Leslie, a 42-year-old middle school teacher, had been experiencing pain and stiffness in her wrists, shoulders, neck and back for a while, so it was no surprise when she told her principal, Ron, that she had been diagnosed with rheumatoid arthritis. There was a family history of it, and she said she was scared that it would progress to the point she would no longer be able to work. Ron suggested she contact the district’s HR Department for a referral for stay-at-work services through their disability insurance company and, when she did, she was contacted by a stay-at-work consultant who reviewed her medical history and completed an ergonomic evaluation. The consultant reassured her that accommodative equipment exists to help people continue working despite the limitations associated with arthritis, and she was given a custom-built ergonomic chair and an electric sit-stand workstation. She later wrote to the consultant, “I didn’t know sitting at work could be so comfortable. Wow! The headrest is a dream. I feel so supported!”¹

National Disability Employment Awareness Month

October is National Disability Employment Awareness Month, an annual celebration of people with disabilities’ contributions to the workforce. Starting in 1945, NDEAM is now administered by the Office of Disability Employment Policy, which has expanded its focus to increasing employment opportunities for people with disabilities.

Most of the attention goes to people with pre-existing disabilities and helping them join the workforce, which is an important goal. But there’s another side to this: More than 375,000 working-age Americans become totally disabled each year, with more than 1.5 million experiencing partial disability.² And even more will face a temporary disability.

We all know the value of preventive care,³ but there’s a prevention option that is frequently overlooked and almost always underutilized: stay-at-work services.

Stay-at-work services are offered under many disability insurance policies and, as is probably obvious, they’re designed to help workers remain on the job despite the limitations and restrictions associated with a disabling injury or medical condition. To be eligible, most plans require that you have active coverage under the disability policy and are currently in appropriate treatment for a diagnosed medical condition.⁴

When can stay-at-work services help?

Andy, a 56-year-old maintenance worker, went to his HR representative after his health insurance denied payment for hearing aids as not meeting the required medical necessity criteria. He reported that he had progressive hearing loss worsened by noise on the jobsite, and he was having difficulty hearing warning signals and understanding verbal instructions. The HR representative referred him to the stay-at-work program, and the stay-at-work professional coordinated the purchase of appropriate hearing aids with adjustable volume levels and noise filters. He later wrote to the consultant, “I do have my hearing aids and really like them. I wish I had gotten them sooner. Thank you for all your help!”

Employees with a condition that limits their ability to complete the essential functions of their job may be eligible for stay-at-work services. An evaluation by a disability professional can determine whether accommodations are available to help overcome the barriers the employee faces and, if there are, can recommend options to the employee and their employer.

Often, workers delay seeking this help, waiting until various treatment options proposed by their physician have been tried and have failed to completely eliminate the problems.⁵ They may not realize the benefit is available, or they may believe it’s not appropriate for their particular situation, thinking, “There’s nothing anyone can do for me.”

In reality, stay-at-work services may be available even in the earliest stages of a condition that may eventually cause a disability leave. And, with continuing advances in accommodative technology, effective adaptation options increase every year.

Data from one large stay-at-work program suggest that the most common conditions addressed in such programs include musculoskeletal disorders, accounting for 68% of referrals, followed by diseases of the nervous system (8%), diseases of the eye, ear, nose and throat (6%), behavioral health conditions (3%), and diseases of the circulatory system (2%).⁶ However, there are situations in which employees diagnosed with literally every other diagnostic category, with the sole exception of congenital and chromosomal conditions, may be appropriate for stay-at-work services.

Stay-at-work services have very high participation and success rates, and participants generally rate their satisfaction with the program highly. Across all conditions, 99.5% of workers who were referred for stay-at-work services agreed to participate, and 84.5% of those workers completed it.⁷ Participant satisfaction surveys indicated an overall satisfaction score of 92%, with 85% reporting that the program had increased their work productivity (64% strongly agreeing), and workers who had received adaptive equipment estimated that their productivity had increased by an average of approximately 54%.⁸

It’s not only the worker who benefits

A 50-year-old Inventory Specialist at a manufacturing plant, April, was referred for stay-at-work services because of tendonitis in her wrists and hands, making it difficult for her to reach and grasp items. The stay-at-work consultant made adjustments to her workspace, including repositioning her tools, and instructed her in better ergonomics. Both the employee and her supervisor thanked the consultant, and the supervisor indicated she would be sharing ergonomic information with her team to help others avoid pain and injury related to poor ergonomics.

Receiving help to stay at work is obviously a win for the employee: the benefits of work go beyond a paycheck, although that’s a central reason we all work. Work is one of the most important human activities, giving our lives a sense of meaning and purpose, offering opportunities for each of us to develop and utilize skills, while defining a role that reflects a significant dimension of our personalities and our lives. Work also provides a crucial environment for social engagement, connection, and community, as well as occupying our time and keeping us busy.

But employers benefit from stay-at-work services, too. That value isn’t always clear to them, though.

Employers generally understand the benefit of preventive services and accommodations, but they frequently overestimate the cost of accommodations, including those associated with stay-at-work services. For example, in a recent survey, a majority of HR decision makers identify cost as one of the biggest challenges with respect to ADA compliance.⁹

The reality does not support that perception: The Job Accommodation Network found that 61% of accommodations were associated with no cost, while 33% incurred a one-time expense with a median cost of $300 and the remaining 6% required ongoing expenses at a median annual cost of $2,400.¹⁰ That suggests an average annual cost of $243 per employee receiving reasonable accommodations.

The cost of disability leaves is far higher, generally representing almost one-third of an employee’s annual full-time wages on average when including the non-claim costs, especially the cost of replacement labor.¹¹ That translates into a gross return on investment of 275% for every stay-at-work referral; when the cost of the stay-at-work consultants is included, the gross ROI is 154%.¹²

Of course, Equal Employment Opportunity Commission (EEOC) complaints alleging failure to comply with ADA requirements, including potential settlement or lawsuit costs, can add significantly to the financial impact when reasonable accommodations are not provided. Those range from $60,000 to more than $285,000¹³ and generate negative publicity, especially through disability advocacy groups and social media, which can damage brand reputation and trust. Stay-at-work services can help avoid those costs.

And, again, the financial benefits for the employer are only one part of the picture: employees who participate in stay-at-work services are more productive, demonstrate better attendance, and are less likely to leave the company after receiving the support. Further, employers report that stay-at-work programs improve team relationships, morale, and customer service.¹⁴

This National Disability Employment Awareness Month, remember the people with disabilities who are already employed and the workers who develop new disabilities after being hired. Keeping them healthy and on the job through preventive services, including stay-at-work programs, can have a profound impact on both the worker and the employer.

1. Identifying information for all cases has been changed to protect the identity of the employees. Claimant quotes are taken from emails saved in the case management system and have not been changed. Case studies are for illustrative purposes only. Interventions discussed are specific to the cases presented and should not be taken as blanket recommendations/ ↩︎
2. Employer Assistance and Resource Network on Disability (No date). Statistics on Disability, https://askearn.org/page/statistics-on-disability, accessed Sept. 25, 2026. ↩︎
3. The Standard (May 1, 2026). An Employer’s Guide to Preventive Care, https://www.standard.com/ahl/news-and-insights/employers-guide-preventive-care, accessed Sept. 29, 2026. This article focuses on the benefits of insurance products that support specific preventive services. A more general discussion of prevention is available at Centers for Disease Control and Prevention (No date). Disability and Health, https://www.cdc.gov/disability-and-health/index.html, accessed Sept. 29, 2026. ↩︎
4. Other conditions may apply; check with your HR representative or review your disability insurance plan description for additional information and referral processes. ↩︎
5. Ron Boudreau, MS, CRC, CEAS (2026). Personal communication. ↩︎
6. All statistics in this article are from the combined insured and self-insured short- and long-term disability results for claims closed between Jan. 1, 2019, and Dec. 31, 2025, based on internal data developed by Standard Insurance Company. ↩︎
7. Note that a stay-at-work case is generally considered to be successful if the employee agrees to participate, does not drop out of the program before completing the stay-at-work plan and remains at work when the stay-at-work case is closed. This means that some employees who are not considered successful in the stay-at-work program may have remained at work, nonetheless. ↩︎
8. Customer satisfaction survey scores are from surveys completed and returned by a random sample of participants in the stay-at-work program between 2021 and 2025. (Earlier data are not available.) ↩︎
9. Ghouralal, S. (May 2026). ADA Accommodation Practices in U.S. Workplaces, Integrated Benefits Institute. https://www.ibiweb.org/hubfs/Resource%20Assets/Research/ADA-Leave_Report_IBI2026.pdf?hsLang=en, accessed Sept. 25, 2026. ↩︎
10. Job Accommodation Network (No date). Cost and Benefits of Accommodations, https://askjan.org/topics/costs.cfm, accessed Sept. 25, 2026. The survey was conducted between Jan. 1, 2019, and Dec. 31, 2024. ↩︎
11. Jolivet, D.N. (Aug. 26, 2026). From Invisible to Impactful: The Real Cost of Employee Absences, presentation at the 45^th Annual Employee Benefits Symposium of the International Society of Certified Employee Benefits Specialists (ISCEBS) and the International Foundation of Employee Benefit Plans (IFEBP). https://www.linkedin.com/in/dan-jolivet-phd/overlay/1790298377069/single-media-viewer?profileId=ACoAAAEPZB0BaGPBoUW0oORhSCXys9z2WkZ455E, accessed on Sept. 29, 2026. See also Jolivet, D.N. & Bonner, C. (In press). The Hidden Costs of Employee Absences: A Call for Strategic Tracking and Management, prepublication copies available on request, and Mercer/Kronos. (2008). The total financial impact of employee absences. https://www.fmlainsights.com/wp-content/uploads/sites/813/2011/09/mercer-survey-highlights1.pdf, also accessed Sept. 29, 2026. ↩︎
12. Estimated stay-at-work claim cost savings are based on the assumption that 75% of successful stay-at-work cases would have resulted in a claim without intervention, and use the IBI benchmarks for average closed STD claim costs for the industrial sector, the year the claim was closed and the primary diagnosis. IBI data are available only for calendar years 2014 through 2024, so the average costs, adjusted to reflect wage inflation, are used to estimate costs prior to 2015. These estimated savings are divided by the actual costs of the stay-at-work case to derive the return on investment estimate.
    This calculation is based on the cost of externally contracted consultants, which is higher than the cost of internal employees, so employers that manage stay-at-work services internally are likely to realize a higher ROI. ↩︎
13. TestParty (November 9, 2025). True Cost of Accessibility Non-Compliance, https://testparty.ai/blog/true-cost-accessibility-non-compliance-calculator, accessed Sept. 25, 2026 ↩︎
14. Job Accommodation Network (No date). Cost and Benefits of Accommodations, https://askjan.org/topics/costs.cfm, accessed Sept. 25, 2026. The survey was conducted between Jan. 1, 2019, and Dec. 31, 2024. ↩︎