Cancer Rehabilitation; the role claims managers play
22 August 2018 | In The News
We have all been touched by cancer at some stage in our lives. The expectation is that 1 in 2 people in the UK will get a cancer diagnosis in their lifetime and for those born after 1960 their lifetime risk of developing cancer is now greater than 50%1. Cancer has a detrimental effect on the lives of those affected and their loved ones. Life after cancer is challenging, everything has changed, so how do cancer survivors rebuild their lives after? How does a diagnosis of cancer effect work and the return to work?
According to Macmillan Cancer Support UK, it is estimated that almost 120,000 people of working age (age 16-65), are diagnosed with cancer every year. Currently 1 in 3 people living with cancer (around 890,000) are of working age and this is expected to rise to 1,150,000 by 20302.
Impact on ability to work
Some common medical barriers to a successful return to work include;
- Recovery after surgery
- Risk of infection
- Skin rashes
Returning to work can provide cancer survivors with some normality and control over their lives. However those returning to work can face many difficulties, balancing work and the demands of their treatment, facing their colleagues and employer.
Cancer patients will have different needs at each stage of their treatment. Activities that healthy individuals take for granted in their daily lives such as, moving around freely, eating and drinking, or talking, can become a challenge. This can lead to a reassessment of their life goals and working life.
Rehabilitation and adjustments in the workplace
We all like to do a good job at work, it makes us feel valued. For cancer patients this can be the first step back into normality and control. It is important to provide the support and encouragement for cancer patients to return to work when possible, this plays a key role in any rehabilitation programme.
Legally it is not necessary for health professionals to be experts in vocational rehabilitation and employment law, but they should be able to guide and enable patients to think positively about work.
One way a successful return to work can be achieved is through following the Macmillan Cancer Support 5 R’s framework;
- Raise work issues with patients early – (early attention to work and early contact with employers can reduce work disability duration).
- Recognise the risk factors for poor work outcomes - (e.g. communication and relationship between patient and employer; any financial concerns; job flexibility or impending change).
- Respond effectively to straightforward work problems that patients identify - (via offering advice directly or referring to specialist employment support).
- Refer patients who have more complex difficulties to appropriate specialist services.
- Revisit work issues at intervals during treatment
What does cancer rehabilitation look like?
Cancer rehabilitation (rehab) is the term used for services delivered by medical specialists and Allied Health Professionals (AHPs) in oncology and palliative care. However it is no longer just about rehabilitation after treatment, it should include supporting people to live with the impact of cancer and the adjustments they need to make from early on in their treatment.
Rehabilitation helps people regain some independence and normality in their lives. Physical exercise alone is not enough, psychological and social treatments are just as important.
Under the Equality Act 2010, in England, Scotland and Wales or the Disability Discrimination Act 1995 (DDA) in Northern Ireland, it is unlawful for an employer to discriminate against any person as a result of their disability.
It is perhaps less commonly known that in terms of the law, a diagnosis of cancer would be considered to be a disability. Therefore any person who receives a diagnosis, or those that have had a diagnosis of cancer in the past, would be protected by law from any unfair treatment at work.
The Equality Act (or DDA) applies as soon as a person is diagnosed with cancer and all patients diagnosed with cancer of any type are automatically covered. Even if they have had cancer in the past, which has been successfully treated and is now in remission, they will still be covered by this legislation and this protection applies for the life of the affected individual.
Therefore every employer has a duty to try to help and support any employee that has received a cancer diagnosis and where reasonable, make adjustments to allow the employee to continue to do their job during and after any cancer treatment.
Discrimination in the workplace can include a range of things, such as:
- Not making any reasonable changes to allow an employee to carry out their job (e.g. to cope with fatigue)
- Giving warnings for having a lot of time off sick, without taking the cancer diagnosis into account
- Suggesting that it would be better if the employee retired or stopped working
- Dismissing the employee for a reason related to cancer
- Demoting the employee to a lower-paid or less demanding job for a reason related to cancer
- Making it difficult for the employee to get any sick pay that they may be entitled to
- Harassment – when an employer or colleague bullies, intimidates, insults or makes the employee feel uncomfortable (e.g. being teased about hair loss).
Disability claims assessors and case managers play a key role in ensuring close collaboration between all stakeholders takes place. Access to clinical experts who can offer vital rehabilitation support both to group & individual income protection claimants with a cancer diagnosis could also make a huge difference.
It is not only the claims assessors’ role to manage the claims process for claimants, they should also be in a position to provide practical advice and emotional support at a time when it is needed most.
This could range from additional funding for counselling; pain management; building confidence and strengthening personal skills; as well as working closely with the employer to help make reasonable adjustments that will support an eventual return to work.
With the rising number of cancer survivors, effective interventions are critical to enable a successful return to work and to reduce the costs to individuals and society at large.
Communication is key to developing and implementing efficient strategies. Close collaboration between all the relevant stakeholders (HR, the employee as well as the members of the patients cancer healthcare team), and the insurer is essential for facilitating any return to work programmes.
The employer having a positive policy and attitude towards workers with a serious illness returning to work is vital. The claims assessor can be instrumental in ensuring the relationship between employer and employee remains open and that returning to work is one less thing for patients to worry about.