Here are some thoughts, from a doctor’s perspective, on how to make your employees’ medical appointments more productive:
Establish a cooperative relationship between your medical advisor and injured employee’s treating physician.
It is essential that your medical advisor is available to call the treating physician. This is a step that must be set up in advance. The medical advisor should be able to take quick action when an injury occurs.
Have your medical advisor contact the treating physician before the exam.
The medical advisor should inform the treating physician that the injured employee is coming for an exam. The medical advisor should ask the doctor to make sure the employee signs the proper releases so that the doctor can call the medical advisor back after the exam. The medical advisor should ask specific medical questions so that the exam will be conducted in such a way that it helps distinguish a work-related injury from a non-work-related injury. The medical advisor should ask the treating physician to take a detailed medical history and to make suggestions of how to get the employee back to work as soon as possible, even if it is on light duty.
The medical advisor can suggest particular tests.
Depending on the type of injury, the advisor might suggest a particular Waddell test if symptom magnification is suspected. “Waddell’s signs” are used to judge pain and injury behavior. Giving background, such as letting the doctor know the worker is unhappy with the job situation, can be helpful.
The medical advisor or employer should request a Functional Capacity Evaluation (FCE).
This is a physical examination assessing a person’s capacity for physical exertion and range of motion activities. Sometimes, FCEs are done by physical therapy operations, which is also a good option. The treating physician orders the FCE.
Get the treating physician to give specific medical restrictions.
Have the doctor be as specific as possible about what the injured employee’s exact limitation. The restrictions should be as detailed as possible about what the injured worker can and cannot do, such as lifting, carrying, walking, standing and sitting. The doctor should keep in mind that a worker may not even know the company can make accommodations or that there is a transitional duty program.
Do not let the treating physician give just “off duty” as a medical restriction.
If the doctor is contemplating taking someone off work, have them give specific medical restrictions unless the worker is bedridden. The company then decides if they can accommodate the physical restrictions so that the employee can return to work. It is helpful to let the doctor know that the employer can accommodate nearly all restrictions. Ask the doctor specifically what accommodations could be made to allow the employee to return to work. The doctor may not have even considered that an employee who is restricted from driving may telecommute or that an ergonomic workstation may help an injured employee with back pain perform a transitional job.
Once there are medical restrictions, it is up to the workplace.
Once there are medical restrictions, it is up to the workplace to decide if they want to make those accommodations and how they will make them. However, be aware that refusing to make “reasonable accommodations” may open up the employer to a discrimination lawsuit under the Americans with Disabilities Act (ADA). The Employer Assistance and Resource Network (EARN), a free service funded by the U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) can help answer these questions.
Make sure the physical restriction form is easy to complete.
It is easier to fill out a simple form with check boxes or items to circle that nearly all doctors are familiar with such as: “Lifting: heavy/ medium/ light”, “pushing or pulling”, sitting and standing time durations and a space for the doctor to write in any additional comments. Ask the doctor to complete your Work Ability Form.
Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is the founder & lead trainer of Amaxx Workers’ Comp Training Center , which offers the Certified Master of Workers’ Compensation national designation.
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