Short Term Disability Services (STD)

Administration and management of Short Term Disability (STD) absences in compliance with the company policies for non-work-related illnesses/injuries in collaboration with the customer

Services include regular and consultative communication with designated human sesources staff.

• Provide centralized intake of all leave requests and absence records in an online database
• Provide information to employees on STD absences and reporting requirements
• Perform initial eligibility determination and secure company forms required for leave programs
• Provide communication to employer of initial absence data
• Track all absences including intermittent absences
• Review job description for utilization in case management efforts
• Provide medical case management on appropriate claims:

✓Initial contact with employee including review of conditions causing the leave request, medical provider demographics, treatment plan, expected time off and case management visit schedule

✓Assessment of other medical/psychological/social factors which may be contributing to the requested time off or may interfere with recovery

✓Secure appropriate consent to communicate to providers

✓Contact health care provider to verify information, review treatment plan, care guidelines and return-to-work strategies

✓Initiate EAP/disease management referrals as appropriate

✓Initiate referral for vocational rehabilitation as appropriate

✓Coordinate treatment plan with return-to-work strategy

✓Communicate all information to employer electronically

✓Arrange independent medical exams where appropriate to provide clarity on the medical condition(s) and impact on work capacity

• Collaborate with human resources/supervisor/legal/medical director as needed to expedite an appropriate return-to-work strategy
• Coordinate with healthcare, EAP and disease management vendors to ensure proper utilization of medical management services
• Employer human resources representatives may have view-only electronic access to all case information as allowed by law

Family Medical Leave Services (FMLA)

• Provide centralized intake of all leave requests and absence records in an online database
• Provide information to employees on Family Medical Leave absences and reporting requirements
• Perform initial eligibility determination and secure company forms required for leave programs
• Provide communication to employer of initial absence data
• Track all absences including intermittent absences
• Review job description for utilization in case management efforts
• Provide medical case management on appropriate claims:

✓The case manager will assess the nature of the requested leave; if appropriate for Short Term Disability (STD), medical management may be utilized per STD guidelines.

✓If assessment indicates that non-employee medical issues are the cause of the leave, the case may be referred for medical management, EAP or other community-based social services with approval of the employer.

✓If the absence is of a non-medical nature, the case manager will consider the use of EAP or other community-based social services with approval of the employer.

• Collaborate with human resources/supervisor/legal/medical director as needed to expedite an appropriate return-to-work strategy
• Initiate recertification requests
• Employer human resources representatives may have view-only electronic access to all case information as allowed by law.