Fit For Work Europe: Belgium Good Practice

Country good practice case study: Belgium Marc de Graaf Prevent

Disability Case Managers: Making the case for work health promotion

Prof. Marc De Greef Executive Director

Musculoskeletal disorders   

Most prevalent cause of work-related illness in Belgium Represent 40% of all working days lost Estimation of the total cost to Belgian society:  

Back disorders: Rheumatoid arthritis :

1.6 billion euro 1.2 billion euro

An early intervention is needed   

Healthy people become ill, stay away from the workplace and after some time …. Become long term benefit recipients with little chance of returning to work Return to work after a long-term of absenteeism?* • • •

•

between three and six months : < 50% more than 1 year : +/- 20% more than 2 years : +/- 10%

An early intervention affects the success rate of RTW-programmes.

*Eurofound, “Employment and disability – Back to work strategies”, 2004

Different stakeholders in RTW process General practitioner

Organizations focused on integration

Direct chief Employer

Insurance doctor

Employee

HRM Trade union representatives

Public health insurance doctor Rehabilitation

Occupational physicians Prevention advisor

Bottlenecks 







Employer and the employee are both responsible for the reintegration process No other actor is officially responsible for reintegration of the employee If an employee is motivated to return to work, he/she will play a key role when negotiating between different actors An individual employee who becomes ill has no or little knowledge about:  The legislation applying to reintegration  The network of actors and the different positions of these actors with regard to reintegration

Disability Case Manager General practitioner

Organizations focused on integration

Direct chief Employer

Insurance doctor

DCM + Employee

HRM Trade union representative

Public health insurance doctor Rehabilitation

Occupational doctor Prevention advisor

Role of the DCM  

 

The intermediary between the employer and the employee A networker, who  optimises communication with and between all legally involved actors;  contacts specialised organisations for specific actions (ergonomic adaptations, psychological assistance, … ) A coordinator and evaluator of the process of reintegration An advisor with regard to reintegration (legislation, concrete actions, …)

Skills and knowledge of DCM Workplace level: Understanding of employer, employee, legal and regulatory systems

Advisory level: Communication, networking and influencing skills

Disability Case Manager: Coach of RTW process

Clinical level: Bringing together workplace demands and functional abilities of the worker

Self-management level: Network of support, coping strategies

Multi-Dimensional Framework

Health Care System

Awareness-raising actions focusing on the advantages which come from investing in people at work are needed. Workplaces should integrate RTW in OSH; Trade Unions should recognize RTW in their strategies; RTW should require proactive action Should include Should be occupational encouraged to approaches and implement an interventions; should integrated approach of A systematic approach acknowledge OSH and the different policies. for effective, safe, prevention at the Action must be taken to sustainable RTW workplace; should play clarify responsibilities. a role in the Collection of identification of workers data needs to be who need a nudge in improved. the right direction Workers should not have financial disadvantages related to RTW; should be partner in RTW process and All dimensions must be should be supported by their workplace. part of the approach to strengthen the possibilities for a safe, sustainable RTW Personal System • Source: Based on “Moving Towards a Robust, Comprehensive Return to Work System”, Judy Geary, IFDM 2006 & “Intro_DM Introduction in DM in Belgium”, Prevent, 2008

Legislative & Insurance System

Workplace System

The first graduated DCM’s

Thank you for your attention!

Prof. Marc De Greef Executive Director