To All Commissioners
Re: 2017 Attendance and Disability Management Programs
Recommendation
That the report be NOTED and FILED.
Background
Absenteeism and disability management represent an onerous and costly challenge for all organizations. Success in meeting the challenge is dependent upon understanding and managing the many complexities and competing elements associated with absenteeism and disability management, including:
- workplace demographics, i.e. aging workforce, availability and extent of benefits (with respect to physical and psychological health disabilities), heightened work/family issues and increased focus and attention on individuals own mental health;
- legislative requirements associated with the duty to accommodate and the provision of leaves of absence;
- the organizational culture around disability and absence; and
- trends and factors impacting the type and nature of illness leading to absenteeism.
As set out in the following table, total average lost time for LTC employees decreased from historical averages of 18.1 per employee (2009 through to 2013) in 2014; however, in 2017, average lost time increased to more historical trends. The increased trend is attributable to overall disability claims, both compensable and non-compensable in terms of the number of claims and durations of same.
Total Absences 2017
| Year | Operations | Fleet& Facility | Admin & Mgmt | Total | ||||
| Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | |
| 2014 | 7,655 | 17.7 | 586 | 6 | 582 | 11.6 | 8,823 | 15.2 |
| 2015 | 8,238 | 18.8 | 546 | 6 | 552 | 8.8 | 9,336 | 15.7 |
| 2016 | 8,214 | 18.0 | 863 | 9 | 308 | 5.1 | 9,385 | 15.3 |
| 2017 | 9,750 | 21.1 | 717 | 7 | 593 | 9.7 | 11,061 | 17.8 |
Of note, excluding Leave of Absences (LOAs) (statutory leaves and contract provisions, whereby the employer has little to no control over), the average lost time in 2014 was 12.2 days; comparatively in 2017, the average lost time per employee 14.5 days. The increase in 2017 is directly attributable to several longer-term employee legislative leaves.
As previously noted, effective management of absenteeism and disability management require dynamic approaches, strategies, and evolving initiatives combined with the consistent application in applying same. Such ongoing initiatives include:
- developing and communicating attendance management policies and programs consistent with practical and legal realities;
- analyzing incidents and causes of disability and absenteeism, supporting effective identification and implementation of prioritized initiatives;
- effectively integrating the duty to accommodate the organization’s culture, relevant policies and programs; and
- developing a culture that encourages all parties to work cooperatively and effectively responding to the collective issues of attendance.
The following report provides a summary overview of LTC’s attendance and disability (both compensable and non-compensable) management performance, including the impact of non-attendance and the various strategies and initiatives undertaken that have and continue to mitigate the negative operational and fiscal impact associated with absenteeism.
Disability Management
Disability management encompasses both compensable sickness and injury (i.e. job related, and therefore subject to the Workplace Safety and Insurance Act) and non-compensable (subject to the terms and conditions of LTC’s wage replacement insurance program as provided under the current insurer, Desjardins Financial Services – DFS).
Disability management is an increasingly important and complex area to manage given the significant financial exposure associated with actual claims and the myriad of legislation (i.e. Workplace Safety and Insurance Act, Occupational Health and Safety Act, Ontario Human Rights Code, and the Employment Accessibility portion of the Integrated Accessibility Standards Regulation under the AODA). In addition, there are provisions in the Collective Agreement pertaining to the return to work program (RTW) which are critical to the issue of disability management.
LTC’s Return to Work Program (RTW)
As noted, a progressive Return to Work (RTW) program for both compensable and non-compensable disabilities is a key element of the disability management program. Employees who are off work are required to provide functional ability information from their attending health practitioner. This information is compared against the physical and non-physical demands of the pre-disability position. If the employee cannot be accommodated to return to his or her pre-disability position, temporary alternative work is explored. A range of value-added temporary alternative work, from interior bus cleaning, customer service work, light duty work in Fleet and Facilities and/or administrative areas is considered. Costs and progress are monitored with the objective of having the employee return to full and normal duties. The RTW program is critical in that it provides an alternative to having employees remain on income replacement benefits pending a return to full and normal duties. The program supports having employees performing productive work (vs. not working) even if it is outside the normal classification. The RTW program benefits both the employee (i.e. maintenance of earnings, connection with the workplace and positive impact on psychological health, as it is proven that the longer a person remains off work, the more difficult it is for that person to return) and the employer (i.e. completion of productive work and effective management/containment of non-attendance cost).
The RTW program is implemented in accordance with the duty to accommodate the disabled employee arising from the Ontario Human Rights Code. The program continues to evolve, as case law in this area continues to expand in terms of what is considered a reasonable and suitable accommodation for a disability, and as such managing these programs while still complying with legislative requirements can be a challenging exercise. The RTW program is defined by three component parts, namely:
- Modified Work: Is any job or bundle of tasks within an employee’s pre-disability position which he/she may perform without the risk of re-injury to themselves or others. This work may consist of regular tasks that have been changed, redesigned or physically modified. If necessary and if it can be reasonably accommodated, there may be a reduction in time or volume of work performed.
- Work Hardening: Involves tasks within an employee’s pre-disability position designed to condition the body and gradually improve strengths and tolerance, to the point where he/she can once again be considered able to perform the essential duties in his/her pre-disability position.
- Alternate Work: Involves temporary short-term alternate work which will be considered for employees who cannot perform the essential duties of their pre-disability position, or cannot be accommodated by way of modified work and/or work hardening. Alternate work that may be available on a temporary basis will not exceed a period of 12 weeks, except by approval of the General Manager, in consultation with Human Resources.
Over the last five years, there has been increased reliance on LTC’s RTW program, for both compensable and non-compensable disabilities, and it is anticipated that this trend will continue. The costs of the overall program have increased from $195,000 in 2014 to $450,000 in 2017. Of note, in 2017, there were several long-term temporary accommodations required, increasing the overall cost of LTC’s RTW program. Notwithstanding this significant increase, the RTW Program continues to be fully funded from the Commission’s Health Care Management Reserve. Contributions to the reserve come primarily from WSIB premium rebates associated with related favourable claims and cost experience much of which results from an effective RTW program. Should the annual costs of the RTW program continue to exceed the WSIB rebates, a new funding model will need to be established.
Although the annual costs have increased, there continues to be significant value in the alternate work programs and job tasks associated with same. Due to the growing demands in alternate work, in mid-2016 and again in 2017, assessments took place to broaden opportunities for reasonable, suitable and sustainable alternate work, so as to better address the demand for same and assist departments with key workload issues. As such, the alternate work program has been expanded and may include available short-term work projects such as those listed below:
- on-board surveys for service plan changes
- outreach/customer service, educating/promoting service plan changes
- auditing of the Interactive Voice Response System
- auditing of the Automatic Passenger Counts
- audit of Fanshawe students Smart Cards usage
- enhanced interior bus washing
- fare media sales in customer service at 450 Highbury
- distribution of fobs relating to the free transit for children 12 and under
- auditing of shelters, stop amenities, etc.
Non-compensable claims are managed in two ways. First administration is involved in individual claims management from the onset of the absence. All employees who are absent must provide the insurer with the appropriate medical information to be entitled to benefits and the employer with functional abilities and prognosis information. Based upon such information, claims are monitored and suitable RTW options are explored and offered as appropriate. Ongoing contact is maintained according to defined schedules with employees who are absent under the Short-Term Disability (STD) and Long-Term Disability (LTD) programs. Secondly, overall claims experience is examined holistically on an annual basis as part of the insurance renewal process. The review includes consideration of the claims’ adjudication and management process provided by the insurer. Non-compensable injuries and illness are covered by STD and LTD programs.
Short-Term Disability (STD)
The following table provides a summary analysis of the change in lost time associated with Short Term Disability (STD) over the past four years. Total average lost time for LTC employees had decreased from historical averages of 7.25 per employee (2009 to 2013) in 2014 and remained consistent through 2015 and 2016; however, 2017 saw a notable increase in lost time, which is also consistent with an increase in the number of claims filed in the same period.
2017 Short Term Disability & Employment Insurance(1) Lost Time
| Year | Operations | Fleet& Facility | Admin & Mgmt | Total | ||||
| Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | |
| 2014 | 3,075 | 7.1 | 220 | 2.2 | 167 | 3.3 | 3,462 | 6.0 |
| 2015 | 3,310 | 7.6 | 121 | 1.3 | 113 | 1.8 | 3,544 | 6.0 |
| 2016 | 3,057 | 6.7 | 479 | 4.8 | 82 | 1.4 | 3,618 | 5.9 |
| 2017 | 3,962 | 8.6 | 305 | 3.1 | 171 | 2.8 | 4,438 | 7.1 |
| (1) under the wage replacement program, employees have a period between eligibility for STD benefits and LTD benefits which they are eligible for Employment insurance sick benefits | ||||||||
Further analysis of STD claims in 2017 provides a summary of high volume and cost of main top categories for STD.
| Cause General Description | % of Total Claims | Est. Benefit Paid |
| Accident/Injury | 38% | $ 242,000 |
| Respiratory/Infectious Disease | 34% | $ 35,000 |
| Mental Disorders | 12% | $ 112,000 |
As noted, the highest volume/type of claims was in the category of “Accident/Injury”, followed by “Respiratory/Infectious Disease” and thirdly, “Mental Disorders”. The highest costs/length of claims was in the category of “Mental Disorders.
Further, 42% of total claims were less than durations of two weeks, and conversely, 13% of total claims were greater than 17 weeks. The increase in STD claims in 2017 is in part attributable to claims relating to “Respiratory/Infectious Diseases,” which were higher than previous years, and duration of these types of claims is normally less than two weeks.
LTC continues to see an increased length of STD claims, some of which are multi-faceted, thereby making successful return to work programs highly complex. As noted above, mental health disorders are considered significant in duration and are the most costly of all types of disabilities to manage.
Long-Term Disability (LTD)
The following table provides a summary analysis of the change in lost time associated with Long Term Disability (LTD) claims over the past four years. The LTD experience tends to be more volatile than other measures, given that any one case can have a very long duration and therefore directly impact LTC’s experience in terms of insurability.
2017 Long Term Disability(1) Lost Time
| Year | Operations | Fleet& Facility | Admin & Mgmt | Total | ||||||||||||||
| Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | |||||||||||
| 2014 | 997 | 2.3 | – | – | – | – | 997 | 1.7 | ||||||||||
| 2015 | 1,145 | 2.6 | – | – | – | – | 1,145 | 1.9 | ||||||||||
| 2016 | 1,283 | 2.8 | – | – | – | – | 1,283 | 2.1 | ||||||||||
| 2017 | 1,485 | 3.2 | – | – | – | – | 1,485 | 2.4 | ||||||||||
(1) Cases where COD has been approved and no likelihood of RTW are not included in above
On average, the number of approved LTD claims has been consistent over the last four years with a slight decrease in 2017. However, the duration of LTD claims has been extending, as reflected in the increase in average lost time per employee in 2017. Further analysis of LTD claims continues to indicate that the highest volume/type/length of claims was in the category of “Mental Disorders” at 33%, followed by “Accidents/Injury” at 27%.
London Transit explores all options of suitable accommodation when employees are deemed totally disabled from their pre-disability position; however, where LTD is approved, it is less likely there will be an opportunity for a temporary RTW accommodation often leading to extended LTD claims. The limited opportunity relates primarily to the nature of the disability, which precludes work in any capacity or the treatment of the disability may take several years and with an unknown prognosis.
Compensable Injuries and Illness – Workplace Safety Insurance Board
London Transit’s Health and Safety Program has a clear mandate/objective to prevent work-related injuries, illnesses and related absences. The objective is further supported by a key principle under the Strategic Outcome of “An Engaged, Diverse and Respectful Workplace” as set out in the 2015-2018 Business Plan, i.e. “creating a safe work environment and encouraging employee health and wellness”.
Notwithstanding the program and various initiatives in place, compensable injuries and illnesses do occur. It is important that such claims are promptly and properly investigated, processed and monitored. This begins with a feedback loop to the Joint Health and Safety Committees in terms of investigating and understanding the event giving rise to the injury or illness, taking preventative steps in the future, and where warranted, enlisting the assistance of London Transit’s ergonomist consultant. It also includes active management of the claim by LTC administration including liaising with the Workplace Safety Insurance Board (WSIB) and appealing approved claims that the administration feels are not compensable under the Act. London Transit utilizes the services of an outside consultant for more complex claims management and for representation when claims appeals are heard.
The following table provides a summary analysis of the change in lost time associated with compensable injuries and illnesses over the past four years.
2017 Workplace / Job Related Injuries / Illness Lost Time
| Year | Operations | Fleet& Facility | Admin & Mgmt | Total | ||||
| Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | |
| 2014 | 63 | 0.1 | 5 | 0.1 | – | – | 68 | 0.1 |
| 2015 | 165 | 0.4 | 10 | 0.1 | – | – | 175 | 0.3 |
| 2016 | 135 | 0.3 | 4 | 0.1 | – | – | 139 | 0.2 |
| 2017 | 344 | 0.7 | 11 | 0.2 | – | – | 355 | 0.6 |
The overall average lost time per employee is directly attributable to an effective Joint Health and Safety Program, a progressive RTW program and a significant investment in claims management, assessment, and prevention. For the last several years, there have been several longer-term compensable disability cases, resulting in those employees participating in the RTW program, performing alternate work on a long-term basis (considered beyond 12 weeks). In 2017, approximately 90% of RTW cases were as the result of compensable claims, thereby providing significantly less opportunity for alternate work to employees off work due to non-compensable disabilities.
WSIB Premium and Rebate Costs
The LTC is a Schedule II employer and as such, the annual WSIB premiums are performance-based. Premium rates are set annually by industry sector and at the end of the year (based on the WSIB’s September to September calendar) employers are retrospectively either surcharged for poor performance or rebated for favourable performance (referred to as the Board’s NEER program). Since 2003, London Transit has received an annual rebate as the result of favourable performance, which has been used to fund the RTW program. The rebate is applied to LTC’s Health Care Management Reserve, which is utilized to fund RTW program initiatives or any surcharge should LTC have a negative WSIB claims/cost experience in a given year. The following table provides a summary of WSIB cost net of NEER performance rebates for the years 2014 through to 2017, noting that the 2017 WSIB assessment is an estimate and not finalized until September 2018.
WSIB Premium and Rebate Costs (000’s omitted)
| Year | Gross WSIB Premiums | Premium Rebate (NEER) | Net WSIB Cost | RTW Program Direct Cost |
| 2014 | $ 1,572,946 | $ (371,378) | $ 1,201,568 | $ 195,000 |
| 2015 | $ 1,636,471 | $ (344,971) | $ 1,291,500 | $ 247,000 |
| 2016 | $ 1,711,610 | $ (384,152) | $ 1,327,458 | $ 360,000 |
| 2017 | $ 1,870,487 | $ (100,000) | $ 1,770,487 | $ 450,000 |
Leave of Absences (LOA) per Statute and/or Employment/Agreements
As noted in the following table, absences due to leaves, which can be paid such as bereavement or unpaid such as pregnancy and parental, and which the employer has little or no control over, have declined marginally over the past four years. Such absences are considered statutory (legislative) in nature or provided by contract. Per Bill 148 and the implemented provisions of the Bill, it is anticipated that in 2018, that lost time per average employee will increase by a minimum of 1 day per employee.
Leaves of Absence – per Statute and/or Employment Contract/Agreement
| Year | Operations | Fleet& Facility | Admin & Mgmt | Total | ||||
| Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | |
| 2014 | 1,402 | 3.2 | 222 | 2.3 | 137 | 2.7 | 1,761 | 3.0 |
| 2015 | 1,073 | 2.4 | 269 | 2.9 | 35 | 0.6 | 1,377 | 2.3 |
| 2016 | 1,396 | 3.1 | 210 | 2.1 | 89 | 1.5 | 1,695 | 2.8 |
| 2017 | 1,559 | 3.4 | 238 | 2.4 | 271 | 4.4 | 2,069 | 3.3 |
Other Lost Time
Non-attendance captioned as other lost time (no disability benefits are payable) has remained relatively consistent since 2013. Non-attendance in this category covers such cases as one day illness and/or sporadic illnesses, the elimination period prior to a short-term disability claim, non-job related injury, book-off personal, absence without leave, late to work and non-compensable days in which approval for an STD/LTD claim is either pending/denied/withdrawn/no further action. Absences in this category may not be paid; however, like other absences, they do have a negative impact on the organization’s ability to provide service.
Most of these types of absences are managed through London Transit’s Attendance Management Program (AMP) as “monitored absences”, separate and apart from the disability management process noted earlier. The AMP establishes attendance standards and employees who fail to meet the standards in a given year progress within the program. Standards apply to both the number of days or part days missed in this category of absence, as well as the number of occurrences (the latter being defined as the number of instances of absence, with a continuous absence treated as one occurrence). Throughout the process, the emphasis of the AMP is on assisting employees to deal with underlying causes of non-attendance and encouraging more regular attendance. The program has proven effective in identifying those employees who require assistance in dealing with factors affecting attendance and has resulted in many success stories where individual attendance has improved. In cases where the non-attendance is attributable to an identified underlying medical condition such that it meets the definition of disability, the employee’s attendance is managed by the Human Resources department due to confidentiality. In addition, “culpable” or blameworthy absences are dealt with through a progressive discipline approach and not the Attendance Management Program.
Other Lost Time – No STD, LTD or WSIB Benefit Payable
| Year | Operations | Fleet& Facility | Admin & Mgmt | Total | ||||
| Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | Total Days | Avg. Per Employee | |
| 2014 | 2,118 | 4.9 | 139 | 1.4 | 278 | 5.6 | 2,535 | 4.4 |
| 2015 | 2,545 | 5.8 | 146 | 1.6 | 404 | 6.4 | 3,095 | 5.2 |
| 2016 | 2,343 | 5.1 | 170 | 1.7 | 137 | 2.3 | 2,650 | 4.3 |
| 2017 | 2,400 | 5.2 | 163 | 1.7 | 152 | 2.5 | 2,715 | 4.4 |
Psychological Wellness
As noted in previous reports, London Transit recognizes that psychological wellness continues to have a significant and direct impact on overall attendance, in terms of sporadic lost time days, non-compensable STD claims, duration of same, presenteeism (attending work, but the mind is elsewhere) and WSIB claims. As noted in Staff Report #1, January 31, 2018, the parties completed key initiatives in the 2017 Mental Health Workplan and have developed a comprehensive Workplan for 2018.
The Cost of Non-Attendance
The cost of absenteeism is generally defined from three perspectives:
- productivity cost, i.e. impact on available productive hours, workload allocation issues and related opportunity costs addressing the allocation issues;
- administrative cost relating to staff time managing absences and the impacts of same; and
- financial costs relating to increased complement requirements, overtime costs and impact on employee benefit costs.
The annual cost associated with non-attendance, considering the above, ranges between $1.9 million and $2.3 million. The estimated cost accounts for approximately 5% of the $46.6 million in annual personnel expenditure, which includes all earnings and employee benefit costs. Personnel costs account for 63% of the $73.4 million total operating budget for conventional and specialized services.
As an average, approximately 80% of all non-attendance is managed via the hiring of additional staff, with the balance being replaced at overtime or not replaced at all. The need to replace the time defines the nature of public transit, i.e. providing a scheduled service to customers noting the majority of employees are Operators whose responsibility is to deliver on-road service. The decision to replace non-attendance with the hiring of additional staff or replace at overtime is predicated upon an assessment of key inputs, namely:
- the nature and extent of service requirements, which are variable by time of day, day of week and time of year;
- the number, timing and duration of periods of absences;
- the impact on efforts and capacity to fill work assignments;
- efficiency considered work rules/requirements – cost of hiring/employing replacement staff vs. applying overtime;
- the impact of legislative changes, (i.e. Bill 148), and
- the impact on the quality of work life.
A complement assessment is undertaken on an annual basis in effort to determine the appropriate Operator complement to ensure service requirements can be met while at the same time mitigating the extent of the need for personnel to be available to fill shifts for same day absences.
Conclusion
As outlined in the report, LTC has clearly defined processes for managing all facets of non-attendance and while the programs are structured, they are also dynamic in nature. Notwithstanding the various attendance and disability management program elements in place and past success with the program, London Transit is and will continue to be challenged with ongoing claims experience. The various elements of the program are the subject of ongoing review and adjustment as necessary.
Julie Hall – Manager of Human Resources
Joanne Galloway – Director of Human Resources
Concurred by:
Kelly S. Paleczny – General Manager