Managing for Wellness - Disability Management Handbook for Managers in the Federal Public Service

1.1  Disability Management in the Federal Public Service

Although disability management varies throughout the federal public service, it is widely considered to involve preventing and managing absence from work due to illness or injury, and minimizing the impact of impairment on the ill or injured employee's ability to participate in the workplace. A range of legislative requirements, Treasury Board policies and collective agreements dictate what can and should be done, and what benefits employees are offered (see section 2.2). How these measures and resources are deployed and administered is determined by departments. While some federal organizations have developed disability management policies and programs, the manner in which disabilities are managed differs from one department to the next.

However, in all federal organizations, successful disability management relies on two factors above all others: 1) engaged, proactive managers, and 2) a team approach. No matter how human resources (HR) services are provided in your organization or how it organizes its employee health, safety and disability management programs, if you manage people, you have specific responsibilities in the area of disability management. In order to fulfill your responsibilities, you need to know what they are (see section 3) and with whom to collaborate within your organization.

Make sure you know who in HR can help you with these responsibilities, specifically your organization's:

Occupational health and safety (OHS) advisor

to guide you in maintaining a healthy and safe workplace;

Compensation and benefits advisor

to provide guidance and information on medical certificates for sick leave, ill or injured employees' entitlements, and administrative requirements, including those related to Workers' Compensation;

Labour relations advisor

for guidance and support to help you assist employees (in smaller federal organizations, this professional may also provide advice on OHS, compensation, and benefits and accommodation);

Staffing advisor

specifically to provide expert advice on options to accommodate an employee who requires modifications to his or her current position, lateral transfers to another position and/or access to the priority administration process; and

Accommodation advisor

specifically to assist you in modifying work duties, using special working arrangements, and in procuring modified computer equipment, assistive devices, ergonomic materiel, etc.

For employees who are represented by bargaining agents, you also need to know who the union representatives are. These individuals can be very helpful in ensuring a safe and healthy workplace and in managing individual cases of employee illness or injury. Like management, unions have a legal responsibility to help ill or injured members return to work.^{Footnote 2}

Some federal departments and agencies have return-to-work coordinators (also called disability management advisors or disability case managers). If you have access to these professionals, be sure to engage them as early as possible. They can help you manage cases of extended absence from work due to illness or injury, and identify the accommodations that ill, injured or disabled employees may require to stay at work or successfully return to work. A number of federal departments also have centres of expertise on accessibility and on the duty to accommodate. Accommodation specialists in these centres can provide managers and employees with invaluable advice on modifying work and workstations. They may be able to help you access adaptive technologies and assistive devices to accommodate employees' limitations or needs, while ensuring that their capacities are being fully utilized.

1.2  Organizations to Which This Handbook Applies

This handbook is intended primarily for managers in the core public administration^{Footnote 3} organizations for which the Treasury Board is the employer. However, it may also be helpful to managers in other federal organizations across the federal public administration.^{Footnote 4}

Virtually every instrument pertaining to work-related illness or injury discussed in this handbook applies in all federal organizations. Every organization in the federal public administration is subject to the Canada Labour Code, Part II: Occupational Health and Safety, and all federal government employees are covered for workplace accidents causing injury and diseases contracted on the job under the Government Employees Compensation Act (GECA), with the exception of regular force members of the Canadian Forces and police officers and civilian members of the Royal Canadian Mounted Police (RCMP).

However, for non-work-related injury or illness, the policies, legislation, services and benefits identified in this handbook may not apply if your organization is a "separate agency" for which the Treasury Board is not the employer.^{Footnote 5} Your organization may not be subject to the Public Service Employment Act (PSEA), which affects whether your employees can participate in staffing processes open to the public service when employees cannot return to their position. Your organization may not be subject to the Public Service Superannuation Act (PSSA), in which case employees would not be entitled to PSSA disability pensions. Finally, your organization may not participate in the Disability Insurance (DI) Plan for employees and/or the Public Service Management Insurance Plan (PSMIP) providing long-term disability (LTD) coverage for executives and certain other unrepresented groups. This affects income replacement benefits for employees with non-work-related injuries or illnesses.

Colour-coded symbols are used in this handbook for managers in separate agencies to help identify what is potentially applicable in their organization. Throughout this handbook, one of four symbols (see Table 1) appears beside those benefits, services and recommended interventions specifically connected to GECA / Workers' Compensation, PSEA, PSSA and the insurance plans. Managers in all federal organizations will find items marked with the star symbol potentially useful. These items include guidance on occupational health and safety and supporting employees who experience an illness or injury as a result of an accident at work or an occupational disease. Whether the benefits, services and recommended interventions identified by the other three symbols are applicable in your organization depends on whether it falls under the PSEA or PSSA, or whether your organization participates in the DI and/or PSMIP LTD plans. In case of doubt, contact your labour relations or compensation and benefits advisor.

Table 1. Symbols Used in This Handbook

Symbol	Definition
	GECA / Workers' Compensation: Applies to employees working in federal public administration organizations, with the exception of any person who is a member of the Canadian Forces or the RCMP's regular force. In the RCMP, "regular force member" refers to police officers and civilian members.
	Public Service Employment Act (PSEA): In addition to all organizations in the core public administration identified in Schedule I of the Financial Administration Act (FAA) and most organizations in FAA Schedule IV, applies to some of the separate agencies identified in FAA Schedule V. More information on federal organizations subject to the PSEA is available at Population Affiliation Report www.tbs-sct.gc.ca/pas-srp/index-eng.asp.
	Public Service Superannuation Act (PSSA): Applies to organizations whose employees participate in the federal public service pension plan, which includes all organizations in the core public administration as well as most separate agencies in FAA Schedule V and many other federal organizations, including Crown corporations. More information is available at Population Affiliation Report www.tbs-sct.gc.ca/pas-srp/index-eng.asp.
	Disability Insurance (DI) Plan and Public Service Management Insurance Plan (PSMIP LTD): In addition to organizations in the core public administration and separate agencies, many other federal organizations that are separate employers participate in these employee benefit plans. Information on employer participants is available in the plan documents. For the DI plan document, visit Disability Insurance Plan www.tbs-sct.gc.ca/psm-fpfm/benefits-avantages/disability-invalidite/index-eng.asp. For the PSMIP plan document, visit Public Service Management Insurance Plan www.tbs-sct.gc.ca/psm-fpfm/benefits-avantages/insurance-assurance/summary-sommaire-eng.asp.

If you are a manager in an organization that belongs to the core public administration, everything in this handbook is applicable.

2.1  The Distinction Between Occupational and Non-Occupational Disability

As a concept, effective disability management does not differ depending on what caused the illness or injury. However, there are different requirements under legislation, different policies related to disability management, and different administrative schemes for the provision of disability management services and benefits, depending on whether an illness or injury is or is not directly related to work.

There are two main types of disability cases: occupational and non-occupational.

• Cases of occupational illness or injury (i.e., directly related to work) are dealt with under the Government Employees Compensation Act, which uses the provincial or territorial Workers' Compensation system to adjudicate claims and provide rehabilitation and other services as well as wage-loss benefits. With the exception of Quebec, occupational disability includes cases of psychological injury and mental stress arising from a traumatic event at work.^{Footnote 6}
• Non-occupational cases (i.e., illness, injury or medical conditions, both physical and psychological, not related to work) are dealt with pursuant to legislation, employer policies, collective agreements and arrangements established with the administrators of disability insurance plans.

With respect to the components of the disability management system, the distinction between occupational and non-occupational illness or injury makes the most difference in support for recovery. It affects the source of benefits and services available to employees with a disabling illness, injury or medical condition. In accommodation, the distinction has little impact on ill or injured employees in terms of what can and should be done to help them stay at work or to assist them in returning to work following an illness or injury. In prevention, the main difference is the requirement to thoroughly report workplace injuries or illnesses in order to make the workplace safer for all employees.

2.2  The Universe of Disability Management Instruments

Table 2 identifies the main disability management instruments in the federal public service arising from legislation, Treasury Board policies, and/or collective agreements. Certain legislative requirements (e.g., under the Canadian Human Rights Act, the Employment Equity Act and the Canada Labour Code, Part II) are further clarified in the Treasury Board's Policy on the Duty to Accommodate Persons with Disabilities in the Federal Public Service and its policy instruments on occupational safety and health. Table 2 indicates which instruments are most relevant to which components of the disability management system. In some cases, instruments can be applied in more than one of these areas—for instance, depending on the circumstances, a special working arrangement can be used to help prevent illness or injury or to accommodate an individual returning from extended sick leave.

Note that your organization may have its own policies for applying these instruments. Please check with your corporate HR services. All instruments are discussed in more detail in each of the sections of this handbook corresponding to prevention, support for recovery and accommodation.

3.1 Basic Managing Principles for Employee Health and Well-Being

As you consult this handbook for guidance in determining how to manage specific cases and for ways to support your employees' health and well-being, know that two basic principles apply.

1. Be proactive about supporting your employees in maintaining their health and well-being.
   • If employees are showing signs of mental stress or physical discomfort, ask them if they need help. At no time are you entitled to personal medical information, including diagnostic information or diagnoses. However, offering to make help available is not an invasion of privacy—you do not need to know private medical details to help employees get the assistance they need. Remind your employees that their health matters to you because, as their manager, it is your job to help them perform to their full potential. They cannot do that if they are struggling with a mental or physical health problem.
   • Become knowledgeable on topics such as work–life balance, workplace mental health risk factors and what can be done to promote and protect employee mental health. Seek out resources and services to enhance your managerial skills, knowledge and competencies for disability management. For more information, see section 4.0 of this handbook.
   • If leave is required for treatment and recovery, keep in touch with the employee. This is the most important action you can take to set the stage for a successful and timely return to work. Following an absence from work due to illness, injury or medical condition (or for any other reason), it is also good practice to hold a "return-to-work" meeting with the employee. This can be informal if the absence was only a few days. In cases of a long absence, several meetings to plan the return to work are advised.
2. Keep the health of your entire team uppermost in mind.
   • When an employee is ill or injured, his or her inability to perform the duties of the job, even temporarily, will affect the workload and thus the stress levels of the other members of your team. It is certain to do so in the event of a protracted absence from work, which could also compromise your team's ability to achieve its business goals. As a manager, you have the right to know that an employee is going to be away from work for health reasons, and you have the right to obtain an expected return-to-work date. Keeping in touch should ensure that you receive the information you need on the expected duration of the absence, helping you manage your unit's workload and avoid overstressing the rest of your team.
   • If the employee is likely to be absent for more than a week, you may need to consult with your staffing advisor to arrange for a temporary replacement. Sources of temporary talent may include corporate assignment programs, work experience programs and/or student programs. If the employee moves to sick leave without pay for an indefinite period, it is your responsibility, in consultation with your staffing advisor, to determine whether and when to take steps to recruit a permanent replacement. Note that if this occurs, you are still responsible for keeping in touch with and supporting the ill or injured employee until he or she is hired into a new position (and reports to a new manager) or ceases to be employed. For more information, see section 5.4 of this handbook.

3.2  Privacy

In Canada, under federal and provincial privacy laws, personal medical information is private, and individuals have the right to control who has access to it. As a manager, you must respect the privacy of medical information even in situations where an employee voluntarily shares this information with you. In other words, if you are made privy to any aspect of an employee's personal medical history or condition, you may not pass along this information to anyone without first requesting and receiving the employee's explicit, written permission.

In the workplace, respecting the confidentiality of medical information is essential for effective disability management. Moreover, you do not need medical information to fulfill your role to support ill or injured employees. Your role is not to diagnose illness or to adjudicate a disability claim. The word of a treating physician is sufficient to verify whether an employee is unable to work for medical reasons. You do not need to know what those medical reasons are. The insurers and/or Workers' Compensation Board will, with the employee's consent, collect the medical information required to process a claim. You do not decide whether an illness or injury is work-related. If an employee tells you that it is, treat it as if it is unless or until a Workers' Compensation Board rules otherwise. You do, however, have the right to know what functional limitations, if any, your employees have in order to fulfill the duty to accommodate and make the appropriate adjustments to enable them to remain at work if at all possible, or to return to work as soon as they are safely able to do so. 

In terms of prevention, in certain situations employees are obliged to disclose personal medical information, such as when they know they have a life-threatening medical condition that could precipitate a medical emergency at work. Employees are responsible for taking all reasonable and necessary precautions to ensure their health and safety and that of anyone else who may be affected by their work or activities. If this requires the disclosure of personal medical information, it must still be treated confidentially. Such information can be shared only with the employee's consent and only for the purposes of making necessary accommodations to ensure the employee's health and safety. If employees do not disclose information about a life-threatening condition, they cannot hold the employer liable for not responding effectively should a related emergency occur.

4.1  Background

The majority of cases of non-occupational illness or injury in the federal public service are attributable to two main causes: psychological and musculoskeletal. There is abundant evidence that these causes of illness or injury can be prevented. In the workplace, encouraging individuals with early symptoms to take remedial action is one of the most effective and least costly ways to support health and well-being. Table 3 at the end of this section provides an overview of these causes of disability, their prevalence in the public service, and some of the workplace interventions that can help prevent them. (Other significant but less prevalent causes of disability are cancer, accidents and cardiovascular illness.)

As a manager, it is important to be aware of "presenteeism," when employees come to work, but for a range of reasons (including poor health) are not working to capacity, if at all. According to experts on health and productivity, presenteeism may be a greater threat to workplace productivity than absenteeism. Some associated conditions include headaches, allergies, arthritis, asthma, diabetes, mental health issues and other pressures causing sleep deprivation, exhaustion and difficulty concentrating.

Encouraging employees to take care of themselves creates a climate that reinforces individual responsibility for maintaining health and well-being. In the core public administration, under the Directive on Leave and Special Working Arrangements, managers are responsible for ensuring that different types of leave are used appropriately. This means that you can, for example, encourage employees to use sick leave for a day or two when they are feeling unwell or to take appropriate leave with or without pay for the care of family.

Studies show that employees who adopt a healthy, balanced lifestyle and whose employers support their efforts to maintain their health are more likely to be healthy, resilient and productive. Employee assistance programs (EAPs), for example, are instrumental in assisting employees with personal or work-related issues related to stress. The key is early problem identification and referral to support.

4.2  Your Prevention Responsibilities Under the CanadaLabour Code, Part II

The purpose of Part II of the Canada Labour Code is to prevent accidents and injury to health arising out of these, linked with or occurring in the course of employment, in any workplace under federal jurisdiction. Under "Duties of Employers," it spells out what is to be done in the workplace to ensure the health and safety of employees. In tandem with the Canada Occupational Health and Safety Regulations, employers are required to adhere to regulated requirements and standards concerning, for example, building and equipment safety, exposure limits for hazardous substances, lighting and sound levels, and elimination or control of hazards in the workplace.

Under provisions outlined in Part II of the Code, managers are required to be adequately trained in health and safety and informed of their responsibilities under Part II of the Code while acting on behalf of the employer. Broadly speaking, managers' responsibilities are to ensure that:

• Appropriate hazard prevention programs are in place;
• Employees under their supervision are made aware of every known or foreseeable health and safety hazard, and each employee is provided with the information, instruction and training necessary to ensure his or her health and safety at work; and
• When incidents affecting health and safety in the workplace occur, they are investigated and reported, and corrective action is implemented and followed up on. (Consult your OHS advisor for information on your organization's accident reporting procedures.)

Employees are expected to, among other things:

• Use any safety materials, equipment, devices and clothing intended for their protection;
• Follow established health and safety procedures;
• Cooperate with those charged with carrying out health and safety responsibilities; and
• Report as soon as possible to their immediate supervisor accidents or any other incidents in the course of their work that have caused them injury or have injured others.

Under Part II of the Code, a workplace that has fewer than 20 employees must have a workplace health and safety representative. Those that have 20 or more employees must have a workplace health and safety committee, and those that have 300 or more employees must also have a health and safety policy committee. The representative and the committees have various powers and duties under the Code aimed at preventing workplace hazards and implementing changes to improve occupational health and safety. For more information, visit Improve occupational health and safety http://www.labour.gc.ca/eng/health_safety/index.shtml.

The Occupational Health and Safety Directive supplements Part II of the Canada Labour Code for the core public administration. Developed by employer representatives and the bargaining agents at the National Joint Council, the directive specifies further employer responsibilities in addition to the ones outlined in Part II of the Canada Labour Code and the Canada Occupational Health and Safety Regulations. Some of these include:

• Consulting with the workplace health and safety committee or the health and safety representative on workplace changes that may effect health and safety;
• Implementing and monitoring the hazard prevention program;
• Providing first-aid services to employees and ensuring the availability of first-aid kits;
• Making prompt referrals for medical treatment;
• Maintaining records of illness or injury in the workplace;
• Making qualified first-aid attendants available to employees during regular working hours (at least 1 per 50 employees); and
• Posting emergency contact information (e.g., hospital, fire, police and poison control).

Your departmental OHS advisor will be able to tell you what your specific responsibilities are under this directive, such as in first aid, and how to ensure that your unit meets and maintains them.

The directive also supplements provisions in the Code that require workplace health and safety representatives or committees. In the core public administration, these entities must handle complaints relating to the health and safety of employees; participate in the implementation and monitoring of the hazard prevention program in the workplace; participate in all inquiries, investigations, studies and inspections pertaining to the health and safety of employees; participate in the implementation of changes in the workplace that may affect health and safety; and inspect the workplace on a monthly basis.

Departments and agencies that have more than 300 employees must also have an occupational health and safety policy committee. Its purpose is to help develop and monitor the department or agency's overall health and safety program and to serve as a forum where management and employee representatives can meet to exchange information and address and resolve health and safety issues. 

As a manager, you can use these mechanisms to engage employees in promoting a healthy workplace. You can turn to the workplace health and safety representative or committee for advice and assistance in educating your employees on health and safety matters and to implement programs for the prevention of hazards in the workplace. The policy committee can assist in planning changes in the workplace that may affect the health and safety of employees and in improving or developing new health and safety programs.

Consult your OHS advisor to find out how these mechanisms are used in your organization to promote employee health and well-being.

4.3  Your Role in Prevention

Good management practices promote good health and well-being. Clarifying work priorities and employees' roles and responsibilities for each task to be performed is one of the best ways to prevent excessive stress in the workplace and create a climate that promotes good health. Encouraging supportive working relationships among team members and helping employees feel that their work is useful are also important ways to support well-being.

Becoming aware of safe work practices and informing your employees is critical to reducing the risk of illness or injury. Ensuring that employees have the accommodations they need, such as ergonomic chairs and keyboards, large monitors, air filters, supplementary lighting and so on, also reduces the risk of illness or injury.

One of the most important roles you have as a manager is to be attentive—look and listen for signs of emotional stress or physical discomfort in the people who report to you and respond in a timely manner. These signs are an early warning that more serious problems could be developing.

Your role is not to get personally involved or become your employees' confidante, nor is it to diagnose a problem. As a manager, your role is to create a work environment that supports employees' well-being and performance. This involves enabling employees to get help if you see signs of a possible health problem.

Communicating that you are concerned and supportive will demonstrate to employees that you care. Maintaining an "open door" policy—encouraging your employees to come to you at any time to ask about getting help—reinforces your commitment to their health and well-being. The more engaged you are in supporting your employees to take action to maintain their health, the more likely you will gain the trust and confidence of employees who require support to recover from illness or injury and return to work as soon as it is safe to do so.

Be aware of the early signs of possible mental health issues. These could include changes in personality and mood; sadness or crying, tiredness and emotional fragility; impatient, negative and disruptive behaviours; unpredictable outbursts and verbal threats; and changes in absenteeism patterns.

When you see these signs:

• Mention what behaviours you have observed and their impact in the workplace and indicate your concern. Remind the employee about your organization's EAP and what it can offer and provide the contact information.
• Monitor the situation. If you see no improvement, set a time to discuss your concerns with the employee by reviewing specific incidents, changes in behaviour, attendance or performance issues, and what assistance the employee may require.
• At the meeting, stick to the facts, but make sure you convey your concern. When you ask about what assistance the employee needs, do not ask for medical information. That is private. If the employee spontaneously provides it, treat that information as confidential. Provide the contact information for EAP again and review how they may be able to help. If applicable, suggest that the employee speak with his or her union representative, who may also be able to help with referrals to other services.
• Depending on what the employee says, review his or her workload and explore changes to his or her schedule or duties. Listen for clues about ways you could support the employee's job satisfaction.

The Canada Revenue Agency developed Mental Health: First Aid in the Workplace to help managers take appropriate action in cases of possible mental illness. Its suggestions on what to say to employees to encourage them to use the EAP are summarized in Table 4 at the end of this section.

Be aware of the early signs of possible musculoskeletal disorders. These include unnatural or unhealthy postures while using a computer and infrequent "mobility" breaks—in other words, you rarely observe the employee away from his or her desk moving around. Listen for complaints of numbness and burning sensation in the hand; pain in the wrists, forearms, elbows, neck or back; and frequent tension headaches.

When you see these signs:

• Take the time to ask whether the employee is in pain or needs a rest break.
• Encourage the employee to get away from his or her desk and take breaks more frequently.
• If you see no improvement, set a time to discuss options for modifying work duties or workload, altering the workstation, or changing the employee's work schedule, and to review the merits of an ergonomic assessment of the job, tasks or workstation.
• Encourage the employee to conduct a self-assessment using the Labour Program's ergonomics-related hazard identification tool developed by ESDC's Labour Program. Depending on the results, order an ergonomic assessment. Consult your OHS advisor about the procedures to follow in your organization for obtaining an ergonomic assessment.

ESDC's Labour Program provides a number of helpful resources to assist you in working with your employees to reduce the risk of musculoskeletal injury. These include:

• General Guide for Identifying Ergonomics-Related Hazards
• Guide for Investigating Musculoskeletal Injuries
• Guide on the Prevention of Musculoskeletal Injuries
• Guide to Address Ergonomics-Related Hazards with Computer Workstation
• Guide to Employee Education on Musculoskeletal Injuries

If an ergonomic assessment recommends modifications to tasks or workstation and/or the use of assistive technologies, you can consult Environment Canada's Accessibility, Accommodations and Adaptive Computer Technology (AAACT) Program. It provides advice and assistance, on a cost-recovery basis, to Government of Canada organizations to help integrate employees with disabilities, injuries and ergonomic requirements. (More information about this program is provided in section 6.4 of this handbook.)

4.4  Prevention Checklist for Managers

5.1  Background

The probability that employees will return to any form of employment following an absence from work for illness or injury decreases sharply the longer they are off work. Numerous studies show that after 6 months away from the job, only 50 per cent of employees will ever return to work. Even more concerning is the study behind Figure 2 which illustrates the decay curve for worker's compensation cases at a major US manufacturer: after 3 months absence, only 50 per cent of employees returned to work, after 6 months, only 20 per cent, and after 12 months, 2 per cent or less ever returned to any form of paid employment. Clearly, helping people maintain their employment can prevent needless disability.

Figure 2 - Text version

Time frame	% Return to work
3 months	50%
6 months	20%
12 months	2%

Reference: American College of Occupational & Environmental Medicine, Preventing Needless Work Disability by Helping People Stay Employed, 2005, Adaptation of Graph: Time is of the essence

The longer injured or ill employees remain away from work, the more likely they will lose their "employee identity," and with that, many of their social contacts and their sense of self-worth. Consequences for the disabled employee include social isolation, diminished economic prospects, and a higher risk of depression and suicide. Consequences for the employer are the loss of skills and experience and higher costs associated with recruiting, staffing and retraining replacements. Consequences for the economy and society as a whole are reduced workforce capacity and productivity.

5.2  Your Responsibilities in the First Days of Absence

Make sure your employees know that they must make every effort to inform you if they are unable to come to work, as early as possible on the first day of absence. If your organization does not have an established policy for absence notification, establish a procedure of your own that fits in with how your business unit operates and inform your staff. For example, tell employees to inform you first and specify how to contact you. Research shows that the most important ingredient in successful disability management is early and sustained contact by the manager. This starts on the first day of absence. 

Make it clear to your employees that there are two main reasons for prompt absence notification: leave policy and their health and safety. As a manager in the core public administration, it is your responsibility under the Directive on Leave and Special Working Arrangements to authorize and approve all absences from work, including sick leave. To use sick leave, an employee must be sick and you must authorize the absence as paid sick leave. In order to do so, at a minimum, you need to be notified as soon as possible that the employee is not at work for health reasons. If you are not sure about how to verify that leave is being used appropriately, consult your labour relations or compensation and benefits advisor.

The most important reason that employees must notify you of their absence as soon as possible is their own safety. Should an emergency occur at work, such as a fire or chemical spill, as a manager, you must be able to account for every employee you are responsible for. At the same time, as your employees' direct report, you are among a handful of people who may be expected to account for their general whereabouts. This can have life or death consequences, particularly for employees who live alone. Failing to show up for work is one of the first signs that a person could be in serious trouble. It is absolutely within your authority to know if an employee who has failed to show up for work as expected is safe, to call them, and to be in touch with their emergency contacts, if necessary, to find out.

In cases where employees have little if any accumulated sick leave and will be absent because of a serious health issue, you need to know as soon as possible. This will allow you to inform the employee of how many sick days they have banked. Consult with your labour relations or compensation and benefits advisor regarding whether to award an employee advance sick leave if he or she requests it. This should be dealt with on a case-by-case basis. (Most collective agreements and the Policy on Terms and Conditions of Employment contain provisions for the discretionary advance of sick leave. For represented employees, it is subsequently recovered through deductions from future earned sick leave credits.)

Whether you initiate the first contact or not, you must enquire as to whether an employee's illness or injury is work-related in order to report it to ESDC's Labour Program within three days. If an employee states that an illness or injury is work-related, you must report it to the Labour Program regardless of whether you agree or have yet to complete your investigation. (See section 5.3 of this handbook for more information.) Note that if you witnessed the workplace incident that caused the injury or were informed of it at the time of the occurrence, this reporting process should already be well underway.

• If the employee informs you that the illness or injury is the result of an incident or accident at work, report this immediately to the appropriate contact in your department to initiate the Government Employees Compensation Act (GECA) process for access to Workers' Compensation benefits (depending on the process your department has established, you may report this to your OHS advisor or online).
• Ensure that the employee is aware that if he or she has less than 13 weeks of accumulated sick leave credits, it is wise to apply immediately for Employment Insurance (EI) sickness benefits, and either DI or PSMIP LTD, while waiting for the provincial Workers' Compensation Board (WCB) to make a decision. Doing so will help reduce the risk that the employee will experience an interruption in income. Ensure that the employee has access to the necessary forms to apply for these benefits.

Then, you need to establish approximately how long the ill or injured employee is expected to be away from work to take steps to manage your unit's workload.

• If the employee is unable or unwilling to answer this question, ask if he or she is getting the care he or she needs, and whether he or she needs help. Remind the employee that the EAP is available at any time and provide the contact information. Suggest that the employee seek medical help if he or she has not already done so. Tell the employee that you will call back in a day or two to find out how he or she is doing and ensure that you do so. You may consider, with the employee's consent, establishing a support network of colleagues who are willing to volunteer their time (outside work hours) to make hospital visits, shop for food and so on. This can be particularly helpful when, for example, the employee lives alone and/or does not have extended family members nearby who can help. 
• Finally and most importantly, if you have any reason to suspect that an employee may be seriously injured or ill and unable to get help or to help him or herself, do not hesitate to contact his or her emergency contact person and express your concerns. In cases of severe mental illness, for example, this type of intervention can save a life.

5.3  Fulfilling Your Responsibilities Under the Government Employees Compensation Act

If an illness or injury resulting from an accident or incident in the workplace requires professional medical care, pursuant to GECA and the Treasury Board's Workers' Compensation policy, you must ensure that it is reported to your designated regional ESDC Labour Program office within three calendar days of the occurrence. In cases of an employee illness or injury that emerges some time after an accident or incident at work, but which did not require and/or receive immediate medical care at the time, or that may be an occupational disease unrelated to a specific incident, you must still ensure that it is reported within three days of your becoming aware.

To enable you to fulfill this reporting requirement, make sure your employees are aware of their responsibility to disclose work-related injuries or illnesses to you. Employees are responsible for notifying you, as their immediate supervisor, of a work-related illness or injury as soon as possible. If they seek medical help outside working hours for an injury that occurred at work, they must likewise notify you.

Note that workplace injuries that involve first aid only are not to be reported to ESDC's Labour Program. However, you must ensure that minor injuries are recorded by the employee who provided the first aid, including the date, type of injury and first aid provided. You must also ensure that these records are kept for two years.

You, your OHS advisor or, depending on the process your organization has in place, your return-to-work coordinator, disability management advisor or disability case manager, will work with the regional office of the Labour Program. This office will ensure that the compensation claim form is completed, submitted correctly and signed by you as the employee's supervisor and/or another person in charge who has first-hand knowledge of the incident. (You may also need to fill out accident investigation forms administered by your organization's OHS unit, pursuant to requirements under the Canada Labour Code for investigating and reporting hazardous occurrences. Consult your OHS advisor about your organization's investigation and reporting process.)

Once you and the employee have provided all the necessary information, the Labour Program will submit the compensation claim form to the respective WCB in the province in which the claimant is employed, triggering the process of adjudication. (Note that this may not be the province in which the employee resides. For example, claims for federal government employees in the National Capital Region who work in Ontario but reside in Quebec would be processed by the Workplace Safety and Insurance Board of Ontario. Claims for employees appointed in Canada but assigned to work outside the country are also processed by the Workplace Safety and Insurance Board of Ontario. Federal government employees in Yukon, Nunavut and the Northwest Territories are considered to be employed in the Province of Alberta and their claims are handled by the Workers' Compensation Board of Alberta.)

The WCB will investigate and determine whether the illness or injury is work-related. If the WCB determines that it is, and the employee has taken or is still on sick leave (with or without pay) as a result of the illness or injury, then he or she is eligible for injury-on-duty leave, retroactive to day one of leave connected to the illness or injury. The WCB will inform you of its decision, verifying the period of disability. You are then expected to authorize injury-on-duty leave.

Consult with your HR advisor about when the employee should apply for EI sickness benefits and either DI or PSMIP LTD, depending on which of the two insurance plans covers the employee. When to apply for these benefits will vary based on how much accumulated sick leave the employee has. As a general rule of thumb, if the employee has less than 13 weeks, which is the elimination period before a claimant may begin receiving income replacement under DI or PSMIP LTD, then he or she should apply immediately. There are two reasons to do this. First, there is no guarantee that the applicable WCB will accept the employee's claim. It may determine that the employee's illness, injury or medical condition is not work-related. If this happens, applying for EI sickness benefits and DI or PSMIP LTD helps reduce the risk that an ill or injured employee will experience an interruption in income. Second, in some situations, the income replacement benefits that the WCB provides may be less than 70 per cent of the employee's base salary. In these cases, employees may receive additional income replacement from DI or PSMIP LTD to make up the

The sooner the work-related illness or injury is reported by your department and the required paperwork is submitted by the Labour Program to the appropriate provincial WCB, the sooner the claim can be processed and rehabilitation and other services be provided to the employee. If there is a potential workplace-based reason for the illness or injury, prompt reporting also enables prompt action to ensure the safety and health of other employees, the better.

Most WCBs facilitate access to medical and rehabilitation services that can make a major difference in terms of recovery time and return to health. WCBs also provide services to support a successful return to work, including functional capacity evaluations and ergonomic evaluations. They may facilitate access to work hardening services—individualized treatment programs to mentally and physically strengthen employees for reintegration into the workplace following a long absence from work for acute care and medical treatment. In cases where an injury or occupational disease leaves the employee with a permanent disability that makes it impossible to resume former duties, some WCBs also provide vocational rehabilitation with retraining for other work.

5.4  Supporting Employees During a Prolonged Absence

In the federal public service, managers have a great deal to consider when supporting employees who are away from work for a protracted period with a serious health issue. As in all areas of management, doing this well requires leadership grounded in the values of respect and integrity, as well as professionalism, good judgment and common sense. Staying in touch with the employee is critical. However, for the duration of the absence, you will also need to manage the impact on the other people in your unit, namely on their stress levels. Remember, you are not alone. In most federal organizations, there are HR advisors who can help. In cases involving represented employees, union representatives can also provide assistance.

Following a period of recovery, which varies in every situation, you must establish whether the employee will be able to return to work in the foreseeable future, and if so, to his or her position. If the employee can return to his or her position, you will need to ensure that all necessary accommodations are identified and provided. If the employee cannot return to his or her position, you will need to establish whether another suitable position can be identified, and whether the employee's needs can potentially be accommodated in another organization. Throughout this process, you must respect the privacy of the employee, including when communicating with the employee's colleagues. (See section 6.0 of this handbook for more information on accommodation.)

To make sure you have the support you need to do the right thing at the right time, adopt a case management approach. Proactive case management helps ensure that contact is maintained and support is provided to help the employee recover and, if at all possible, return to meaningful and productive employment. As a manager, you can establish a "case management team" for the injured or ill employee. This will allow you to clearly identify who is handling what, when decisions will be required from whom in order to ensure the employee receives disability benefits and services, and how to keep track of the employee's progress. It will also ensure that you identify the employee's accommodation needs as early as possible so that accommodations are in place when he or she is ready to return to work. You are advised to include all case management contacts and related information in the case file. This must be stored securely (i.e., under lock and key) and access must be carefully monitored.

At a minimum, the members of the case management team should include the employee, you and all your HR advisors (see section 1.1), and the union representative (if applicable). Because every case is unique, your team may also involve other professionals who can help facilitate a timely return to work. These individuals may include:

• The employee's treating physician and other medical professionals, such as an occupational health evaluation specialist, to ensure that functional limitations and functional capacities or abilities are identified and cross-matched with job functional requirements to assist with accommodation and return-to-work planning;
• The WCB adjudicator or nurse case manager, or if the employee claims DI or PSMIP LTD, the insurance provider's claim manager;
• Facilities and IT experts to provide advice on logistics regarding implementing required accommodations; and/or
• A representative from your organization's corporate services branch in procurement and/or materiel management, to ensure that any required assistive devices, services or other workplace accommodations are provided in a timely manner for the employee's return to work.

Each team will differ for each case. Depending on the severity of the illness, injury or medical condition and the employee's recovery time, each case will likely involve different combinations of services and supports. Your focus should be on ensuring that every resource that can possibly support the employee in the recovery process is being fully leveraged to maximize the likelihood of a successful return to work.

5.5  When a Return to Work Is Not Possible

In some situations, when the prognosis is very poor and/or the treating physician reports permanent and severe limitations that make a return to work highly unlikely, it may be clear early on that a return to work will not be possible. As a manager, the leadership, sensitivity and compassion you exhibit in managing these cases sends a powerful message to all your employees. For individuals for whom it is clear a return to work is not possible, depending on the severity of the functional limitations caused by the illness or injury, the employee may not be in a position to discuss or review options concerning termination of employment. In this case, whoever possesses power of attorney will likely be your main point of contact.

Normally, in cases where it is highly unlikely the employee will be able to return to duty, under the Guidelines for Termination or Demotion for Unsatisfactory Performance; Termination or Demotion for Reasons Other than Breaches of Discipline or Misconduct; and Termination of Employment During Probation, a number of options for separation from the public service should be reviewed. First however, after the employee has exhausted sick leave credits, you should authorize enough sick leave without pay for the employee and/or his or her power of attorney to work with you and your team of HR advisors to make preparations for separation on medical grounds. At a minimum, your advisors should include your labour relations and compensation and benefits advisors, as well as the employee's union representative (if applicable).

The options to present to the employee are outlined in the following:

• Resignation, in which case, depending on years of service and the collective agreement, he or she may be entitled to severance pay (but would lose entitlement to health and dental benefits and, if the employee is unrepresented, some benefits provided under PSMIP);
• Termination of employment for medical incapacity, in which case he or she may be entitled to more severance pay than with resignation, particularly if the employee has fewer years of service;
• Retiring on medical grounds and applying for a disability pension under the PSSA, in which case Health Canada certifies whether the employee's condition meets the PSSA's definition of disability; or
• If the employee is aged 50 or older, applying for a retirement pension under the PSSA, potentially with a reduction because of age and/or insufficient years of pensionable service.

Each of these options will have different ramifications for the income and benefits a disabled employee receives after employment ceases. All factors, such as the employee's age, years of pensionable service, and whether he or she has been found eligible to receive Workers' Compensation, CPP/QPP disability benefits and/or income replacement benefits under DI or PSMIP LTD under the insurers' definition of "total disability," need to be considered. For example, depending on the option selected, the employee may not be eligible for continuing coverage under the Public Service Health Care Plan or Dental Plan; he or she may lose coverage under the Supplementary Death Benefit Plan, and his or her survivors may not be eligible for certain survivor benefits under the PSSA. Refer to Public service pension and benefits www.tbs-sct.gc.ca/psm-fpfm/pb-pa/index-eng.asp for helpful information on how pensions are calculated, including in cases of retirement because of www.tbs-sct.gc.ca/pubs_pol/hrpubs/pensions/psppg-corprfp-eng.asp.

You are advised to ensure that the employee (or his or her power of attorney) fully understands the implications of the termination options before a final decision is made. The goal should be to ensure that the employee and/or his or her power of attorney are provided with all the necessary information to make the best possible decision for the employee and his or her family.

6.1  Background

Employees do not need to have been absent from work for a protracted period of time for health reasons to have their work duties modified or to receive accommodations in the workplace. Appropriate and timely accommodations can prevent employee injuries and illnesses. Suggestions for how and when managers should consider taking preventive action to accommodate the needs of employees are discussed in section 4.0 of this handbook.

In cases that involve a prolonged absence from work, the goals of the accommodation component are to create a welcoming workplace for the returning employee and support a successful return to work. Reintegration into the workplace is a vital step in the recovery process following an illness or injury. In the vast majority of cases, reconnecting with work colleagues helps build self-confidence and a sense of belonging and purpose, both of which contribute to restoring and maintaining optimal health.

6.2  Duties of Accommodation

All employers in the federal public administration have a duty to accommodate. This is a legal obligation under the Canadian Human Rights Act, which has been affirmed and clarified by the courts, including the Supreme Court of Canada.

For organizations in the core public administration, the duty to accommodate is further clarified under the Treasury Board's Policy on the Duty to Accommodate Persons with Disabilities in the Federal Public Service. The Employment Equity Act, the purpose of which is to achieve equality in the workplace, reinforces the duty to accommodate. In the core public administration, it requires that the conditions of disadvantage in employment experienced by persons with disabilities be corrected to give effect to the principle that employment equity means more than treating persons in the same way; it also requires special measures and the accommodation of differences.

You may need to request an occupational health evaluation, also referred to as a Fitness to Work Evaluation (FTWE), to help identify appropriate accommodations if the information provided in a medical certificate is not sufficient. Pursuant to the Occupational Health Evaluation Standard, if the employee is absent for a lengthy period and a return date has not been established, or he or she is returning to work and you have serious concern about his or her fitness for duty, you can request an FTWE to verify whether the employee can safely return to work.

This evaluation will tell you what, if any, functional limitations the employee has that will need to be accommodated for a successful return to work. With the employee's consent, the evaluation can be conducted:

• By his or her treating physician or by an occupational health evaluation professional to whom the physician makes a referral;
• By the insurer or a Workers' Compensation Board if the employee is receiving disability benefits (in which case, it is called a functional capacity evaluation or assessment); or
• For organizations in the core public administration, by Health Canada, as an FTWE through the Public Service Health Program.

Note that Health Canada will not perform an FTWE if an employee is receiving either Disability Insurance (DI) or long-term disability (LTD) benefits under the Public Service Management Insurance Plan (PSMIP) or is on injury-on-duty leave or Workers' Compensation. In these situations, an occupational health evaluation can be arranged by the insurer or the provincial Workers' Compensation Board to assist in planning for the employee's return to work.

Ensure that the professional conducting the occupational health evaluation receives a description of the employee's day-to-day work and job duties that outlines the physical and psychological requirements of the job. Consult your occupational health and safety and/or accommodation advisor about the procedures to follow to request an evaluation (or if the employee is receiving disability benefits, a functional capacity evaluation or assessment). In federal departments and agencies that have created return-to-work coordinator or disability advisor positions, arranging for an occupational health evaluation may be a function that these professionals perform.

Note that the occupational health evaluation or FTWE report may give the employee additional information that, for reasons of privacy, will not be provided to you. This information could include the identification of previously undiagnosed conditions and recommendations for additional or alternative treatments or investigations, both of which can be of invaluable assistance in enabling the employee to maintain and improve his or her health.

As manager, ensure that all accommodation options have been explored and that you have discussed them thoroughly with the employee, his or her union representative (if applicable), and your human resources (HR) advisors. The chosen option should be consistent with the recommendations of the employee's treating physician and/or the findings of an occupational health evaluation professional. It should be the one that best meets the needs of the employee and the employer, and in situations involving co-workers, the one that is least likely to interfere with collective agreement rights. Note that should a represented employee opt not to include his or her union representative in the return-to-work and accommodation process, you must still consult that representative if the accommodation arrangement has implications for the applicable collective agreement. For more guidance on the duties of accommodation, please refer to the Canadian Human Rights Commission's A Guide for Managing the Return to Work.

6.3  Undue Hardship

Under the Canadian Human Rights Act, employers and service providers are expected to build accommodation into their policies and practices and address the needs of specific employees up to the point of undue hardship. The Canadian Human Rights Commission (CHRC) describes undue hardship as "the limit of an employer's capacity to accommodate without experiencing an unreasonable amount of difficulty."^{Footnote 9}

There is no precise legal definition for undue hardship or formula for determining when the point of undue hardship has been reached. Each situation must be evaluated individually. For an accommodation to be considered too much of a burden, section 15(2) of the Canadian Human Rights Act states that "it must be established that accommodation of the needs of an individual or a class of individuals affected would impose undue hardship on the person who would have to accommodate those needs, considering health, safety and cost."

If accommodating a person poses an undue risk to the health or safety of that person or others, an employer may be able to establish undue hardship. For most situations in the federal public administration, cost is unlikely to be a valid reason. According to the Commission, "unduly high cost" would occur when "it affects the very survival of the organization or business, or if it threatens to change its essential nature."^{Footnote 10} In most situations in the federal public administration, this threshold is unlikely to be reached.

An employee who is denied accommodation can file a grievance under the collective agreement (if represented) and/or a complaint with the Canadian Human Rights Commission. Complaints can be made in relation to any aspect of employment, including pre-employment testing, the working environment, training and promotions.

6.4  Accommodation Scenarios

While in most cases of employee illness or injury a return to work is feasible, as a manager you may be facing one of several scenarios. (See section 5.5 on what to do when return to work is not an option.) Circumstances will differ depending on whether a returning employee has any functional limitations that prevent him or her from performing his or her normal or modified job duties, and whether, over the period of absence from work, his or her position has been filled on an indeterminate basis or no longer exists.

Resources and services are available to assist you. Be sure to consult you accommodation, labour relations and staffing advisors as well as your return-to-work coordinator, disability management advisor and/or disability case manager, if your organization has this expertise.

In all cases, a return-to-work plan is strongly advised. This plan should be developed by you and the employee, with input from your HR advisors and, if applicable, the employee's labour representative, as well as his or her treating physician and/or the insurer's or WCB's adjudicator or case manager. Table 6 outlines four basic scenarios that you and the employee may face, and the actions to consider, including the return-to-work plan.

6.5  Accommodation Services and Options

Prevention

Recovery (including disability benefits)

Accommodation

Overarching

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