The heterogeneous impact of stricter criteria for disability insurance.

The Netherlands reformed its disability insurance (DI) scheme in 2006. Eligibility for DI became stricter, reintegration incentives became stronger, and DI benefits often became less generous. Based on administrative data on all individuals who reported sick shortly before and after the reform, difference-in-differences regressions show that the reform reduced DI receipt by 5.2 percentage points and increased labor participation and unemployment insurance (UI) receipt by 1.2 and 1.1 percentage points, respectively. It increased average monthly earnings and UI claims to overcompensate lost DI benefits. However, older individuals, women, individuals with temporary contracts, the unemployed, and low-wage earners did not compensate or compensated to a much smaller extent for the lost DI benefits. The effects are persistent during the 10 years after the reform.

Allied health workforce development for participant-led services: structures for student placements in the National Disability Insurance Scheme.

BACKGROUND: Health, disability, and community services are increasingly transitioning from government-led to participant-led funding models, which intend to increase choice and control for service users. Allied health practitioners, who provide many frontline services within the resultant marketised environment, must adjust their knowledge and skills to meet participants' expectations. However, future workforce strategies to address allied health student capabilities to provide these services have received limited attention. This study explored shifting understandings and practices related to allied health student placements during the implementation of a participant-led funding model within the Australian disability sector: the National Disability Insurance Scheme (NDIS). METHODS: Data for this study came from a two-year disability workforce project exploring allied health placements. Service providers, participants, university representatives, disability advocates and students participated in 48 interviews and two focus groups to provide perspectives on allied health workforce and student placements. The findings result from secondary deductive analysis undertaken following project completion that used Gidden's (1984) Structuration Theory as a conceptual lens to identify structures and actions related to the marketised service environment that influenced how allied health student placements were undertaken. RESULTS: The findings were organised using two Structuration concepts: knowledgeability, and duality of structure. These described how service providers, supervisors and students understood, legitimised and prioritised placement activities, and how these structures influenced and were influenced by the actions of stakeholders across NDIS settings, contexts and time. Initially, existing placement structures were not compatible with new structures emerging in the disrupted NDIS service environment. However, over time, and responding to new knowledgeability of service providers, supervisors and students, placement structures were identified, monitored and adjusted to reflect perspectives of all stakeholders. CONCLUSIONS: Participant-led funding invoked structural changes in disability service provision that transformed how stakeholders understood placements and the role of students in service provision. Whilst there were new opportunities for placement, tensions were identified in how learning activities can be enacted within a marketised system in which resources are aligned to participant needs, and structures for workforce development and learning activities are less visible. Further conceptualisation of how student learning and workforce development activities can fit with contemporary funding models is necessary to meet participant, service provider and student needs.

The experiences of people with disability and their families/carers navigating the NDIS planning process in regional, rural and remote regions of Australia: Scoping review.

BACKGROUND: Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas. METHODOLOGY: Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process. RESULTS: Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio-economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process. CONCLUSION: There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process.

Claims Procedure for Plans Providing Disability Benefits. Final rule.

This document contains a final regulation revising the claims procedure regulations under the Employee Retirement Income Security Act of 1974 (ERISA) for employee benefit plans providing disability benefits. The final rule revises and strengthens the current rules primarily by adopting certain procedural protections and safeguards for disability benefit claims that are currently applicable to claims for group health benefits pursuant to the Affordable Care Act. This rule affects plan administrators and participants and beneficiaries of plans providing disability benefits, and others who assist in the provision of these benefits, such as third-party benefits administrators and other service providers.

The Essential Types of Insurance for New Dentists.

Although these insurance options may seem overwhelming and expensive, consider the cost of not having proper coverage in place if something catastrophic happens, such as a disability or lawsuit early in your career. Being a dentist is one of the best occupations there is. The future of dentistry is bright and new dentists can make a great living with a successful career that lasts as long as they want. Part of that successful career is being sure you have the right type of coverage in place so that if something catastrophic happens the insurance company takes the risk rather than your practice, your professional reputation, or your pocket book.

Supporting carers in online role-diverse communities: A case study in Australia.

This study aims to understand the effects that role-diverse online communities have on informal carers, particularly in providing support. Australian Facebook communities used to support those involved in the National Disability Insurance Scheme (NDIS) were explored. Social network analysis of an NDIS-centred community was conducted, based on 909 publicly visible interactions that occurred in May-June and August-September 2019. Two managers of informal NDIS communities were interviewed, the transcripts of which were analysed using NVivo. Results from the two analyses suggest that both an individual carer's attributes and the collective attributes of the network defined the capability of the network to support the carer, often depending on the experiences and expertise of those offering support. Support was unconstrained by role, though differing goals and expectations often impeded collaboration between roles. The outcomes of support provision were shown to affect not only individuals but also the collective network. However, while effective, community spaces currently lack organisational backing and resources available to informal communities are constrained. Findings drawn from this study, which we believe are applicable to a broader, international context, are three-fold. Firstly, it is recommended that informal support communities clearly define purpose and create multiple channels to ensure that all participants can meet their needs. Secondly, the benefits of participation to organisations should be further explored. Finally, the use of social network analysis as a method in this study has provided significant insights into the communication patterns and activities of the community under study. Future use of SNA in similar studies may provide further insight into the effectiveness and interactions of community-based support methods.

Short-term Disability Insurance, Return to Work, and the Responsibility of the Orthopaedic Surgeon.

Millions of Americans are unable to work every day because of illness or injury. Many of these individuals have musculoskeletal issues and are under the care of an orthopaedic surgeon. Short-term disability insurance programs have been developed to address the financial burden experienced by workers who are temporarily without income. Private insurance companies and state-sponsored programs are the two most common forms. Most disability plans require verification from a physician that the worker is unable to work or is able to work in a limited capacity. Quite often, this responsibility falls on the orthopaedic surgeon. Our participation is important and substantial, yet we receive little instruction on the role that we play in this process. This article explains the history and development of short-term disability programs, describes the way they currently function in our country, and clarifies the role of the orthopaedic surgeon in the process.

How common is "parking" among Social Security Disability Insurance beneficiaries? Evidence from the 1999 change in the earnings level of substantial gainful activity.

Fewer Social Security Disability Insurance (DI) beneficiaries have their earnings suspended or terminated because of work than those who are actually working, partly because beneficiaries "park" earnings at a level below substantial gainful activity (SGA) to retain benefits. We assess the extent of parking by exploiting the 1999 change in the SGA earnings level from $500 to $700 monthly for nonblind beneficiaries using a difference-indifference analysis that compares two annual cohorts of beneficiaries who completed their trial work period, one that was affected by the SGA change and one that was not. Our impact estimates, along with results from other sources, suggest that from 0.2 to 0.4 percent of all DI beneficiaries were parked below the SGA level in the typical month from 2002 through 2006. The SGA change did not yield any difference in mean earnings, although it did result in a small reduction in months spent off of the rolls because of work.

Disability, absence and the health reform era.

The total cost of employee absence for many employers is high, and the correlation between employee health and disability is clear. This article reviews several challenges employers face in managing employee health and absence in a well-integrated manner. Although such an undertaking is not easy, the additional cost national health care reform may bring makes the interrelationship between employer profitability and employee absence, health and disability more crucial than ever for employers to recognize and manage.

Improving workplace productivity--it isn't just about reducing absence.

Employers must get more aggressive in their health and productivity strategies. A comprehensive strategy includes data analytics across health and lost-time programs, absence policies that meet today's needs for both employer and employee, health and wellness programs targeting modifiable health behaviors, and absence program administration that is aligned to operational goals. This article targets key aspects of a comprehensive long-term health and productivity strategic vision. An organization can use these aspects independently to address immediate tactical issues while it develops its broader strategy. The target areas include a view from the perspective of data management, absence program design and management, employee health and wellness, and behavioral health.

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS).

PURPOSE: The substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery requires a period of absence from work, with the majority of costs arising from the minority of workers with the longest duration absences. The objective of the Ontario Life After Workplace Injury Study is to describe the long-term health and labour market outcomes of workers disabled by work injury or illness after they are no longer receiving benefits or services from the work disability insurance authority. PARTICIPANTS: Workers disabled by a work-related injury or illness were recruited from a sample frame of disability benefit claimants with oversampling of claimants with longer benefit durations. Characteristics of workers, their employers and claimant benefits were obtained from baseline administrative data. Interviews completed at 18 months post injury (T1) and to be completed at 36 months (T2) measure return-to-work and work status; income; physical and mental health; case manager and healthcare provider interactions and employer accommodations supporting return-to-work and sociodemographic characteristics. Of eligible claimants, 40% (1132) participated in the T1 interview, with 96% consenting to participate in the T2 interview. FINDINGS TO DATE: Preliminary descriptive analyses of T1 data have been completed. The median age was 50 years and 56% were male. At 18 months following injury, 61% were employed by their at-injury employer, 16% had changed employment and 23% were not working. Past-year prescription opioid use was prevalent (34%), as was past-year cannabis use (31%). Longer duration claimants had poorer function, recovery and health and more adverse labour market outcomes. FUTURE PLANS: Multivariate analyses to identify modifiable predictors of adverse health and labour market outcomes and a follow-up survey of 96% of participants consenting to follow-up at 36 months are planned.