or the absence of one – that often determines whether they return to health or spiral into prolonged absence.
Having it, however, is not the same as getting it right.
According to Grossman, an effective program needs to start with the plan sponsor's contract - understanding the specific provisions and definitions, then shaping the approach around that employer's reality rather than applying a generic template.
"A good plan is going to be adaptable and not rigid," she explained. “The next phase is a sustainable and rigorous case management approach that's grounded in fair and evidence-based decision-making using data. Members need timely and consistent decisions that are going to be delivered with empathy especially during vulnerable times. This balance ensures sustainable recovery while sort of taking these workplace realities into account.”
Grossman believes the goal is to strike a balance between what the individual claimant needs and what the employer can sustain, keeping recovery and return to work at the centre of every decision.
"Case management needs to be adapted to meet the individual member where they're at," she said.
According to Grossman, a well-run program has plenty of resources available and helps employees return to health and productivity faster than they would on their own, with case managers acting as navigators through a healthcare system that is difficult to handle alone. She also acknowledged how there’s an isolation problem that goes unaddressed too often where employees off work lose daily contact with colleagues, which can compound stress and slow recovery.
"It's stressful for people when they're off. They're worried about themselves, they're isolated, they're often not in communication with their work families, which for better or for worse is how most people spend most of their time with," she said, adding case managers who do the job well also provide coaching and realistic expectations about timelines and barriers, making the support far more holistic than a monthly deposit.
“It’s really providing more holistic support for the member beyond just income. It's getting them back to work and supporting them physically and emotionally,” she added.
All of this is easier said than done, however, as Grossman noted the disability landscape is becoming harder to manage because claims are more complex than they used to be. Instead of straightforward cases with a clear recovery timeline, insurers are increasingly dealing with employees who have mental health conditions alongside other health issues, which makes claims more difficult to assess and support.
She also acknowledged the delays in accessing care, either through emergency departments or specialist appointments, as a major reason claims are lasting longer.
Additionally, employers are paying more attention to mental health, psychological safety, workplace culture, and the need for flexibility, especially in the years since the pandemic.
Consequently, data analytics is playing a bigger role in case management by helping insurers spot risks earlier, estimate likely claim duration, and identify interventions sooner so they can try to limit long absences.
Having a disability management program in the workplace is effective for two key factors. Employers need to accommodate workers with disabilities not only to stay compliant with the law, but also to hold on to talent. Grossman believes too many plan sponsors still treat accessibility as a chore or framework in place instead of seeing it as a practical way to support retention and productivity.
From an employee standpoint, disability benefits have become a talent issue as much as a protection issue, said Grossman. In a labour market where employees have options, stronger benefit packages can make employers more attractive, especially to younger workers who place greater weight on work-life balance and expect employers to support mental health in a serious way.
She suggests that organizations with structured disability programs, including clear support for employees making mental health claims and returning to work, are better positioned to compete for talent.
“A huge important part of the workforce right now is the older employees too. The older you get, there’s a higher chance you need your disability benefits then,” noted Grossman. This older component of the workforce, they're filled with knowledge, they're filled with experience and you want to have them at work, and you want to keep them there. Having a strong disability program, whether it be short term or long term is, is really appealing to talent.”
Yet, she suggests the bigger problem is often execution. Employers may understand the intent of accessibility standards, but many lack clarity on roles, responsibilities, timing, and how those requirements should work in day-to-day operations. Without a clear policy or defined process, accommodation tends to be handled inconsistently from case to case.
To that end, she emphasized plan sponsors need a formal strategy rather than an improvised approach. Even if that requires upfront investment, a structured accessibility policy can reduce financial risk, help employees return to work sooner, and improve productivity over time.
Furthermore, plan sponsors need systems that keep employees connected to work while they are away, because long absences make it harder for people to return, Grossman underscored. That means staying engaged with the employee throughout the leave period, whether through an insurer, a disability program, or an accommodation service, instead of letting the person disappear for weeks at a time.
The objective should be to support a return to the workplace, even if that begins in a modified capacity, while preserving the employee’s connection to the job and their sense of purpose.
She also stressed the importance of oversight and clarity around responsibilities. Employers need to understand what their legal obligations are, what employees are responsible for, and what can and can’t be asked during the process.
“It's really about having a structured program that's applied consistently, that’s adaptable, customizable, data driven and really finds that sweet spot balance between the individual need and the plan sponsor need and having a program that has the built-in flexibility to do both,” she said.
