A Better Back to Work

Disability Leave

These best practices can ensure a successful and long-term return from disability leave.

By Kristin Tugman, Ph.D.

Understanding the psychological impact of short- and long-term disability on employees can go a long way toward successfully bringing those workers back on the job. Organizations play a pivotal role in that process. While significant effort has been made to overcome the physical barriers that prevent individuals from returning to work, what is often overlooked is that disability can be as much a psychological event as it is a physical one.

Employers have an important opportunity to partner with employees on disability leave, using consistent contact and communication from the start to support a return to full-time employment. Without such support, it becomes exponentially less likely the employee will ever return. In fact, a Prudential research report, Exploring the Psychology Behind Return to Work, finds that the mindset of a person experiencing a disability plays a significant role in his or her ability to return to work in an expeditious manner. Two theoretical concepts drive the thought process of employees on disability leave:

  1. cognitive adaption, in which employees psychologically adjust to injury or illness, and
  2. cognitive appraisal, in which those employees determine if their situation is a threat to them and, if so, create coping mechanisms for dealing with the situation.

Letting employees fend for themselves psychologically during their time away from work can lead to a “disability mindset.” This can include myriad feelings, including shame or guilt at being disabled, becoming too comfortable with disability leave, and fears of failure upon returning to work. Without HR’s active engagement, including creating parity between mental health and physical illnesses, the research shows that employees on disability leave often experience denial of a mental illness, therefore failing to make the necessary effort to recover. Fear of relapse and concern over being forced to resume full responsibilities too quickly are among the other cognitive barriers that can impede the process.

The issues around returning to work will continue to grow in urgency. An aging workforce and population, the rise in obesity and chronic conditions, the increased demands of the corporate workplace and other factors are contributing to an expected 37 percent rise in disability costs over the next few years unless organizations take action.

But beyond that, creating formal return-to-work programs shows value and consideration for all employees, not only those impacted by a disabling event, but by also reducing strain on other workers covering for colleagues on leave. It also limits hiring and training costs for temporary and replacement employees.

Changing Mindsets

The reasons for disability leave can also impact its duration. Prudential’s quantitative analysis of more than 223,000 short-term disability claims and 11,000 long-term disability claims from 2011 to 2015 showed that subjective claims that often have uncertain recovery times—for conditions like depression, chronic fatigue, general pain, and fibromyalgia—are more likely to become long-term disability claims than non-subjective ones for procedures such as back surgery.

More telling, however, were results of Prudential’s qualitative analysis of interviews with a broad pool of employees that had been on disability. The results show that while financial concerns were a leading driver in returning to work, they didn’t necessarily result in a returning employee remaining at the company for a long period following the disability leave. Instead, what mattered most was:

  • whether the employer maintained a connection with them throughout the leave;
  • if there was an individual plan for that employee to transition back to work;
  • if the employer worked with the employee’s managers and co-workers to reduce the stigma of taking disability, including the tendency to feel sorry for the employee; and
  • if information on disability insurance was proactively and clearly explained.

Employees didn’t just fare better when communicating with their employer. The interviews also found that meaningful connection to co-workers was instrumental in helping that employee successfully return to work. A gesture as simple as sending a card to check in on a colleague can actually make a world of difference.

The less employees on leave worried about financial and communication concerns, the more they worked to recover and get back to normal life—one in which work plays an integral part. Regaining a sense of control and self-confidence also factored heavily into a successful return to work among employees interviewed. They viewed the process of recovery as part of resuming that control, thereby improving their self-esteem and providing an experience that could also positively impact their personal lives.

The research makes clear the value of helping employees on disability leave overcome the psychological barriers to returning to work. To that end, organizations should consider a few best practices.

  • Maintain the connection with the employee starting from the day disability leave begins.
  • Communicate realistic—yet flexible—expectations on when the employee will return to work and transition back to full responsibilities based on the individual employees’ circumstances.
  • Create a safe work environment for the returning employee by actively working to reduce the stigma of extended leave held by managers and co-workers.
  • Take care not to expect less from an employee while incrementally increasing workload—avoid pitying the employee and, as a result, making him or her feel less valued.

Companies can and should play a crucial role in helping employees on disability not just return to work faster, but also more effectively. Disability leave is a time when employees will judge whether the organization cares about their recovery and return to work. Knowing the employer truly cares is the first step on the road to recovery.


Dr. Kristin Tugman is vice president of the health and productivity analytics and consulting practice at Prudential and author of the report.

Posted September 19, 2019 in Benefitsin Engaged Workforce

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