A functional capacity evaluation (FCE) is a comprehensive series of test administered by an occupational therapist or a physical therapist who has had specialized training in performing a FCE.  The tests are specifically designed to measure:

• stamina
• dynamic strength
• mobility
• flexibility
• body mechanics
• cardiovascular condition
• balance
• coordination
• dexterity
• ability to tolerate functional activities

Used to Determine Employee’s Readiness to Return to Work

In workers’ compensation claims, a functional capacity evaluation is often utilized to determine the injured employee’s physical readiness to return to work and to measure any physical limitations the employee will have as a result of the work comp injury.  A FCE can also be utilized to determine the injured employee’s physical capabilities for vocational retraining when the injured employee will be permanently unable to return to his/her prior vocation.

A functional capacity evaluation can be one of two types, either a job-specific FCE or a general purpose FCE. In a job-specific FCE, the therapist is provided a detailed job description prior to the testing in order to tailor the FCE to the specific job of the employee.  To have a very accurate FCE, the therapist should visit the job site to have a detailed understanding of the functions of the job.  In a general-purpose functional capacity evaluation, the testing measures the employee’s strength and tolerance in completing standardized or common work task.

Test Can Last Several Hours to Two Days

After a determination of the type of FCE, the appointment date is scheduled for the injured employee.  An FCE can last from several hours to two days, depending on the nature and extent of testing.

At the start of the functional capacity evaluation, the therapist will perform a comprehensive interview of the injured employee.  The interview is designed to identify any factors that could impact the employee’s ability to participate in the FCE.  The therapist will want to know if the employee has any issues with asthma, COPD or other lung/breathing problems, high blood pressure, physical limitations besides the work comp injury, and obtain the employee’s own assessment of their physical condition including the employee’s perception of his/her pain level.

Measure Various Physical Tests

In conjunction with the interview, the therapist will complete a clinical assessment of the employee to establish a baseline for the FCE.  The therapist will measure the employee’s range of motion, balance, grip strength and coordination to establish the testing plan.

In a job-specific FCE the therapist will measure the employee’s ability to lift, carry and perform other tasks in comparison to the performance levels identified in the employee’s job description guidelines. In the general purpose FCE, the therapist will measure the employee’s maximum ability to lift, carry and perform routine work-related task.

5 Categories of Physical Demands

The U.S. Department of Labor characterizes jobs in 5 categories depending on the physical demands of the job.  For instance, an over-the-road, or long-haul truck driver is classified as a “heavy” physical demanding job.  The 5 categories are defined as:

• Sedentary:  exerting up to 10 pounds of force occasionally

• Light:  exerting up to 20 pounds of force occasionally or up to 10 pounds of force frequently

• Medium:  exerting 20 to 50 pounds of force occasionally or 10 to 25 pounds of force frequently

• Heavy:  exerting 50 to 100 pounds of force occasionally or 25 to 50 pounds of force frequently

• Very Heavy:  exerting in excess of 100 pounds of force occasionally or in excess of 50 pounds of force frequently or in excess of 20 pounds of force constantly

If the therapist is performing a general purpose functional capacity evaluation on a truck driver, the therapist would determine the truck driver’s job is a “heavy” physically demanding job. The general purpose FCE testing would measure the employee’s ability to meet the requirements of the “heavy” job classification.  However, some truck drivers are “drive and drop” drivers where they never touch the cargo.  The hardest part of their job is cranking the landing gear of the trailer up and down and disconnecting the fifth-wheel.  Their job requirements would fall in the “medium” job classification for physically demanding.  Therefore, when there can be different levels of physical effort needed for a job title, it is to both the employer’s and the employee’s benefit to provide a detailed job description to the therapist and to request a job-specific FCE.

Biggest Issue is Validity of Effort by Injured Employee

The biggest issue with FCE is the validity of the effort put forth by the injured employee.  If the injured employee has been advised by his/her attorney that the better they do on the FCE, the lower their permanent partial disability settlement will be, the employee is given a financial incentive to put forth less than their best effort.  If there is any concern the employee may not make a sincere effort in the FCE, the therapist should be advised prior to the FCE.  The therapist can give the employee several different tasks or activities that measure the same physical ability.  If the test results reflect a variation in the employee’s ability within a specific category when measured by two or more different methods, the therapist will be able to identify the employee who is trying to game the testing and include in their post testing report the fact that the effort put forth by the employee was inconsistent.

Results Compared Against Specific Job Description

When the FCE testing is completed, the therapist will compile the employee’s test results.  The test results will be compared against the specific job description requirements or the general physical level classification of a job to see if the employee can return to performing the job. The results of the FCE are then reported to the treating doctor and workers’ compensation adjuster and/or nurse case manager.

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 founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

How familiar are you with the physical demands of every job in your company? That may sound like a loaded question, but the more understanding you have of each job, the better you’ll be at preventing injuries, reducing workers’ compensation costs and improving your bottom line.

However, many companies face the challenge of lack of time or resources to do a thorough and complete job of developing a physical demands database. The development of technology and artificial intelligence now makes this easy.

Why It’s Important

Let’s take drivers at a trucking company as an example. We know that long hours of sitting are required. We know when the drivers reach their destinations they must unload and reload the truck. And let’s say we even know that the items being off- and on-loaded weigh approx. 50 lbs. each.

Based on the 5 strength categories outlined by the Department of Labor – sedentary, light, medium, heavy, very heavy — we might conclude this particular job fits in either the ‘medium’ or ‘heavy’ strength category.

This is good information. But is it enough to ensure job applicant Fred can handle it, or Joe the returning injured worker won’t reinjure himself? Maybe there is more information we could use.

For example, how many 50-lb items are lifted per day on average? What percentage of the lifting time is spent with the item held at shoulder height, between waist and shoulder, or above shoulder height? Does the worker need to bend or twist in a certain way while moving the items on and off the truck? What, if any hand movement is required; i.e., are the items in boxes with handles, or does the worker pick up each item from the bottom? What surface heights are involved?

If Joe, returning from a shoulder injury, is to do this job, a basic description plus the DOL strength category of ‘medium’ might indicate he is a good fit. But if the job requires him to spend 1 – 2 hours each day with his hands reaching above shoulder level to off- and on-load the truck, Joe will be at high risk for reinjuring himself. In that case, we’d put Joe in another position that would not put undue stress on his shoulder. That is the benefit of accurate, precise and detailed job descriptions.

Physical Job Demand Descriptions

Physical job demand descriptions should provide as much detail as possible. In addition to the basic summary of the tasks involved, it should drill down to the specifics of the impact on any affected body part. For example, it should include the precise required angles of elbows, shoulders, and trunk; hand height; and reach distance.

Organizations should know exactly how much stress a job will put on a worker’s body and which parts specifically. Such knowledge will help make a much better decision about what workers can do which jobs without risk of injury.

Ergonomists are often called upon to help provide job descriptions, and with good reason. Their training gives them more insight into the physical demands of each task. However, advanced technology may be able to generate job descriptions that are at least as good and in less time, freeing up ergonomists to focus on developing programs to prevent injuries.

Researchers in Canada recently conducted a study to see how job descriptions created by video kinematics compared to those produced by two groups of ergonomists; experienced and novice.

Study

The researchers compared video-based joint angle and reach envelope measures for 10 simulated work tasks to the physical job demand descriptions from the ergonomists.  As they pointed out, “physical job demand descriptions often lack detail and format standardization, require technical training and expertise, and are time-consuming to complete. A video-based physical job demands descriptions tool would significantly decrease the time burden on ergonomists in documenting job parameters and may aid practitioners in determining the suitability of a job for a worker returning from injury.”

Tasks were recorded using a fixed position smartphone camera that was synced with the motion capture. The video was analyzed by Canadian company MyAbilities Technologies, Inc., who uses digital job profiles for injury prevention, fitness for duty, as well as to facilitate timely return-to-work to the worker’s own or modified job.

Physical job demand descriptions identifying the same angle and distance measures were done by the ergonomists for each task. The ergonomists estimated trunk angle, shoulder angle, elbow angle, hand height, and reach distance for the posture that represented the ‘greatest amount of the work cycle.’

“Overall percent agreement for video kinematics compared to motion capture was 82.5 percent,” the study said. “ video-based analytics had an equal or lower (i.e., better ) posture score than [either group of] ergonomists for 85 percent of ratings and was outright lower than both groups [of ergonomists] for 50 percent of ratings.”

The researchers said the study suggested that “video-based job task assessment may be a viable approach to improve accuracy and standardization of field physical demands analysis and minimize error in joint posture and reach envelope estimates.”

Conclusion

The study results are great news for organizations trying to prevent injuries — or re-injuries. By simply taking a video via smartphone of a worker doing job tasks and uploading it organizations can instantly have access to detailed job descriptions to help them make well-informed decisions when fitting workers to jobs and ensure they keep their workers safe and healthy.

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 founder & lead trainer of Amaxx Workers’ Comp Training Center.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

So you have decided to provide some light duty or transitional work for injured workers to decrease wage loss expense.  First of all, congratulations! This is the first step in decreasing claims costs. The wage expense in a comp claim is most usually the biggest cost, and any chance you have of decreasing that cost should be taken.  But what should the workers do?  What if they do not follow the rules and get hurt again? What if this light duty work hinders the rehab and recovery?

These are all common issues and concerns. But there are ways to work around them with jobs that already in the workplace for these workers to do.  Jobs that are no more or less strenuous than anything else they do on a daily basis while out of work.  If stumped for ideas as to where to start, use this information, and then further customize your jobs based on the building blocks we list below.  These will not apply to all areas of every employer, but at least it offers possible job ideas.

1. Janitorial tasks

Although not glamorous, janitorial tasks are a much-needed function of the workplace. A broom is not heavy so sweeping the floor and back storage areas are not only sanitary but can also reduce risks for slips and falls due to debris. Maybe wiping down machines and making sure they are in proper working order is a job the injured party can do based on their level of experience.  With winter looming, salting entryways and making sure rugs and mats are in good shape and in good working order is a must to prevent falls.  Mopping could also be done, but it can involve lifting and twisting with a wet, heavy mop, so make sure your worker is capable of that before you assign that task to them. The goal is to have them working with light materials and prevent exertion that can cause further injury.

2. Maintenance tasks

There may be a lot of jobs around the shop that are not done on a regular basis. Oiling machinery will increase the performance of the machine, as will changing belts, cleaning guards, checking saw blades, or cutting surfaces.

The tasks are not limited to only machinery.  Light painting can freshen and improve the look of the work floor. Replacing broken faucets, light bulbs, cracked mirrors, or repairing/caulking windows that may be not closing properly can also help. Checking outlets for proper power wattage is another one.  Go out on the floor and ask workers what needs to be done or what is not working properly and make the injured worker a “to-do” list.  There may not be enough work for them to last weeks, but at least it gets them back to work and doing something while in recovery mode.

3. Office tasks

These jobs can include answering the phone, taking sales orders from clients, copying materials for files, or scanning paperwork for example.  Ask the office staff about any upcoming projects and what needs to be done they have been putting off for a while.  Chances are there are some sedentary work tasks available and needed, and this is a perfect task for your injured worker to do.  That way a fully functional worker without work restrictions can focus on more important tasks, or jobs that are more strenuous in nature.

4. Inventory

A lot of employers carry a certain level of inventory for workplace needs. Obviously, the amount of inventory being carried depends on the type of workplace. But if you have the need, this is another light task the injured worker can do. Taking proper inventory and ordering more supplies is also another task to cross off your own to-do list.  Have the injured worker tally up what is currently in stock, what needs to be ordered, and when it should arrive before supply runs low. This is also a good time to have the worker shop and price supplies.  You might be able to find another vendor that can provide a better supply for a lower price.  This way not only gets the injured worker back to work, but the employee is also saving you money in the long-term.

5. Job supervision and reporting

If the injured worker is unable to do the normal job, maybe the employee can still go out on job sites and help the other workers.  Not only supervise the overall job, but the worker could also assist in gathering light materials needed for the job.  If the work involves ladders and scaffolding, have someone on the ground to help the other workers, so they do not have to go up and down the ladders repeatedly to fetch materials or tools.

The injured worker also can report back like how the job is going so far, and recommend any changes or needed materials for the job site.  This will keep the job running on time for completion, and it is just another task that nobody thinks of until the issue arises.  You stay on top of the job status, and if certain recommendations are suggested and implemented, maybe that job is completed sooner than expected, resulting in a happier client.

6. Performance reviews

If there is a management member out of work due to a claim, maybe now is a good time to bring them in to do annual performance reviews.  This way they can pull all the personnel files on the workforce, review them, get updated feedback from other supervisors on what the current performance is like, and then sit down with the employee to conduct a review and suggest improvements.  Again this may not supply the injured workers with weeks and weeks of work, but at least it is something that needed to be done. And if you have the right candidate to do it then it makes sense to have that person complete the task.

7. Security

A lot of larger employers, such as grocery stores and retail businesses, have in-house surveillance cameras. The injured worker can monitor the day to day surveillance, clean up messes or spills, rotate product, place shelf signs, or any other light task that may need to be done.  Theft prevention can also be addressed; however, you do not want the injured worker trying to apprehend anyone and get injured again.

8. Accounts payable/receivable

Another sedentary job is shifting the injured worker over to helping with accounts receivable/payable.  Your business probably has vendors to pay, and you also may have clients that have outstanding invoices.  Have the worker take over the books, and see if they can collect payment on some of the invoices that have not been paid.  Sometimes a faxed invoice to a client followed up by a phone call is all it takes to get the invoice paid.  This task will clean the books up, and make the company current with payments that are coming in and going out all the time.

9. Assign a helper

If the injured party has restrictions but can still do most of the job, assign an entry-level helper to go along and do the tasks that they cannot do.  This provides the newer employee  a chance to learn more about the business and job duties, and it allows the injured worker to keep doing the normal job, now with the assistance of a helper

10. Reach out to the injured party for ideas

When you just cannot think of anything for the injured worker to do, reach out to them and see what ideas the employee has.  The incentive for the worker is the chance to return to work, and maybe make the normal pay instead of collecting reduced wages on workers comp.  Sometimes great ideas are suggested. So keep an open mind, solicit some ideas from them, and try to do what you can to implement those job ideas.

Summary

Trying to create jobs for injured workers can be a difficult task.  But with an open mind and some creativity, get injured workers back to work.  Not only does this cut down on the workers’ comp expense but it also can complete some overdue tasks.  Put some thought into it, and ask others around the workplace for ideas.  Together you should be able to come up with a list of tasks that need to be done.  Every dollar saved on wage loss will count in the end.  Keep track of the cost of having these workers come back to light duty work, and weigh it against the cost of keeping them out of work, only returning at full duty.  You will be surprised at the cost savings of implementing a light duty work program.

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the co-author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:.

Contact: RShafer@ReduceYourWorkersComp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

A good job description is like money in the pocket for workers’ compensation payers. The more specific the information is available, the better the chances of returning an injured employee to work that much sooner. A well written, appropriately available job description is invaluable for any organization that ever has an injured worker.

Job Descriptions

Surprisingly, many organizations have either poorly written or no job descriptions at all. The vast majority are vague and don’t provide nearly enough information on which to make decisions about whether an injured worker can physically handle a particular job. It is not uncommon to see a company with multiple locations have different job descriptions for the same jobs at each location.

Medical directors for third-party administrators cite the lack of adequate — or any — job descriptions as one of their major hurdles in getting injured workers back on the job.

Some job descriptions include the 5 strength categories outlined by the Department of Labor:

1. Sedentary
2. Light
3. Medium
4. Heavy
5. Very heavy

This, at least, gives the treating physician an idea of how much weight and effort is needed to do the job. But it fails to take in many other factors that can be crucial to fitting an injured worker in the right position.

For example:

• Does the job require the worker to bend, kneel, reach – and how high?
• Are long periods of standing necessary?
• Is driving a requirement?
• Would climbing be important, such as climbing onto equipment?
• Is pushing and/or pulling involved?
• Are specific body parts more taxed than others, and to what degree?
• What cognitive skills are needed?

The more detailed, accurate information provided in the job description, the easier it is for physicians to determine if an injured worker can handle the job and what, if any accommodations could enable him to return to work.

In addition, a good job description (profile) reduces the number of injuries at an employer by identifying injury risks and preventive ergonomic modifications.

Disability Duration

Getting injured workers back on the job in some capacity saves costs for the employer/payer, who no longer has to pay workers’ compensation benefits. But it also saves the employer/payer additional, though overlooked costs; that is, preventing an injury from becoming one of the small percentages of claims that consume the majority of costs.

Estimates are that somewhere between 5 – 10% of claims comprise 80% of workers’ compensation costs. While some of these involve catastrophic injuries, many are seemingly small claims that stay on the books for months or years, often involving multiple medical treatments and medications. That is the impact of disability duration on utilization.

Additionally, the longer a person is out of work and the more treatments/medications he receives, the more likely he is to continue in that vicious cycle. He develops a disability mindset and believes he truly needs whatever medical services are suggested.

Physicians cannot take all the blame for these claims. If employers/payers cannot provide accurate job descriptions that include specific job demands, and if they are unwilling to make accommodations, the doctor can only do what he is trained to do; help the injured worker resolve his injuries and pain.

In addition to providing accurate job descriptions, it is also incumbent on employers/payers to work with treating physicians to help them understand the benefits of returning an injured worker to some sort of work — for the injured worker as well as the employer/payer.

Get Help Creating Accurate and Comprehensive Job Descriptions

The creation of accurate and comprehensive job descriptions is often outside of an employer’s capability.  Technology is advancing in a way that makes the creation of this important information easy.

ODG, one the leading providers of evidence based medicine guidelines has recently incorporated a unique new product option, the ODG Job Profiler.

The ODG Job Profiler is an innovative software platform powered by MyAbilities™ which adds job demand data across every industry and occupation by providing a comprehensive database of physical, cognitive, and environmental demands specific to over 30,000 jobs spanning nearly every industry. This solution helps insurers, third-party administrators (TPAs), and employers identify and mitigate the risk of injury by creating a customized Physical Demands Analysis (PDA) for each job function, adjusting disability duration guidelines according to job demands.

This information is then packaged as an online digital job profile and becomes shareable to all stakeholders in a claim, streamlining the RTW process and allowing for automated job matching between the individual’s capabilities and available jobs.

Suggested Actions

Shortening up disability durations is key to reducing workers’ compensation costs. Organizations can achieve this by:

1. Getting accurate, detailed job descriptions. Get help directly from an outside service provider, or work with a with a TPA or insurer that can provide access to better physical demands descriptions for various occupations, especially if the provider is using a national database.

2. Taking videos of employees doing their jobs. This can become part of a job description. It can also be used to show the treating physician exactly what a job entails, which will help make more informed decisions about getting the worker back to the right work and seeing if accommodations would help.

3. Partnering with the treating physician. The doctor treating the injured worker should be part of the caregiving team. The physician is a vital part of the RTW process since she has the authority to release the employee to work and the type of position he can do.

4. Providing training to avoid reinjury. Based on the job demands and the worker’s condition, some training may help ensure the employee is doing tasks properly.

Conclusion

Helping injured workers recover and return to productivity should not be left to chance. By having a strategic plan of partnering with physicians, TPAs, insurers and others involved in a claim, and providing as much detailed information as possible — especially job descriptions — organizations can prevent routine claims from becoming expensive, long-lasting ventures.

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 founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2019 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

ACOEM Whitepaper: Preventing Needless Work Disability by Helping People Stay Employed


Hey, there. Michael Stack here, CEO of Amaxx. One of the most fundamental goals in workers’ compensation is to return our injured employees to work and back to function. I want to draw your attention to a white paper written by ACOEM several years ago entitled Preventing Needless Work Disability. You could find a link to that white paper below. Within that paper, they talk about a three-part framework or a three-step framework to consider return to work on nearly every single workers’ comp claim. I want to walk you through what that framework is when you’re considering return to work for your injured employees.

ACOEM 3-Part Return to Work Framework

The first part is to assess where that current employee is. The next piece is compare. Then, the final piece is to create. So assess, compare, and create. Assess where they currently are. What are their current job restrictions? What restrictions do they get from the physician that say they could only lift 20 pounds or 50 pounds and they can bend this way or stretch this way X amount of times standing, whatever that happens to be? Where do they currently stand? Compare that what the job descriptions are, the physical demands of their actual jobs. You should have a very comprehensive library of what this means at your organization so you can compare one with two. It’s very, very simple when you actually break it down.


Simplicity of High-Level Understanding


Then, the final piece is to create that job. What are those action steps, then, to now put this into practice? Obviously, there’s a lot more depths to each one of these steps. But if you can understand the high level of what it is that we’re actually trying to accomplish, it can ultimately be fairly simple in your mind to now put this all together. So assess, compare, and create. Three steps in the return to work framework in ACOEM’s Preventing Needless Work Disability white paper, which I highly recommend downloading and checking out. It’s a great resource. Again, my name is Michael Stack, CEO of Amaxx. Remember, your work today on workers’ compensation can have a dramatic impact on your company bottom line. But it will have a dramatic impact on someone’s life. So be great.

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 founder &lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com. 

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under InternationalCopyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.