Why Employers Need 3rd Party Adjudication of Disability

Look at the Doctor using privacy laws as a basis for fraud. One doctor even points out this is what he does every day. If you rely on a doctors note as the basis for establishing a legitimate sick day or short term disability claim here is a little window into the culture which is created. For more check this prior post and this brief excerpt from my blog in 2007.

The International Foundation of Employee Benefit Plans recently completed a survey of their membership on Salary Continuation and Short Term Disability (STD) which you can find for free here.
The survey revealed that salary continuation/STD is the black hole of employee benefit plans in terms of quantifying cost and controlling utilization.
Reasons cited for the difficulty of quantifying cost and controlling utilization and effecting changes are;
1.Union Contracts

2.Employee perception of value (Did anyone explain the probability of disability and the impact on employees of a sickness or injury which prevents work?).

3.State Mandates like CA Paid leave (Huh?)

4.FMLA Integration ( the machine is so well oiled and automated it cannot be improved?)

5.Management Buy-in (Did anyone explain the facts and costs?)


6.Entitlement (getting warmer!)

7.A lenient culture that does not enforce return to work (getting hotter!)

8.Most of the plans are payroll matters not ERISA plans (red hot, since employer cannot enforce plan terms and win an ADA challenge since payroll plans are not bonafide employee benefit plans

HIPAA ,ADA, Cho Seung-Hui & Unintended Consequences

Walter Olson has written a lucid account of the role privacy laws like HIPAA and others contributed in preventing VA Tech authorities from acting to avoid the recent shooting. It is worth two minutes of your life to read it here.

Walter Olson edits two fine blogs Overlawyered.com and PointOfLaw.com and is a senior fellow at the Manhattan Institute

File this one under unintended consequences.

In a way it is akin to all the employers trying to engage their workforce in a serious good faith wellness effort who are hindered by ADA & HIPAA and bad thoughts of the EEOC in your workplace asking "What were you thinking?" So you water down the effort to keep the lawyers and Fed's out of the benefit department. Yet the whole time you must ask whether the intent of the ADA & HIPAA was to prevent making a member conscious of what they are at risk for absent an intervention? I mean a disability is imminent from a cursory scan of a lot of pharmacy records in many cases not to mention the Health Risk Assessment right? How Ironic. The Americans With Disabilities Act actually results in more disabilities. Unintended Consequences.

I can almost picture Ronald Reagan whispering, "I Told Ya."