Number of State Caseworkers on Family Medical Leave Increasing

The Arizona Department of Economic Security in south Phoenix.
The Arizona Department of Economic Security in south Phoenix. Elizabeth Whitman
The number of state disability caseworkers going on Family Medical Leave has almost tripled in the last five years, according to data obtained from their employer, the state Department of Economic Security.

Some caseworkers employed by the agency's Developmental Disabilities Division (DDD) say the job itself is making them sick, particularly due to their long hours and overburdened caseloads.

The Family Medical Leave Act, established in 1993, allows employees of state agencies to take paid, protected  leave for specified medical reasons. According to data obtained by a request under state public records law,  173 caseworkers employed by the agency have taken Family Medical Leave so far this year. That’s a 180 percent increase over the number who went on medical leave in 2015 — which was 62 caseworkers for the full year — despite staffing levels remaining roughly the same.

One woman who recently resumed her job at the DES after three months of medically prescribed rest credited her absence to illness she acquired from the stress of the job.

The caseworker, who asked to remain anonymous out of fear of retaliation, has been with the state for 13 years, but said conditions have worsened recently. Though she'd seen her workload steadily rise in recent years, she said her health problems began when she was transferred to one of the Phoenix offices in late June of this year.

Caseworkers employed by the state receive new cases each time they're transferred to a new DES office, and she said the ones she inherited critically lacked up-to-date client information.

“I received 72 cases on my first day [at the new office] — and all of them were behind,” she said.

Caseworkers are supposed to receive just 40 cases at a time, each for an adult or child with developmental disabilities who receives services through the state's Medicaid program, according to the program's policy. But reports from over a dozen current caseworkers, several developmental disabilities service providers, a current client with developmental disabilities, and a lawsuit filed earlier this year, all suggest that state caseworkers are often assigned far more than that, with some DDD employees handling over 100 clients at a time.

The anonymous caseworker said she started getting headaches and nausea, making it difficult to keep down food, due to the long hours she was working to keep up with each of her cases and adequately serve the disabled clients that each represented. In the hours she wasn’t working, her anxiety over all the unfinished tasks kept her awake at night, further deteriorating her health.

At first she said she asked for overtime pay, but it was declined, according to June emails. As her stress grew, she notified management of the impossibility of meeting all her client’s needs. She was told to do her best, according to an email reviewed by Phoenix New Times.

“They basically said, ‘Just do what you can in 40 hours,’” the caseworker said. “But of course I still worked,” she said. The caseworker has a brother who is developmentally disabled and relies on DDD services — she said she knows how critical it is for their caseworkers to stay up to date on their work.

By July, after three months at the new office, she sought a medical evaluation. Her doctor recommended temporary leave from her job immediately, she said.

“Patient is under extreme amount of stress, increasing anxiety to the point where she is unable to function or interact with others,” a doctor’s note from September 22 states, “At this time, the patient is unable to perform all job functions.”

The DES, though a spokesperson, declined to go into detail about the reasons behind the increase in employees taking Family Medical Leave.

"The Arizona Department of Economic Security (DES) cannot provide any details as to why individual employees apply for family medical leave as this information is confidential and protected by the Health Insurance Portability and Accountability Act [HIPAA]," spokesperson Brett Bezio said. "DES Support Coordinators, which are also known as case managers, provide critical services to our members in the Division of Developmental Disabilities. DES is committed to ensuring Support Coordinators have all the resources they need to continue to provide quality services to our members, including offering the Employee Assistance Program."

The Employee Assistance Program, available to all state employees with benefits and members of their household, provides mental health care, information and resources designed to help staffers handle an array of life challenges, he said.

"We encourage staff to utilize the EAP to address the complexities of life and everyday issues such as work- or home-related stress, grief and loss, energizing a career, and dealing with trauma," Bezio said.

Now back at work, the caseworker said she has 63 cases — almost the amount she was assigned when she left for Family Medical Leave. She’d tried to work out an arrangement where, per another order from her physician, she would only be assigned 40 cases upon her return.

“Patient will be limited to a 40 caseload,” the treatment schedule portion of her most recent U.S. Department of Labor Certification of Health Care Provider for Employee’s Serious Health Condition states.

But the DDD's Human Resources declined this request, offering instead to have her work fewer hours, resulting in a pay cut.

Otherwise, she would be expected to match the caseload amounts of her full-time peers, according to October emails, suggesting the typical caseworker in the office has more than the 40-case maximum.

“Welcome to DDD!” she said. “I’m currently looking for another job. It’s too much.”
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Hannah Critchfield was an editorial fellow for Phoenix New Times starting in 2019.