In many jurisdictions around the world, social security institutions are responsible for the provision of financial support and services of “last resort” to persons with disabilities. More often than not, persons with disabilities arrive at this point after having exhausted many other economic support and service avenues, enduring a lengthy and arduous eligibility process with subsequent physical, psychosocial and economic exhaustion. The consequences of this process lead to a very low outflow of beneficiaries from the social security system on a worldwide basis. The Organisation for Economic Co-operation and Development (OECD) has documented that people almost never leave the long-term disability benefit system for employment. This leaves social security institutions with only the most limited reactive, client-directed programme and policy options once social security system acceptance has been achieved by the person with a disability.
It is generally recognized that a relatively small proportion of claims will account for an overwhelming amount of overall long-term disability costs. This fact is clearly associated with the reality of significantly reduced return-to-work outcomes where time away from work exceeds six months in duration. In order to address this major challenge, social security institutions, especially employees’ compensation boards, have introduced special measures such as triaging of claims as part of their operational procedures.
In simple terms, the only viable approach for a social security institution to proactively address this fiscal and social conundrum is to influence its jurisdictional labour market environment in a manner that ensures that a person who acquires a disabling occupational or non-occupational injury or illness, placing them at risk of losing their workplace attachment (and potentially suffering from the many associated negative consequences), is maintained in economically viable and sustained employment.
Persons who have suffered an accident or disease and who are now living with a temporary or long-term disability are given the chance to return to the labour market and to contribute to the economy through return-to-work programmes. Disability is not a long-term static condition, but a dynamic process that can be changed and improved when the right measures are in place. In this regard, every social security institution should link a return-to-work programme with prevention strategies and health promotion programmes in order to assist enterprises in identifying reasons for long-term sick leave and consulting them to find solutions for better health conditions for workers at a very early stage – before compensation. Social welfare insurers, run by institutions authorized by the State, have to respect the UN-Convention of the Rights of Persons with Disabilities (CRPD). According to Article 27, Section 1k, the states that have ratified the Convention have to implement return-to-work programs that retain the employability of workers by avoiding long-term disabilities and ensuring their employment. Decision makers in social security institutions are on the right pathway if they start an initiative (action plan) in their organization to realize the efficiency of return-to-work programs and at the same time contributing to the implementation process of CRPD in their country.
Workplace-based return-to-work programmes are generally considered as the organizational structures, policies and procedures at a workplace designed to ensure that sustained workplace attachment is maintained for a person whose continued employment is jeopardized as a consequence of their having a disabling occupational or non-occupational injury or health condition.
Continued and economically viable and sustained employment for injured, ill or disabled employees ensures that, potentially, they will not enter a social security system but instead remain full economic and social contributors and participants in all aspects of society.
The consequences of losing gainful employment for persons with disabilities are highlighted by the fact that around the world persons with disabilities face disproportionately high levels of poverty, much higher levels of unemployment and under-employment, and are often marginalized in all aspects of society.