those for other occupational illnesses or injuries. Another common risk factor facing chiropractors is physical stress caused by highly repetitive tasks that arise from ordinary arm and hand movements, such as bending, straightening, gripping, holding, or reaching. These common movements are not harmful on their own but can become hazardous based on pos- ture, frequent repetition, or the amount of force used. Although each individual action may not be particularly intense, the collective effect of many smaller traumas can result in lasting and painful damage. Examples of chronic musculo- skeletal disorders include carpal tunnel syndrome, tendonitis, thoracic outlet syndrome and tension neck syndrome. The most important aspect to a valuable disability management program is that it treats the person, not the disability. While the disorders are preventable, there are rarely outward warning signs. By the time pain appears, it is typically too late to prevent or fully eliminate the condition without treatment and/or rehabilitation and rest. Painful symptoms can lead to im- proper sleeping patterns, poor eating hab- its, depression and even substance abuse. As musculoskeletal disorders are reported very late when joint use is severely restrict- ed, prevention and/or early recognition of these disorders is pivotal. PREVENTIVE APPROACHES Chiropractors can combat physical and mental stress by creating a proper work- place layout that, among other things, decreases the overall stress of repetitive motion by implementing reasonable rest periods, work hours, and client load. Another preventive approach includes helpful resources such as Employee As- sistance Programs (EAP), which provide assistance in dealing with physical and emotional stress management, strong social networks, and support. EAPs pro- vide confi dential, short-term counselling services for those with work or life issues that affect work performance. www.canadianchiropractor.ca EAP counsellors can help improve work conditions by identifying the stress- ful aspects of work (e.g., excessive work- load) or life and designing strategies to reduce or eliminate the identified issues. For example, stress management train- ing is easy to implement and may rapidly reduce stress symptoms such as anxiety and sleep disturbances. The end result of a strategic EAP is the ability to identify and manage stressors in the workplace, encourage the adoption of healthy cop- ing behaviours, and gain access to high- quality health and wellness programs and services. DISABILITY MANAGEMENT Should an injury or illness develop, a ho- listic approach focused on return-to-work strategies is benefi cial. Effective disability management programs include a solid un- derstanding of what causes sick leave, the use of appropriate interventions, and re- spect for the interrelation of physical and mental issues – factors that support recov- ery. They should also start addressing all the individual’s needs from the first day of disability, not after the paperwork has been completed and approved. The value of this approach is that it doesn’t leave the person languishing while waiting for support. In traditional disability management, it can take four to fi ve weeks to have a case adjudicat- ed. During that time, the injured or ill individual is left without support. The emerging best practice in disability man- agement is to reach out to the individual right away. This gives the case manager an opportunity to assess co-existing issues and provide the appropriate support. For example, an employee may be on disability leave because of a back injury and simultaneously be suffering from depression. When physical and mental disabilities are identifi ed early and treat- ed in light of each other, recovery from both the physical and mental disability may be more expedient and effective. According to industry reports, 82 per cent of disability claims involve mental health issues as the primary or second- ary cause. Traditional disability manage- ment focuses on the physical. Leading- edge and effective disability management programs are able to identify and address mental health issues and provide ap- propriate treatments and interventions. Without this kind of support, employ- ees may be physically ready to return to work but, without the accompanying mental readiness, the return is often less than successful and may create a more complex problem. Should an injury or illness develop, a holistic approach focused on return-to-work strategies is beneficial. Return to work is a key component to disability management. Presumably, the goal isn’t just to have the DC feeling better, it’s to help them return to the workplace and be productive and engaged there. In a holistic program, case managers work to ensure a successful return to practice. This may include providing guidance and sup- port for addressing colleagues’ concerns or questions in a way that is respectful to the affected employee – in this case, the DC. It also includes assessing job require- ments and environment, and working to make certain accommodations if any are deemed necessary. The most important aspect to a valu- able disability management program is that it treats the person, not the disability. WHY LONG TERM DISABILITY INSURANCE? Long Term Disability (LTD) insurance is also essential for chiropractors who do not have the luxury of paid sick leave. In the event of an unforeseen illness or injury, LTD insurance may be the only thing that prevents chiropractors from losing their home, business or other hard-earned ac- quisitions. Recognizing this important fact, the Canadian Chiropractic Association (CCA) has assisted in designing a flexible and cost-competitive disability insurance benefi t for chiropractors. To learn more about LTD insurance and other programs and services avail- able under the CCA Group Benefits pro- gram, visit www.cca.hroffice.com. Chiropractors who take a proactive ap- proach to health and wellness today, posi- tion themselves strategically to be healthy, happy, productive and financially secure throughout their careers, even in the event of unforeseen illness or injury. • CANADIAN CHIROPRACTOR | OCTOBER 2009 • 9
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