congress of avapes on rehabilitation and inclusion dr. jur. friedrich mehrhoff, german social...
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Congress of AVAPES on Rehabilitation and Inclusion
Dr. jur. Friedrich Mehrhoff, German Social Accident Insurance, Berlin
Sao Paulo, November 2011
“Global success factors of Return-to-work”
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 2
German Social Accident Insurance
• Back to work after work accidents and occupational diseases
• Close contact to enterprises as their members
• Liability for safety and health at work and rehabilitation
• “Rehabilitation” comprises acute treatment, medical rehabilitation and social participation.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 3
Statutory Accident Insurance in Germany
A comprehensive
service
Compensation (financial benefits, pensions)
Rehabilitation (medical treatment, vocational and
social rehabilitation)
Prevention (preventive measures)
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 4
Facts
Around 500 million people in working age are disabled worldwide (WHO-report 2010).
80% of disabilities are not inborn, but developed during life time.
Most of them become invalid, unemployed and dependant of long-term benefits.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 5
Thesis
Return-to-work strategies attract traditional vocational rehabilitation to the enterprises / employers by prevention programs close to the worksite.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 6
Vocational rehabilitationReturn-to-Work
as a global movement
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Return on Investment
The state increases the prosperity of the society that corresponds to its workforce and its working longer and harder (demographic factor).
Employers need their skilled workers fit for work on a long-term base and want to strengthen their work capacities.
Health providers are paid for supporting their clients on their way back to work. This main reason of financing a health care system must respected by physicians.
Insurers profit from investing in RTW instead of paying early and permanent compensation. 80% of the costs are paid for only 20% of the cases.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 8
Terms
InclusionRehabilitation
Disability Management
Return to
work
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 9
Return to Work (RTW)
Stakeholders
State / social partners
Disabled persons / users
Service providers /professionals
Insurers / payers
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 10
Key questions around the world
How employees with disabilities can receive comprehensive medical, vocational and social services out of one hand?
How employers can be motivated and supported in their activities by reintegrating disabled employees at the
workplaces?
How medical services can act close to the working life with the link to vocational rehabilitation and social inclusion?
How payers, which pay health services can support these challenges?
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 11
Success factors
Strategies
Case
Management
Collaboration among insurers
Acceptance by the disabled
Early Intervention
Holistic Approach
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Key elements of success
Early intervention
• No application!• Early information• Pro-active management• Close contacts to work places
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Key elements of success
• Bio-psycho-social model (ICF)• Employer’s liability • The key-role of physicians and clinics• Prevention and Rehabilitation
Holistic Approach
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 14
RTW - Chain
Activities of Services
Employability
Health and Safety
Health Promotion / Wellbeing
Disability Management
Rehabilitation
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 15
Case Management
• Paradigm-shift from Compensation to Management• Disability Manager as experts• Efficiency: 80% of the costs in 20% of cases• Individual plans correspond to CRPD
Key elements of success
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 16
Art. 26, 1 a / UN-CRPD„Habilitation and Rehabilitation“
“Services and programs begin at the earliest stage, and are based on the multidisciplinary assessment of individual needs and strengths…”
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 17
Disability Management
Employer
Consensus-based
Employee
International Labour Organisation (www.ilo.org)
NIDMAR / Canada(www.nidmar.ca)
DGUV (www.dguv.de)
Employment
contract
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 18
Global Standard in Disability Management
Qualifying experts
Disability Managementwww.disability-manager.de
www.ifdm2012.comLondon
Quality audit in enterprises
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 19
Certified Disability Management Professional
CDMP
Persuadeemployers
Networking
Legal
knowlegdeMedical aids
Evaluation
Assessment
Ethical behaviour
CaseManagement
Social competence
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 20
Qualifying experts in Germany
German Social Accident Insurancewww.dguv.de
Certification and Recertification
Canadian Initiativewww.nidmar.ca
726 Disability Managerswww.disability-manager.de
25 moduls offered by
Educational partners
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 21
CDMPWorking in enterprises
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DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 23
Audit and Certification in Germany
German Social Accident Insurancewww.dguv.de
Financial incentives by insurers
Ford Germanywww.ford.de
Standards for Service providers
Auditor in Germanywww.iqpr.de
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 24
Collaboration among insurers
• Social security branches• Federal approaches• Needs of smaller enterprises• Regional Centers of Competence
Key elements of success
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 25
Acceptance by the Disabled
UN-Convention on the Rights of People with Disabilities (CRPD) in 2008.
Codification in social and labor law by compulsory duties and incentives for RTW.
Action Plans for implementing CRPD in the society.
Key elements of success
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 26
Art. 27, CRPD „Work and Employment“
„ (1) States parties shall safeguard and promote the realization of the right to work, including for those who acquire a disability during the course of employment, by taking appropriate steps, including through
legislation, to, inter alia:
(k) Promote vocational and professional rehabilitation, job retention and return to work programmes for persons with disabilities.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 27
Conclusion: Criteria for a successful RTW
• A holistic case management which takes all needs and abilities of persons with health problems into consideration.
• A strong support from the social partners (employers and employees) make programms in RTW successful.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 28
• Actors need strategic partners for combining activities in prevention, acute treatment, medical rehabilitation, vocational and social participation.
• Employers and Insurers should qualify their staff in disability management standards and finance incentives for
comprehensive service of health providers.
• People with disabilities should be strengthened as their own case manager (participation) based on CRPD (inclusion!).
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 29
• Employers need and expect an advice-service “out of one hand” for their reintegration activities covering safety and health promotion and RTW.
• Rehabilitation International should contribute to provide global guideline and standards in RTW including structural, process and outcome criterias.
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 30
International Cooperation
•International Labour Organisation (ILO)
•International Social Security Association (ISSA)
•Rehabilitation International (RI)
•International Disability Management Standard Council (IDMSC)
DGUV, Sao Paulo, November 2011Dr: jur. Friedrich Mehrhoff Seite 31
Further Information
• www.disability-manager.de• www.ifdm2012.com• www.dguv.de• E-Mail: [email protected]• www.issa.int• www.idmsc.org• www.riglobal.org