Most reputable organizations want to do the best for their employees, including when they get injured. They want to get appropriate, immediate medical care to them. It helps both the employee and employer by ensuring the worker recovers quickly, and the employer saves money by getting their loyal employees back at work. On its surface, it seems a fair system for all concerned. Yet many – probably most – employers do their companies a disservice by paying unnecessarily for injuries that were not incurred while the worker was their employee.
Workers who sustain soft tissue injuries deemed work-related are generally covered by workers’ compensation. But what if part of the injury was pre-existing? It should not be the responsibility of the current employer to foot the bill for ailments the worker had prior to the injury. The goal of the workers’ compensation system is to return the injured worker to his pre-injury condition, NOT to 100 percent of function. Unfortunately, most organizations have no knowledge of the employee’s pre-injury condition, so they just pay the bill. Because of that, the exact cost of these unnecessary expenses is unknown.
With the workforce increasingly comprised of older workers, chances are the vast majority of new hires have some physical ‘baggage’ they bring to the job. Additionally, soft tissue injuries are expected to be on the rise as more people are working from home due to the pandemic. Therefore, it behooves employers to have baseline data of their workers’ health status for comparison purposes if and when they subsequently become injured. Doing so can save organizations money while still ensuring their injured workers get the care they need.
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Baseline
“The real key to understand with the baseline is if you don’t have measurements on a pre-existing injury for an employee, then no pre-existing injury exists,” explained Larry Feeler, CEO of WorkSteps. “What that means is without a documented baseline, they’re presumed perfect when you hire them, and whatever aliments happen are completely your fault.”
Say, for example, that a worker presents with an injury that shows his function has declined 56 out of 100 on an impairment scale. The employer would have to pay for a 44 impairment. However, if the employee was only at 78 at the time of hiring, the organization would only be responsible for 22 percent. Those costs can quickly add up.
Trying to prove the pre-existing impairment after an injury is nearly impossible. Unless there is documentation to show the employee had previously had surgery for a pre-existing condition, the employer is probably stuck with the bill to return the worker to 100 percent.
But how can you have such baseline data on employees without violating laws, such as the Americans with Disabilities Act and HIPAA? It’s a matter of doing appropriate physical testing of the employee upfront to ensure they can handle the physical demands of the job, then properly securing and storing that information to be reviewed if an injury occurs.
The Testing
Once the interviews have been conducted and background and drug tests done, the employer can make a conditional offer of employment – contingent on the applicant’s ability to meet the physical demands of the essential functions of the job. The idea is to help prevent an injury that could have been foreseen.
By understanding such things as the push/pull and material handling forces necessary, these forces can be replicated and the person tested to make sure he can accomplish them.
These functional capacity evaluations determine the range of an employee’s actual physical capabilities. The person is tested for various physical movements that would be needed to do the job effectively. It may include, for example:
- Floor-to-waist lifts
- Waist-to-eye lifts
- Carrying
- Crouching
- Squatting
- Ladder climbing
- Balancing
Stamina, flexibility, mobility, body mechanics, dexterity, and other aspects of the person’s physical condition are measured.
“What we’re trying to do with physical testing is just like having individuals try out for a sport; we want to make sure that each person can demonstrate they are physically capable to perform at their position,” Feeler said. “We want them to be able to demonstrate that they can pick up a 60-pound box with handles on it or that they can pick up a specific tarp and put it on a device.”
The information from the testing must be handled correctly. The employer should have no knowledge of the person’s physical abilities, other than a ‘yeah’ or ‘nay’ as to whether he can do the job. The information would not be available unless the person later has an on-the-job injury, and then it would only be available to appropriate parties.
The testing should take a baseline of the impairment rating according to the AMA guides for all the joints of the body. Any documented range of motion loss can then be apportioned to what is pre-existing.
“So, if I dislocated my shoulder in 1990 and have a 10% range of motion loss, then that is subtractable from any new impairment,” Feeler said. “If a doctor post-accident states the employee has a 12% impairment now but knows he had 10% when he was hired, then the doctor’s not really too worried about it. But, if he has a brand new 12% impairment, then it is serious because 15% is lifetime benefits under most state laws.”
Conclusion
Hiring the best person for the job means finding the applicant with the correct skill set and someone who can do the job without hurting himself. Determining a person’s physical abilities to do the essential functions of the job can also uncover any pre-existing conditions, which can potentially reduce the employer’s exposure if the worker becomes injured after hiring.
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.
Contact: mstack@reduceyourworkerscomp.com.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.
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