Operational reintegration management (ORM): theoretical findings & experience in shaping the process
by Lena Peters & Felix Lichterfelde (1. Semester Master Psychologie – Human Performance in Sociotechnical Systems, Technische Universität Dresden)
Has your company been struggling with sick leaves and downtime over weeks and weeks? While the staff shortage itself can be stressful, so are the costs that arise with having to compensate the absent colleagues. The operational reintegration management might be your solution! The aim of this blog entry is to receive a general overview of the operational reintegration management. Therefore, we investigated and summarized the need of the ORM, demonstrated its advantages and procedure and pointed out some hurdles and problems in its process. We interviewed a specialist, who has been working for over 20 years in the content of ORM, to obtain some practical insight.
Introduction
Estimates by the German Federation of Trade Unions (Deutscher Gewerkschaftsbund; DGB) show that half a million employees lose their jobs every year due to sickness-related dismissals (especially those with chronic and long-term illnesses at an older age) (Knoche & Sochert, 2013). Once the job is lost, re-entering the workforce is a challenge that can hardly be overcome. The main reason for this is that health-impaired applicants have poorer chances of integration. This issue does not only concern the individual applicant, but represents a social and economic problem as well.
One solution for this problem is the operational reintegration management, short ORM. It is essential to note that the ORM itself does not make employees healthy, but it does bring many benefits. ORM can aid in reducing periods of incapacity to work and preventing chronic illnesses (if taken up at an early stage). Additionally, it has been shown to minimize costs for the employer, since the remaining employees no longer have to work overtime to compensate for the missing manpower and training for substitutes becomes redundant. On top of that, ORM can also increase the motivation and engagement of employees, strengthen their loyalty and attachment to the company and raise the attractiveness of working for a certain employer (Huber, 2014; Knoche & Sochert, 2013).
The process of the ORM is strictly regulated by legislation. Instead of one selective event this management should be understood as a clarification process, ending in either the reintegration of the employee or acceptance of immutability. The entire process should always be systematic and constructive. To increase a feeling of safety for all participants, the ORM should consist of a mandatory set of rules and a plan for the entire process. All information should be documented in detail and a strict data protection should be insured, transparency being a key factor for success. Keep in mind that a good structure and enough preparation mitigate the fears of the affected employees, hence leading to higher wellbeing and better health (Huber, 2014)
There is no one correct procedure for conducting an ORM. Instead, companies need to develop their own organization-specific approach. Duration, form and number of participants depend on the individual circumstances of the company and the individual goals for the affected employee. Since these factors and goals are ever changing, so is the ORM and it should be continuously developed and adapted (Huber, 2014).
The law gives the following directions on conducting an ORM: § 84 para. 2 SGB IX states the overall goals of this intervention: overcoming the incapacity to work and preventing relapse. Eligible candidates for an ORM are those who have been incapable of work for at least 6 weeks during the last 12 months. The reason for incapacity, whether or not the incapacity was interrupted, whether payment was continued, whether the affected has a medical sick leave or the affected is still incapable of working – all these factors are irrelevant. The law also states that it is the employer’s responsibility to initiate conversations around incapacity of work, therefore giving them the right to analyze data to discover eligible candidates. In addition to the employer and the person concerned, other participants of the ORM usually include Works Council and, if necessary, the severely disabled representatives, if the person concerned wishes so (Huber, 2014).
Even though there is no clear given structure, in general a few important steps can be distinguished. First of all, eligible employees need to be discovered. This is usually done by analyzing data such as absent time and the corresponding employee. This process does not require the consent of the employee. On the other hand, the employer is not allowed to receive information about the reason for the absence (employee’s right of self-determination). In a second step, the employee is informed about the goals, the procedure and the data protection during the ORM. It is crucial to let the employee know that the intervention can be canceled at any given time without any consequences for the person such as being fired. The entire ORM is always based on the concept of voluntariness and there are many personal reasons why employees might choose not to participate. The choice of the person concerned will be respected and should be noted in protocol. If the employee accepts participating in the intervention, then the next step would be a first interview. The goal of this interview is to develop specific measures, distributing responsibilities and deciding how long these measures should take. All this information will be noted in a measures plan. After developing these measures, they will be put into practice to test their effectiveness and eventually adapt them. The OMR ends if the measures prove to have achieved the set goals or if they prove that the case is immutable and reintegration impossible. In both cases this will be noted in a closure documentation (Huber, 2014).
Carrying out an OMR can be challenging. One problem is that many different institutions such as doctors, health insurance, integration offices and statutory accident insurance all work with affected employees simultaneously. This again leads to a state of confusion and to a lack of structure. Another problem is that the affected employees sometimes resist the OMR in different forms, mostly out of lack of trust and subconsciously questioning what consequences this intervention might have for them personally. The SCARF model was developed to solve this issue. It is a model that can be used in preparation of the first interview to answer the questions of the affected accurately and strengthen their trust in the process. SCARF stands for the five different types of questions the affected might ask: status, certainty, autonomy, relatedness and fairness. Status includes questions concerning the effects of the illness on the status and career of the employee. Certainty is about confidentiality and agreements being followed through with. Autonomy focuses on the employee being able to participate in the process by contributing with their own wishes and decisions. Relatedness touches on the subject of relations to other people, such as the way colleagues view the employee because of their illness and their “worthiness” as a team member. Finally, fairness concerns how others are affected by this change and whether or not the circumstances of the affected are sufficiently taken into account (Heimann, 2022).
In the following, an interview with an expert was conducted. The goal of this interview was to compare theoretical beliefs about the ORM process with its implementation in practice. Therefore, the interview questions concerned two different major aspects of this intervention: the process itself and everything it entails and the acceptance by the employees.
The interview
Our Interview-partner has been working for more than 20 years in an occupational social service of an administrative authority, which is responsible for several thousands of employees. Furthermore, she graduated a training to become a specialist in addiction prevention. Our interview contained the following questions and paraphrased answers:
Which core tasks does your job contain?
- contacting employees who have been sick for more than 6 weeks or who have become sick for several times
- offering these employees the ORM consultation
- leading through the ORM process
What options does the ORM process at your employer offer (e. g. to retain, to shorten working time)?
- One option offered by the ORM is re-training. Another possibility would be starting to work part time or simply working shorter hours, which has a very high acceptance rate. The affected employee is still able to return to working full-time again, but only after this decision is approved by the specialist office.
- If occupation can no longer be carried out, the concerned persons are able to apply for benefits for participation in working life. This is clarified via pension insurance carriers with reference to the EU pension. A prerequisite for these benefits is to have taken in part in a professional & medical rehab. This entire possibility is discussed in the counseling interview.
- In some cases, a company conducted medical examination is necessary due to the amount of restrictions. In the case that the employee can no longer continue working his or herr job, the employer must then find out what other possibilities can be found for employing the individual. If on the other hand the medical examination has a positive result, then the next step is to look into specific restrictions and whether or not it is possible to continue working the old job or if the personnel office needs to find a new job „suitable for suffering“.
How is the process of the ORM at your employer shaped?
- As required by § 167 SGB 9, employees who have been sick for more than 6 weeks receive a written letter including a prepared form for their response that must be sent back. This letter serves as a first introduction to the ORM and offers the employee a consultation. The employee then answers whether or not he/she is willing to accept this offer now, or if she/he wants to start the ORM at a later time (e.g. because of starting chemotherapy).
- The second step of this process is the appointment agreement, during which the principles and the goal of the ORM are explained in detail and possible measures are discussed. The latter are put down in the action plan. It should be noted that staff representatives (such as staff council and / or disabled representation) can be part of this process if the employee wishes so, especially if the case is difficult (e.g. searching for a new job). This decision is always voluntary and has to be offered by the employer. In the case that the employee continues to be ill for longer, then the usual procedure suggests a gradual reintegration, or an application for medical rehab. This is decided and optimized individually for each case by talking with superiors, the affected person and personnel administrators. The goal is to examine how work overload can be optimized, including the workplace and equipment.
- The third and in the ideal case final step consists in deriving measures for the individual case.
Who is involved in the ORM process?
- HR technician, HR physician, supervisor, or in the HR department responsible person, but also internal institutions (e.g. in the administration) or external institutions (e.g. addiction counseling center, tumor counseling center, professional promotion organization (recommend other occupation, depending on age, health assessment of the pension insurance institution))
What are the differences in the ORM process for physical compared to mental diseases?
- Mental diseases are increasing and this requires new individual solutions. For example, opportunities via health insurance or training organized by the employer may have relaxing effects during everyday business or individual measures.
- Furthermore, an action plan, possibilities of training e.g. exhaustion: what can be done personally? Possibilities like an individual coaching and supervision can be useful. If all these measures are not enough, maybe therapy is necessary.
- If physical deficits exist, the personnel doctor has to judge if the employee can continue to work.
Data protection: How willing are the employees to transmit/disclose their data? What do you do if the data is not disclosed? How do you deal with employees who may not want to be integrated?
- The EU General Data Protection Regulation provides an Oath of secrecy exemption if health data is collected. The advisor preserves the file and precisely discusses with the consultant which data can be shared to which authority. The EU General Data Protection defines the topics that may be part of the ORM consultation.
- The opening of an ORM process is noted in the employees personnel file (only the fact that ORM procedure has been opened, without giving details of the case). When the procedure is completed and three years have passed, this letter is removed from the personnel files.
- Most of the employees are confident with data sharing, there are only a few difficulties/negative experiences and few complaints.
- If complaints appear, there is a recall of the approval, or the file is destroyed. In this case support can no longer be given (as initially intended). A reason for that might be that employees are very unsettled about the ORM process.
Do you have problems clarifying the cost-bearer for (help)measures?
- The employer as an institution always pays for the costs and the consultation takes place during their working hours. If workers are severely disabled, the integration office pays for remodeling the workplace (if the remodeling is related to disability). If the employee is not severely disabled, we apply for the assumption of costs over the pension fund. Alternatively, we investigate, if we (as the employer) can organize certain workplace equipment (for example: desk with adjustable height). The employer is primarily responsible for the workplace equipment.
How do you prepare for the first interview?
- Look at the ORM file, investigate which department the employee comes from; look at what’s his/her job; listen carefully, especially to the problems of the employee; show comprehension at eye level; introduce the ORM process. The main task of the initial consultation is to discuss where the employer can give support, furthermore we do a mediation to other institutions
Which other problems do you have to deal with during the process of the ORM?
- There is a lot of positive feedback to the process of ORM. Sometimes the ORM process is not initiated because other measures have already been initiated, or during the acute phase of the disease, employees may not be ready for some measures suggested.
Is there an interim filling of the original job, if the original holder is sick for longer?
- Representation scheme: in the meantime, colleagues take over, normally the person taking part in the ORM process should take it over again as soon as possible.
Estimated: How many percent of the employees were reintegrated?
- 50 % of those who claimed the consultation also claim the reintegration
How often does it happen that the ORM is refused as a voluntary (help)measure?
- Rarely, because during the consultation both examine what’s important to the employee, nothing is done against the will of the person concerned.
How do the employees react to the ORM?
- Very positively.
What should be improved in general concerning the process of the ORM?
- Not much: individuality is important, so meeting individual needs, more structuring makes the advisory more difficult to find individual solutions, it’s important to have networks, listen well which needs are affected now and later (e.g. because of disease progression), building trust and motivation are important during the initial consultation
Would you like to add something to this interview?
- The ORM is a good opportunity to get back to work. Especially larger companies should have a contact person for the ORM process. During the current lack of specialists, it’s important to take care of your staff.
Summary & Implications
After conducting our expert interview, we found that the practice and our theoretical findings correspond. Unsurprisingly especially the legal framework, such as who is eligible for the ORM process or general conditions concerning data protection and the concept of voluntariness, are identical and are handled in practice as required by theory. Concerning the ORM process, a few key elements become clear. During the entire process all decisions must be transparent and most importantly voluntary. This is achieved by working together with the affected employee, giving her/him a sense of being heard and seen instead of working over their head. The trust built during these consultations lasts a work lifetime and strengthens the relationship between employer and employee. The acceptance of the ORM process is mostly affected by the trust and interaction between the employee and the person leading the ORM process, which leads to the point that the employee agrees to and is very satisfied with the ORM. The process focuses on the specific individual needs of the employees and tries to find solutions that are realistic for their life situation. Due to this fact, there are only a few cases of employees deciding to regret the employer’s offer. Concerning the costs of the ORM it is important to note that all financial responsibility lies with you, the employer. In the long term, this has shown to still be less expensive than covering for the affected employee (Huber, 2014). Our specialist once more emphasizes the importance of the ORM as a tool to help staff get back to work, so why don’t you check out ways to conduct an ORM or improve the existing ORM process in your company?
References
Heimann, E. (2022, Februar 4). Betriebliches Eingliederungsmanagement (BEM) erfolgreich gestalten: Praxis und Recht. Expertenforum Arbeitsrecht. https://efarbeitsrecht.net/betriebliches-eingliederungsmanagement-leitfaden/
Huber, A. (2014). Das Betriebliche Eingliederungsmanagement. Betriebliche Gesundheitsförderung: Das Praxishandbuch für den Mittelstand, 59-73.
Knoche, K., & Sochert, R. (2013). BEM in Deutschland: Verbreitung, Erfahrungen und Perspektiven–ein Fazit. iga. Report 24, 52.