title: Return to work and claim duration for workers with long-term mental disabilities: impacts of mental health coverage, fringe benefits, and disability management.
abstract: This paper examines the relationship of mental health benefits provided by 116 employers, to return to work and duration of disability claims for 407 of their employees who were on long-term disability (LTD) leave for mental disorders. Mental health benefits data were coded from summary plan description booklets provided by employers. Information on other fringe benefits and employers' disability management practices were obtained from a survey of the employers. Relationships between mental health benefit features, other fringe benefit and disability management factors, and our outcomes were estimated via logistic regression and survival analysis. Results indicated that three mental health benefit plan features were negatively related to the return-to-work probability:(1) a high deductible (> $600), (2) longer preexisting condition exclusion periods, and (3) having a carve-out. This suggests that cost saved by access restrictions may be partially offset by higher turnover costs for employees with disabilities due to mental disorders. Carve-outs were also predictive of shorter claims duration.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University, Hampton House Room 429, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, Maryland, USA. salkever@jhu.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Salkever
authors.forename: Judith A
authors.initials: JA
authors.lastname: Shinogle
authors.forename: Howard
authors.initials: H
authors.lastname: Goldman
mesh_terms: D005260:Female; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D006801:Humans; D007345:Insurance Claim Review; D019458:Insurance Coverage; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology*; D008962:Models, Theoretical; D012051:Reimbursement Mechanisms; D012456:Salaries and Fringe Benefits; D014481:United States; D014942:Workers' Compensation