1. Social Security Organisation of Malaysia Return-to-Work and Disability Management under the auspices of the Social Security Organisation, Malaysia – applying the UN Disability Convention DR. MOHAMMED AZMAN BIN AZIZ MOHAMMED Deputy Chief Executive Officer SOCIAL SECURITY ORGANIZATION MALAYSIA (SOCSO) drazman@perkeso.gov.my 21-22 June 2011 Stellenbosch, South Africa 1

2. Social Security Organisation of Malaysia 2 Overview on SOCSO UNCRPD SOCSO’s RTW Program – Chronology – Concept – Legal Mandate Impact? Conclusion Scope of Presentation

3. Social Security Organisation of Malaysia

4. Malaysia Capital: Kuala Lumpur Land Area: 329,845sqm Population: 28million (approx.) Workforce: 12.7million (Unemployment: 3%) Climate: Tropical (avrg. 33 degrees Celsius), Rain and shine all year round. Social Security Organisation of Malaysia

5. Overview of the Social Security Organisation, Malaysia (SOCSO)

6. Social Security Organisation of Malaysia Statutory Organisation governing Employment Injury Insurance Scheme & Invalidity Pension Scheme in Malaysia. protection CORPORATE GOAL - To provide comprehensive social security protection for Malaysians. to promote occupational health and safety CORPORATE OBJECTIVE - To ensure and guarantee the timely and adequate provision of benefits in a socially just manner and to promote occupational health and safety. SOCSO

7. Social Security Organisation of Malaysia Currently insuring 13.2 million workers & 727,744 employers (All workers with income of RM3000 (≈ US$10 00) and below). Contribution of 2.25% of the average salary (1.25% Employment Injury Scheme – Funded by Employer & 1% for Invalidity Pension scheme – Equally Shared by Employer & Employee) Manage over 78,000 Claims/per year Over 55,000 accidents Over 13,000 permanently disabled Over 10,000 Claiming for invalidity (≈3000 certified invalid) SOCSO

8. Social Security Organisation of Malaysia UN Convention on the Rights of Persons with Disabilities (UNCRPD)

9. Social Security Organisation of Malaysia Adopted on 13 Dec 2006 at UN HQ, New York Opened for signature on 30 March 2007 Entered into force 3 May 2008 149 signatories and 103 ratifications to the Convention Malaysia signed on 8 April 2008 and ratified on 19 July 2010 South Africa signed 30 March 2007 and ratified on 30 November 2007 UNCRPD

10. Social Security Organisation of Malaysia

11. Article 26 - Habilitation and rehabilitation Article 27 - Work and employment UNCRPD

12. Social Security Organisation of Malaysia 1. States Parties shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life. To that end, States Parties shall organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes, particularly in the areas of health, employment, education and social services, in such a way that these services and programmes: a) Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths; b) Support participation and inclusion in the community and all aspects of society, are voluntary, and are available to persons with disabilities as close as possible to their own communities, including in rural areas. 2. States Parties shall promote the development of initial and continuing training for professionals and staff working in habilitation and rehabilitation services. 3. States Parties shall promote the availability, knowledge and use of assistive devices and technologies, designed for persons with disabilities, as they relate to habilitation and rehabilitation. Article 26 - Habilitation and rehabilitation 1. States Parties shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life. To that end, States Parties shall organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes, particularly in the areas of health, employment, education and social services, in such a way that these services and programmes: a) Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths; b) Support participation and inclusion in the community and all aspects of society, are voluntary, and are available to persons with disabilities as close as possible to their own communities, including in rural areas. 2. States Parties shall promote the development of initial and continuing training for professionals and staff working in habilitation and rehabilitation services. 3. States Parties shall promote the availability, knowledge and use of assistive devices and technologies, designed for persons with disabilities, as they relate to habilitation and rehabilitation.

13. Social Security Organisation of Malaysia 1. States Parties recognize the right of persons with disabilities to work, on an equal basis with others; this includes the right to the opportunity to gain a living by work freely chosen or accepted in a labour market and work environment that is open, inclusive and accessible to persons with disabilities. States Parties shall safeguard and promote the realization of the right to work, including for those who acquire a disability during the course of employment, by taking appropriate steps, including through legislation, to, inter alia: a) Prohibit discrimination on the basis of disability with regard to all matters concerning all forms of employment, including conditions of recruitment, hiring and employment, continuance of employment, career advancement and safe and healthy working conditions; b) Protect the rights of persons with disabilities, on an equal basis with others, to just and favourable conditions of work, including equal opportunities and equal remuneration for work of equal value, safe and healthy working conditions, including protection from harassment, and the redress of grievances; Article 27 – Work and Employment (1) 1. States Parties recognize the right of persons with disabilities to work, on an equal basis with others; this includes the right to the opportunity to gain a living by work freely chosen or accepted in a labour market and work environment that is open, inclusive and accessible to persons with disabilities. States Parties shall safeguard and promote the realization of the right to work, including for those who acquire a disability during the course of employment, by taking appropriate steps, including through legislation, to, inter alia: a) Prohibit discrimination on the basis of disability with regard to all matters concerning all forms of employment, including conditions of recruitment, hiring and employment, continuance of employment, career advancement and safe and healthy working conditions; b) Protect the rights of persons with disabilities, on an equal basis with others, to just and favourable conditions of work, including equal opportunities and equal remuneration for work of equal value, safe and healthy working conditions, including protection from harassment, and the redress of grievances;

14. Social Security Organisation of Malaysia c) Ensure that persons with disabilities are able to exercise their labour and trade union rights on an equal basis with others; d) Enable persons with disabilities to have effective access to general technical and vocational guidance programmes, placement services and vocational and continuing training; e) Promote employment opportunities and career advancement for persons with disabilities in the labour market, as well as assistance in finding, obtaining, maintaining and returning to employment; f) Promote opportunities for self-employment, entrepreneurship, the development of cooperatives and starting one's own business; g) Employ persons with disabilities in the public sector; Article 27 – Work and Employment (2) c) Ensure that persons with disabilities are able to exercise their labour and trade union rights on an equal basis with others; d) Enable persons with disabilities to have effective access to general technical and vocational guidance programmes, placement services and vocational and continuing training; e) Promote employment opportunities and career advancement for persons with disabilities in the labour market, as well as assistance in finding, obtaining, maintaining and returning to employment; f) Promote opportunities for self-employment, entrepreneurship, the development of cooperatives and starting one's own business; g) Employ persons with disabilities in the public sector;

15. Social Security Organisation of Malaysia h) Promote the employment of persons with disabilities in the private sector through appropriate policies and measures, which may include affirmative action programmes, incentives and other measures; i) Ensure that reasonable accommodation is provided to persons with disabilities in the workplace; j) Promote the acquisition by persons with disabilities of work experience in the open labour market; k) Promote vocational and professional rehabilitation, job retention and return-to-work programmes for persons with disabilities. Article 27 – Work and Employment (3) h) Promote the employment of persons with disabilities in the private sector through appropriate policies and measures, which may include affirmative action programmes, incentives and other measures; i) Ensure that reasonable accommodation is provided to persons with disabilities in the workplace; j) Promote the acquisition by persons with disabilities of work experience in the open labour market; k) Promote vocational and professional rehabilitation, job retention and return-to-work programmes for persons with disabilities.

16. Social Security Organisation of Malaysia SOCSO’s Return to Work Program

17. Social Security Organisation of Malaysia Chronology Introduction of the RTW Program. Appointed Service Providers with biopsychosocial rehabilitation approach. Focus on Physical Rehabilitation Introduction of 5 Disability Case Managers (Pilot) under the Medical & Rehab Department of SOCSO Covering 2 States 1 st RTW Conference Additional of another 5 Disability Case Managers (10 Case Managers) Establishment of a Job Placement Unit Covers 5 States International Collaboration 2 Case Managers were sent to Germany for 3 months Additional of 25 Case Managers (Total 35) Cover all states 2 nd RTW Conference Professional Certification (15 CDMPs) Ministerial KPI Established as a RTW Dept. 3 rd RTW Conference 20052007200820092010

18. Social Security Organisation of Malaysia Case Management is a collaborative process that facilitates recommended efficient treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals to ensure that they return to employment. Planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation. Medical case management may include, but is not limited to, care assessment, including personal interview with the client, and assistance in developing, implementing and coordinating a medical care plan with healthcare providers, as well as the clients and the clients’ family evaluation of treatment results while promoting cost-effective care. Concept of Case Management facilitates efficient appropriate medical care ensure that they return to employment. Case Management is a collaborative process that facilitates recommended efficient treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals to ensure that they return to employment. achieve the goal of medical rehabilitation care assessment in developingimplementingcoordinating a medical care planhealthcare providers clientsthe clients’ familyevaluation of treatment results promoting cost-effective care Planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation. Medical case management may include, but is not limited to, care assessment, including personal interview with the client, and assistance in developing, implementing and coordinating a medical care plan with healthcare providers, as well as the clients and the clients’ family evaluation of treatment results while promoting cost-effective care.

19. Social Security Organisation of Malaysia RTW Service Providers Coordinating Treatment/ Rehabilitation Related Stakeholders (employers, family, etc) Insurer (SOCSO) Facilitate

20. Social Security Organisation of Malaysia Section 40 (1) for the rehabilitationre-employment The Organization may, in addition to the scheme of benefits specified in this Act, promote measures or co- operate with existing institutions for the improvement of the health, occupational safety and welfare of insured persons and for the rehabilitation and re-employment of insured persons who have been disabled or injured and may incur in respect of such measures expenditure from the funds of the Organization within such limits as may be prescribed by the Minister. Legal Mandate

21. Social Security Organisation of Malaysia Section 57 free of charge facilities for (1) An insured person suffering from or claiming to suffer from invalidity or permanent disablement may be provided by the Organization, free of charge facilities for physicalvocational rehabilitation physical or vocational rehabilitation. nature and scale (2) Facilities under subsection (1) shall be of such nature and scale and shall be provided to such insured persons and on such conditions as may be specified by the regulations. Legal Mandate

22. Social Security Organisation of Malaysia Impact?

23. Results Social Security Organisation of Malaysia N = 4256

24. Results Social Security Organisation of Malaysia Impairment (%) Represents a Client Disability Durations 56.76% Reduction (Avg) Impairment 1.92% Reduction (Avg) Without CM With CM

25. Social Security Organisation of Malaysia Impact of RTW? Why? Higher Impact due to Trauma Longer disability durations Longer treatment period y = 1026245.13x 2 - 3227200.01x + 66002069.43 R² = 0.94 Introduction of RTW Program Increase from 10 to 35 Case Managers, Nationwide coverage, Over 3500 Employment Injury cases RM105,864,158 (-)RM1,856,547 (-)RM10,905,701 RM120,083,125 Reasons: reduction of disability duration Injuries / Diseases are better managed, (Coordinated Treatment/Rehabilitation) leading to reduction of disability duration (workers are recovering faster and getting back to work).

26. Social Security Organisation of Malaysia Cost vs Returns Cost Analysis Average Program Cost per Insured Person RM3,239.38 Average Possible Returns RM7,884.06 Net Benefit of (RM7,844.06 – RM3,239.38) = RM4,644.68 Other Social (qualitative) Benefits + DM program benefits outweigh costs by a 1.43 : 1 ratio. N = 1008

27. Social Security Organisation of Malaysia BeforeAfter Skills 5.126.42 Career Goals 5.106.45 Independence 6.007.20 Self Esteem 5.937.10 Self Confidence 6.037.47 Health Condition 5.566.86 Pain Tolerance 6.047.15 VAS – 100mm Clients’ Status

28. Social Security Organisation of Malaysia BeforeAfter Depression14.648.21 Anxiety13.217.04 Stress14.938.75 Clients’ Status

29. Social Security Organisation of Malaysia Insured Person’s Perception Very Good12.77% Good59.57% No Benefit27.66%

30. Social Security Organisation of Malaysia Employer’s Perception Very Interested8.78% Interested76.35% Willing to consider4.05% Not Interested10.81%

31. Social Security Organisation of Malaysia In line with UNCPWD Addressing Health/Disability Psychosocial Improvements Employees’ Perception Employers’ Perception Returns of RTW/DM Strategies

32. Conclusion Work is a social right! The ultimate objective of social security systems is to honour benefits when they are due - First of all, the Social Security System must be sustainable. A Social Security System which include and not exclude. Investing in People – Creating Opportunities, not sympathy. Social Security Organisation of Malaysia

33. Thank you Social Security Organisation of Malaysia Social Security Organisation +6 03 4264 5480 drazman@perkeso.gov.my