CAN-ASC-1.1 Standard on employment: Public Review Draft – 9. Work disability management, accommodations, stay at work and return to work

This clause specifies policies, processes, and programs for disability management in the workplace (herein referred to as the work disability management system). The work disability management system is directed at addressing the accommodation needs of persons with disabilities, whether their disability is long-standing or acquired while at the organization.

This clause addresses issues of disclosure and accommodation, as well as stay at work (SAW) and return to work (RTW). It emphasizes the proactive removal of barriers and the provision of facilitators (defined as someone or something that assists with the end goal). Focus is given to secondary and tertiary prevention, with consideration of the continuum from primary, secondary, and tertiary prevention. Primary prevention refers to the prevention of exposure that can cause ill health. Secondary prevention refers to addressing workers’ accessibility needs on a timely basis to ensure optimal workplace accommodations, and, in case of an absence, RTW. Tertiary prevention refers to minimizing the impact of disability on functioning, work engagement, and work productivity, as well as preventing further barriers. The focus in this clause is on workers already affiliated with an organization, so the emphasis is on ensuring continuity.

A work disability management system is a framework of policies, processes, programs, procedures, practices, and plans used to manage work disability at an organizational level. The work disability management system is established by an employer focusing on preventing productivity losses and engagement losses while at work or from work absences because of illness, injury, or disability, and on preventing the risks that cause these losses. (From Government of Canada) WDM systems are inclusive of stay-at-work and return-to-work plans.

Stay-at-work (SAW) plans are a tool for managers to proactively help ill or injured workers, or workers who acquire a disability, remain in productive employment in a timely and safe manner.

Notes:

1. Some workers can safely perform productive and meaningful work while they are recovering.
2. Staying at work is beneficial to the worker and is part of the recovery process.
3. Different situations require different solutions.

Return-to-work (RTW) plans are a proactive tool for managers to help injured, and, where appropriate, ill workers, as well as workers with disabilities, return to work after an absence if it is safe to do so.

Note: Return-to-work plans are intended to be transitional and for a fixed duration. These plans may, when required, be integrated into an accommodation plan of an ongoing nature.

9.3.1 Policies

9.3.1.1 Policy development

Policies provide strategic direction to the organization and shall be documented and easily retrievable by all workers. The organization shall develop policies that:

1. ensure that changes made to the work disability management system do not create new barriers;
2. have individualized accommodation plans consistent with its policies on work disability management;
3. identify what accommodation options are available and clearly outline them;
4. take a “yes by default” approach to providing workplace accommodations to minimize the “policing” of accommodations;
5. minimize the need for the disclosure of personal medical information to the employer;

Note: For example, identify a threshold of resources/costs below which one requires medical documentation.

6. ensure that medical documentation is used to support needed accommodation and not deny it;
7. integrate feedback mechanisms to inform the work disability management system and support the identification and prevention of emerging barriers; and
8. include case examples where possible.

In developing policy according to the above requirements, organizations shall comply with Clause 5.5.3 and Clause 9.3.2.

9.3.1.2 Policy requirements

Management of the organization shall establish and maintain the organization’s work disability management system policies in consultation with workers and other relevant internal workplace parties, including worker representatives. The work disability management system policies shall:

1. satisfy applicable legal requirements and other relevant obligations and requirements;
2. be appropriate to the nature and scale of the organization;
3. be structurally supported and clearly documented;
4. include a framework for setting and reviewing work disability management objectives and targets;
5. be documented, implemented, maintained, and periodically reviewed based on an established and appropriate review frequency to ensure continual improvement;
6. be communicated to all workers;
7. be available to external interested parties, as appropriate; and
8. be integrated with other parts of the organization’s management system.

The clauses that follow are about specific areas where policies need to be developed.

9.3.2 Disclosure and accommodation

A successful work disability management system exists when workers feel safe to self-identify as a person with a disability and are confident that this disclosure will lead to increased workplace supports rather than reprisals from others within the organization. Key to this is the development and implementation of a robust individualized accommodation policy and accompanying process.

This policy and accompanying process shall:

1. outline the roles and responsibilities of all persons involved in the accommodation process;
2. apply to all workers, regardless of disability status or position within the organization;
3. provide for continuity of support while workers are employed by the organization;
4. require the employer to cover the cost of obtaining the medical documentation it requests, and any associated lost time;
5. minimize the amount of medical information requested, respecting the worker’s privacy and confidentiality regarding their medical condition;
6. focus on functional information that will guide accommodation, as well as SAW and RTW procedures and practices;
7. require worker input and informed consent regarding how the implementation of accommodations will be communicated on a need-to-know basis;
8. assess medical documentation objectively, avoiding unreasonably questioning when it is provided by the worker;
9. where the workplace is unionized, require the employer to inform the worker of their right to union representation and, in consultation with the worker, involve labour representatives in accommodation processes, where needed;
10. involve a disability organization representative or a competent alternative to support workers with disabilities in accommodation processes in a non-unionized workplace, where needed;
11. train managers and workers responsible for making accommodation decisions on the accommodation policy and the duty to accommodate;
12. keep the accommodation process agile and adaptable to changes in workers’ responsibilities to minimize the risk of losing accommodations through career development and advancement;
13. acknowledge a worker’s request for accommodations in a timely manner;
14.  promote equity across the organization by providing workers in all positions within the organization with access to reasonable accommodations;
15. make assistive technologies and adaptive workplace supports broadly available to maximize access;
16. provide protection for workers making disclosures or requesting accommodations, including a non-reprisal approach to prevent a negative impact on their career opportunities, growth, and advancement; and
17. communicate the accommodation process to all workers and have the information available to all workers without restrictions to accessing the information.
18. make access to accommodations non-contingent on medical documentation;
19. Include development and implementation of a feedback mechanism for workers to evaluate their experience accessing workplace accommodations;
20. provide workers with frequent and meaningful opportunities to request accommodations prior to making a decision that would adversely affect them; and
21. require the organization to inquire with the worker about the need for accommodation when the organization is aware, or reasonably ought to be aware of a relationship between a disability and a worker’s job performance.

9.3.3 Benefits and other supports

The organization shall have a formal policy on the provision of benefits programs and services for workers. The policy shall:

1. focus on supporting worker engagement, health and well-being;
2. require that information on benefits and services and how to access them is readily available to workers in accessible formats;
3. minimize the requirement for medical documentation and paperwork to access benefits; and
4. include a worker-centred process for periodic identification of needs, gaps in needs, and opportunities to address them through additional programs and services.

9.3.3.1 Programs

The organization should consider the following in the development of programs:

1. paid sick leave;
2. Employee Assistance Plan (EAP)/Employee and Family Assistance Plan (EFAP);
3. dental plan;
4. extended health care;
5.  pharmaceutical plan;
6. vacation time beyond the minimum requirement of the law;
7.  short-term disability (STD) and long-term disability (LTD);
8. paid casual absences;
9. personal/family leave;
10. reimbursement of costs for securing supporting documentation required for benefits receipt;
11. supplemental assistance for workers when the need for benefits coverage (e.g., health, dental) extends over or beyond what is currently covered;
12. a documented accommodation plan to provide continuity over the course of employment with the organization; and
13. a centralized accommodation fund to address accommodation needs and removal of financial disincentives within operations (e.g., a manager’s concerns that accommodation costs will reduce their operating budget) to hire, retain, and promote talented persons with disabilities within a team or department, and support the duty to accommodate.

9.3.3.2 Operationalization of programs

The organization should:

1. provide information sessions for workers on the benefits and services available from the organization and in the community, and how to access them;
2. train workers on key accommodation issues such as the duty to accommodate principle and the right to accommodation; and
3. review accessibility requirements of third-party programs and service providers to confirm that the needs of workers are met and seek out alternative providers as necessary.

9.3.4 Maintaining worker engagement (i.e., Stay-at-Work)

Maintaining worker engagement, even when a worker experiences a temporary or longer-term health decline, is possible with timely accommodation. Such efforts can even avoid the need for a health absence. Organizations shall:

1. require that workplace events are inclusive for workers with disabilities and facilitate accommodation requests of workers;
2. provide workers with work hour flexibility to the extent that business needs permit;
3. promote timely reporting of changes in a worker’s accommodation needs;
4. focus on supporting worker health needs by providing accommodation to support the worker to stay on the job;
5. clearly identify the process for early intervention with appropriate resources to support a worker staying at work, if possible; and
6. respect instances when a worker's functional abilities cannot be met through employer-presented or discussed accommodation processes in the workplace. In such instances, medically necessary time off work shall be acknowledged and respected.

Refer to Clause 9.3.2 for details on the accommodation policy and process to be followed to support staying at work. Refer to Clause 9.3.5 below for guidance on criteria for accommodation in own job versus a different job.

9.3.5 RTW following a health-related absence

The organization shall have a formal RTW policy and process that:

1. identifies the role of key workplace parties in the RTW process;
2. is proactive and equitable in RTW regardless of the reasons for the absence;

Note: Eligibility for some benefits programs may be based on the cause (i.e., work-related or not work-related) or other factors such as the type of labour contract, but all efforts should be made to treat all workers equitably and minimize the disparities that may arise due to cause, contract type and other factors.

3. supports the worker and minimizes the impact of RTW on their health and wellbeing;
4. involves the active participation of, and consultation with the worker and their representatives (if applicable), the worker’s supervisor, and key workplace parties;
5. includes the development of a formal RTW plan customized for the worker and their role;
6. includes early and ongoing communication with the worker;
7. provides timely access to information relevant to the RTW process for the worker (and their representative, if applicable), their supervisor, and other key workplace parties;
8. respects the workers’ privacy; and
9. includes a mechanism for internal redress if the RTW plan is not implemented as agreed to.

9.3.5.1 Other RTW requirements

The RTW plan shall:

1. be documented, agreed to and periodically reviewed by the worker and supervisor to confirm that it continues to meet the worker’s needs;
2. make an early and safe return to work a priority;
3. describe the accommodations and accommodation review process;
4. prioritize in the following order:
   1. return to the worker’s own job with or without accommodations or modified duties, and
   2. assignment to different job duties with or without accommodations, or modified duties that are consistent with the worker’s duties and skills;
5. provide meaningful work and equal pay when a different job is part of the RTW process;
6. ensure continued provision of supports and benefits needed to promote health and wellbeing;
7. require worker input and informed consent regarding how the implementation of accommodations will be communicated to those impacted by their implementation and based on a need-to-know basis; and
8. provide for an internal review if the RTW plan is not implemented as planned.

9.3.5.2 The implementation of the RTW plan requirements

The Implementation of the RTW plan shall:

1. include the supervisor, worker and, if the workplace is unionized, the worker representative;
2. support timely and coordinated access to benefits and supports (e.g., STD, LTD, EAP/EAFP), or workers’ compensation (WC) as applicable, while the worker is off work and during the transition back to optimal functioning; and
3. include a process evaluation to ensure that the RTW plan is being implemented as planned and does not preclude the worker from accessing opportunities for advancement.