Companies are using advanced technologies to manufacture their products, create intellectual property, and deliver their varied services. But are they making use of new technologies to optimally manage their own workforce? In the majority of cases, the answer is No.

Most of the tools and processes being used to assess job demands, hire capable workers, prevent injuries, manage recovery, and return to work, have not kept up with available software and methodologies.  These new advancements can substantially enhance the health, safety, and productivity of a company’s greatest resource – its employees.

Let’s review some of these options with which employers and brokers should become familiar.

Technology for Physical Demands & Ergonomic Risks

Do employers really understand the physical demands of each of their company’s jobs, as well as the ergonomic risks that each job may present?  Traditional job descriptions do the former poorly, and the latter not at all. With the use of today’s technology, a company risk manager can potentially access comprehensive, quantified digital job profiles for virtually every position in their organization, either “off the shelf” or customized with a few modifications. Additionally, they can use a smartphone to capture an employee performing his/her job and upload it into artificial intelligence-powered software that automatically produces a video digital job profile displaying the job in action with quantified physical demands.

Value of Digital Job Profile

Using today’s technologies, an employer can cost-effectively build a digital database of all their company’s jobs which can be used to create precise protocols for post-offer employment testing.

Benefits include:

• flag high-demand jobs, ranking the body regions most susceptible to injury, leading to prompt ergonomic mitigation.
• suggest training programs to build and maintain endurance, specifically tailored to the demands of each job.
• facilitate return to work based on digitally matching the employee’s clinical status during, and at the end of rehabilitation, to his/her own job or other company jobs in the database, consistent with any physical restrictions or limitations.
• decrease an employer’s risk exposure for ADA non-compliance.

The technology of this type is not confined to industrial applications but is also available for office workers. Office worker technology can provide computerized video-guidance allowing the employee to assess their workspaces (computer, monitor, keyboard, chair, etc.), generate instant ergonomic modifications, and if necessary, recommendations for the purchase of more suitable equipment. This feedback and information support productivity, comfort, and a reduced risk of work-related conditions.

Share Digital Job Profile with Stakeholders

Last, but not least, if and when an injury occurs, the digital job profile is electronically shareable with the employer’s insurer, TPA, or managed care organization (or for self-administration) and provides a roadmap for claim and medical managers to make informed compensability determinations and pursue evidence-based treatment and return-to-work strategies. But more about that in a future installment.

Employers, and brokers are well-advised to explore these novel approaches which modernize our approach to workforce management.

Jacob Lazarovic MD, Medical Advisor at Amaxx LLC, has considerable experience in managed care, including 18 years as chief medical officer at Broadspire , a leading TPA. His department produced clinical guidelines and criteria to support sound medical claim and case management practices; participated in analysis, reporting and benchmarking of outcomes and quality improvement initiatives; and operated a comprehensive in-house physician review (peer review) service. He has been published extensively in industry journals and has held several senior medical management positions at companies including HealthAmerica, Blue Cross/Blue Shield of Florida and Vivra Specialty Partners. In his current capacity as CMO at MyAbilities Technologies, he has developed evidence-based online clinical applications that support the company’s digital job profile software, and its claim and medical management tools geared to functionality-driven return to work and job-mat

… We look at the work comp industry. What are the common questions that employers will ask when an employee is injured is how long is my employee going to be out. What is my expectation for how long they should be out, and then two, how do I know when they’ve started to go off the tracks?

Evidence-Based Medicine Injury Duration Guidelines

Today I want to introduce you or possibly re-introduce you to evidence-based medicine injury duration guidelines. There are two primary providers of this information in our industry. MD Guidelines and ODG Guidelines. Both credible sources of information and data that you can reference.

I want to walk you through an example here on the board. We’re going to talk about John who works in your warehouse. John’s job or part of John’s job is to lift 50 lb boxes, and he sustained a partial rotator cuff tear injury, which is the data that you see here on the board and this is provided by MD Guidelines.

Over here you can see the physical demands or the types of jobs from sedentary to medium to very heavy and heavy jobs. This is the expectation for recovery minimum, optimum, and maximum expected recovery time based on physician consensus of required physiological healing time. This is how long the body should heal based on this type of injury.

Example: Heavy Physical Demand Warehouse Position

Let’s take a look at this. Now, John’s 50 lb box lifting job would fall into this heavy category. You can see here that the optimum recovery time is 42 days. So even if I have no medical background or any medical training and you don’t have any medical background or any training in the medical field, you can look up this information and know very quickly it’s about six weeks that I can expect optimally that John should be back to his job. And it could be up to 85 days and it could be as low as just a couple of weeks here that he could be back to work, obviously based on a number of factors.

But this now starts to set your initial expectation just like that Google Maps app going somewhere you’ve never been, dealing with an injury maybe you’ve never dealt with before.

Now you also need to know when you’re starting to go off the tracks and so you look at John’s recovery time and now it’s clicking away and now you’re getting over here and you’re like, “Hey, what’s going on over here? Why is John not even close to recovering when the expectation should be that, optimally, you know, just within a couple of six weeks, you know, three, four, five, six weeks, he could potentially be back to work.” So what’s going on here? I’m off the tracks. My ETA has now gotten much higher than it was before. So it gives you that indication of when you’re off the tracks and potentially you need to work with your adjuster, work with your claims handling team, to bring in some other interventions to get back on the track and going in the right direction. Hugely valuable information to tap into and leverage to give you that information to make those appropriate decisions.

Common Mistake Employers Make with Injury Duration Guidelines

One last quick point I want to make here because I often see employers misinterpreting these numbers. Go back to this example of John. You say he’s going to be out six weeks. I’m not even going to think about bringing him back to work or expect he’s going to be back to work until this timeframe because that’s what the injury duration guidelines say.

I want to draw your attention up to here though. This is what transitional duty is all about. This is what late duty is all about. Sedentary and light jobs you should be able to get John back to work lickety-split within a couple of days even at the maximum required is four days. So within a couple of days, John should be back to work doing sedentary or light duty in a transitional duty type capacity.

When you do that, you’re going to angle John’s recovery time this way. When you leave John out of work and you don’t bring him back up here, you’re going to angle him this way and you’re going to probably end up being even further than maximum. When you get those people back to work right away you’re going to improve their recovery times. When you don’t, you’re going to make sure that recovery time is significantly longer, which as we know, anytime you see that ETA go up significantly higher when you’re driving, it’s not something you’re looking for and particularly in Workers’ Compensation. The impact of that is much greater. It impacts an individual’s life; it adds significant cost to your claim.

Again, I’m Michael Stack, CEO of Amaxx. Remember your work today and Workers’ Compensation, it can have a dramatic impact on your company’s 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 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.

TORONTO, Oct. 9, 2018 /CNW/ – Crawford & Company (Canada) Inc. today announces the integration of Crawford EmployerWORKS™ software with its human risk service line. Crawford EmployerWORKS is an innovative software platform powered by MyAbilities™. It was designed to streamline and standardize the collection, communication, and analysis of physical, cognitive and psychosocial demands tied to risk assessment and return to work efforts. As a tool for the adjudicators, case managers and workers’ compensation consultants of Crawford’s Human Risk division, Crawford EmployerWORKS further empowers our professionals to effectively and efficiently handle disability claims by ensuring a prompt and successful return to work and implementing proper measures to prevent workplace injuries.

“Specializing in occupational (workers’ compensation) and non-occupational (leave and disability) claims from a claim and case management perspective, our human risk division strives to identify and implement new, effective methods to manage such claims ensuring a safe, timely and sustainable return to work,” said Heather Matthews, senior vice president, Crawford Human Risk. “Crawford EmployerWORKS serves to simplify and enhance our communication capabilities with clients, reduce claim costs, and increase success rates tied to sustainable return to work solutions.”

Click HERE to access EmployerWORKS’ capabilities.

This analytical system leverages the vast Crawford EmployerWORKS database to identify typical job demands linked to specific job profiles while incorporating risk factors to assist in mapping out a sustainable return to work solution. Crawford EmployerWORKS also includes tools to identify barriers for return to work in the form of physician causation analysis and psychosocial factors.

“We believe that everyone – employees, employers, health practitioners and insurance companies – will benefit from better prevention, injury management and return to work solutions through advanced ergonomics, artificial intelligence and digital risk assessment technology,” said Reed Hanoun, CEO of MyAbilities. “The EmployerWORKS suite is a whole new take on human asset management. We truly believe that we will revolutionize the way industries manage their ergonomics and safety strategies and that they will never look back!”

Through the use of innovative technology, Crawford continues to adhere to its mission to restore and enhance lives, business and communities by leveraging the appropriate expertise and analytical tools to identify and remove barriers hindering injured parties from obtaining gainful and meaningful employment following an accident, injury or illness.

About Crawford®

Based in Atlanta, Crawford & Company (NYSE: CRD-A and CRD-B) is the world’s largest publicly listed independent provider of claims management solutions to insurance companies and self-insured entities with an expansive global network serving clients in more than 70 countries. The Company’s two classes of stock are substantially identical, except with respect to voting rights and the Company’s ability to pay greater cash dividends on the non-voting Class A Common Stock (CRD-A) than on the voting Class B Common Stock (CRD-B), subject to certain limitations. In addition, with respect to mergers or similar transactions, holders of CRD-A must receive the same type and amount of consideration as holders of CRD-B, unless different consideration is approved by the holders of 75% of CRD-A, voting as a class. More information is available at www.crawfordandcompany.com.

About MyAbilities

MyAbilities is an Ontario-based healthcare data analytics company, focused on process automation for workplace safety, ergonomics and injury management. With its AI data-driven Software-as-a-Service (SaaS) offering, we help employers, insurance companies, healthcare providers and injured workers by preventing workplace injuries, expediting the return to work of injured workers, and reducing the cost of claims while promoting a healthy and fit workforce. More information is available at http://www.myabilities.com.

SOURCE Crawford & Company (Canada) Inc.

For further information: For more information, contact: Heather Matthews, Senior Vice President, Human Risk, Crawford & Company (Canada) Inc., Tel: 519.578.5540 Ext. 2672, Email: Heather.Matthews@crawco.ca; For media inquiries, please contact: Gary Gardner, Senior Vice President Global Client Development, Tel: 416.957.5019, Email: Gary.Gardner@crawco.ca

Related Links

http://www.crawfordandcompany.com

You are all probably aware of many of the standard strategies that can be employed to ensure timely return to work during and after recovery from an occupational injury or illness.

Technology Can Make Return to Work More Efficient

But are there any newer technologies and approaches that can facilitate this process to make it more effective and expedited?

In a previous article, I discussed the critical need for an advanced form of “job description,” which we refer to as a digital job profile (DJP) containing a comprehensive physical demands analysis(PDA).  It bears repeating that the digital job profile is the cornerstone to understanding the explicit, quantitative demands of a job, and is utilized by all stakeholders in the claim management continuum. How can we return an individual to modified or full duty without knowing exactly what the job requirements are?

Psychological Component Can Play Greater Role Than Biological

Many of you are aware of the biopsychosocial model of injury or illness. In short, this is the recognition that non-physical factors highly impact functional restoration. In fact, many experts feel that the psychosocial components play a greater role than biological ones. You have undoubtedly noticed that the same type of injury may be devastating to one individual, while a more resilient person easily overcomes it. It is extremely helpful to predict whether your claimant is likely to be in the former or latter category.  If the claimant is fragile from a psychosocial perspective, many mitigation strategies can be employed to prevent the delayed return to work/life activities that inevitably accompanies these comorbidities.

Fortunately, there are automated, online screening tools available that allow you to enter claimant responses to a brief series of questions, and provide you with an immediate, calculated psychosocial risk level (high, medium, low). These validated tools may also recommend various interventions derived from the response pattern of claimants to the questionnaire. Some folks will benefit from cognitive behavior therapy, and others from family counseling, vocational guidance or psychiatric assessment. Risk screening helps to identify the level of risk, as well as appropriate strategies to help individuals better cope with the added stress of an injury or illness.

Share Digital Job Profile with Treating Clinicians

Now that you have shared the digital job profile with treating clinicians, allowing them to set rehabilitation modalities and goals, and have dealt with any potential psychosocial risks, what is the most efficient way to monitor progress and make decisions about return to work? Again, technology to the rescue!  One can send the digital job profile to a clinician, such as a physician or physical /occupational therapist, along with an online app that allows them to quickly and electronically document the capacities and/or restrictions and limitations related to any impacted body regions. This information is then instantly available to claim adjusters and nurse case managers and allows for quick determinations about a return to full or transitional modified duties, and at the end of treatment, this facilitates the “job matching” process. Automated algorithms can assess whether the claimant can return to their own job, alternate employment at the same company, or any other job contained within an extensive jobs database.

These processes streamline the recovery and return to work process by applying standardized objective functional metrics, validated screening and analysis tools, and integrated information-sharing among stakeholders. Additionally, they serve as an important defensive strategy given current ADAAA regulations and EEOC challenges.

Jacob Lazarovic MD, Medical Advisor at Amaxx LLC, Chief Medical Officer at MyAbilities. has considerable experience in managed care, including 18 years as chief medical officer at Broadspire, a leading TPA. His department produced clinical guidelines and criteria to support sound medical claim and case management practices; participated in analysis, reporting and benchmarking of outcomes and quality improvement initiatives; developed educational and training programs that updated the clinical knowledge and skills of claim professionals and nurses; provided expertise to enhances the medical bill review process; and operated a comprehensive and unique in-house physician review (peer review) service. He has been published extensively in industry journals and has held several senior medical management positions at companies including HealthAmerica, Blue Cross/Blue Shield of Florida and Vivra Specialty Partners

First, let’s get our terminology straight. The terms “job profile” or “job description” are often used synonymously. These two terms refer to a more-or-less complete depiction of the tasks, physical and perhaps cognitive demands, and environmental characteristics of a particular position at a particular employer.

A well-designed job profile has great potential value, but the truth is that many employers have not expended the resources and time to develop comprehensive and quantitative databases of all their company’s positions.

In my experience, many jobs have no available profiles whatsoever, and when they do exist they are often incomplete, qualitative, sketchy documents on paper that provide little useful, actionable information.

Why is a Good Job Profile Important?

A good job profile describes every task and function of the job with detailed physical demands for each task.  A good job profile can:

• set out the requirements of the job which can optionally be used for post-offer testing
• identify ergonomic risks that can be modified to avoid injuries in high-intensity job tasks
• explicitly document the body regions most susceptible to injury for each job, allowing for targeted fitness programs that can proactively reduce injuries. Preventing injuries is preferable to treating them!

Job profiles need to be presented in a “user-friendly” digital format, using accessible graphic displays and even annotated videos of the job being performed. Users need to be able to manipulate the data to find exactly the level of detailed information they require.

Easily Share Roadmap For Recovery

If and when an occupational injury occurs, the job profile should be electronically shared with the employer’s claim and medical managers, whether the employer self-manages claims, or these services are performed by an external TPA, carrier, or by other managed care entities. This is invaluable as the claim/medical team now has a “roadmap” for the recovery and rehabilitation process, aiming to achieve the specific physical demand goals depicted in the job profile.

The job profile can and should be securely shared electronically with treating clinicians (physicians, therapists, etc.) who now have accurate information to rely on for treatment planning purposes.

• Progress can be easily monitored against job demands, enabling timely decisions about restrictions/limitations and return-to-work capabilities, as well as an assessment of the efficacy of the current treatment regimen.
• Should the claimant achieve maximal medical improvement short of his/her present job demands, the residual capabilities can be automatically compared to all other available jobs in the employer’s database to match the claimant to other suitable employment available at his/her company (or elsewhere ).

Job Profiles Are Critical To Optimally Manage Human Capital

In summary, job profiles are critical for employers to optimally manage their valuable human capital proactively to maintain fitness, safety, and productivity, as well as for the cost-effective management of medical recovery, rehabilitation and return to work when occupational injury or illness occurs.

Jacob Lazarovic MD, Medical Advisor at Amaxx LLC, Chief Medical Officer at MyAbilities, has considerable experience in managed care, including 18 years as chief medical officer at Broadspire , a leading TPA. His department produced clinical guidelines and criteria to support sound medical claim and case management practices; participated in analysis, reporting and benchmarking of outcomes and quality improvement initiatives; developed educational and training programs that updated the clinical knowledge and skills of claim professionals and nurses; provided expertise to enhances the medical bill review process; and operated a comprehensive and unique in-house physician review (peer review) service. He has been published extensively in industry journals and has held several senior medical management positions at companies including HealthAmerica, Blue Cross/Blue Shield of Florida and Vivra Specialty Partners

Lost time from work is a significant driver in workers’ compensation claims.  Consider some of the following statistics:

• On any given workday, up to 5% of the total US workforce is off work;

• Lost wages and productivity account for $267 billion per year – with roughly $88 billion of that amount attributed to work injuries; and

• Time off from work due to injury accounts for additional stressors on employees, employers and the claims management team. This includes increased workplace dissatisfaction, loss of workplace morale, increased overtime (including mandatory overtime costs) and a reduction in the quality of work one performs.

The bottom line is nobody wins when an employee is off work due to an injury.  Based on these factors, interested stakeholder seeking to improve their workers’ compensation programs and improve efficiency should seek to return injured workers to work – and do so as soon as possible.

Opportunities to Return Employees to Work

Quick and effective return to work benefits all interested stakeholders.  There are countless ways to return an employee to work following an injury.  It takes time and energy, but it has many benefits to the program’s bottom line.  This requires a plan that needs to be in writing and strictly followed to drive program efficiency.

• Prepare a written RTW policy: This policy should encourage all employees regardless of their age, tenure with the employer or position to return to work following a work injury.  It should require contact between all interested stakeholders.  One key consideration is the number of weeks an employee can perform light duty work with the date of injury employer.  Doing so tends to motivate employee’s to return to return quickly to work.

• Prepare a written job description: When it comes to job descriptions, the devil is the details.  Important information should conform to the state’s workers’ compensation act and what is considered “suitable gainful” employment.  Items that need to be defined include both the essential and marginal functions the employee will perform.  The wages and hours and employee will work are also important;

• Identify a RTW Coordinator: A RTW Coordinator serves an important role in the RTW process.  Not only are they are responsible for serving as a point of contact for the employer, but they will also understand the myriad of complex legal issues associated with workers’ compensation.  This includes such matters as short-term disability, ADA, and FMLA;

• Identify and catalog light duty jobs available: There are countless activities an injured worker can perform in a light duty capacity that meets a wide variety of work restrictions.  Clerical positions that are generally sedentary include answering telephones, filing documents and checking safety supplies.  Other positions one can consider for employees with medium duty restrictions include light maintenance, cleaning common areas, updating safety materials (policies and procedures and First Aid kits) and grounds maintenance.

• RTW form development: Workers’ compensation is a form driven system which can be used to one’s advantage in the RTW setting.  Forms can include job offers, acceptance of duty letters and other communications.  Well drafted forms help communicate policies, procedures and expectations to everyone.

• Communication with the workforce: It is important that all employees are aware of and understand a well-written and consistently implemented policy.  Steps to make sure this occurs includes incorporating the RTW aspects of the workplace into new employee orientation, easily accessible workers’ compensation forms, and ongoing education during quarterly/annual workplace safety training and meetings.  Mentioning it at all trainings reinforces the importance of RTW as a workplace policy and can boost workplace morale.

Conclusions

Lost time following a work injury reduces the profitability of an employer and increases the cost of a workers’ compensation program.  Taking affirmative steps to put injured people back to work through an RTW program, increase a program’s efficiency, and make a company for efficient.  Part of this includes creating an effective RTW policy and making sure it is implemented within a workplace environment.

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 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.

Members of the claims management team and other interested stakeholders in a workers’ compensation program need to be proactive when it comes returning an injured employee back to work.  This includes being ethical and hardworking when it comes to vocational rehabilitation matters.  This is especially the case when it comes to overcoming common barriers in the RTW and rehabilitation process.  Failure to do so can result in increased workers’ compensation costs and other added expenses.

Who is Responsible

The employer is the most important and impactful party in return to work.  The best practice is for the employer to develop the position of a “RTW Coordinator.”  This should be a person who is knowledgeable in human resource matters, state and federal disability and discrimination laws, and accessible to the entire workforce.  The RTW Coordinator should also be responsible for all interactions with the injured worker on behalf of the employer and maintain documentation related to a workers’ compensation claim.

• Responsibilities of the Employer: This party is responsible for reporting the work injury and helping with the investigation.  The employer should take action in letting the employee know their rights, which is often required under a state workers’ compensation law.  They are also responsible for identifying available light-duty work opportunities and monitor the employee’s recovery.

• Responsibilities of the Insurer: Coordinate with the employer on all work injury matters and pay for all workers’ compensation benefits the injured employee is entitled to under the law.  The insurer can also make recommendations on light duty job opportunities and provide education to their insured.

Overcoming Common RTW Barriers

There are numerous barriers to effective RTW following a work injury.  Employers, insurers and other interested stakeholders should make an effort to understand these barriers and overcome common objections to returning an employee back to work following a workers’ compensation injury.

• We do not have light duty available – Sorry!

There are countless opportunities for an employer of any size to provide RTW opportunities for injured employees in need of light duty work.  The key is being creative!  Examples can include clerical positions in the front office and maintenance positions such as cleaning or performing lawn maintenance.  A light duty position can also include the review of policies and procedures and making sure the company’s safety training is up to date.

In order for a light duty job offer to be effective, it must meet certain requirements outlined in law or rule.  Factors to consider include specific details contained within the job offer description and consistency of the offer when compared to the employee’s normal position – e.g., If the employee was working the first shirt at the time of injury, make sure the job offer is for that same shift.

• The labor unions are tough – they will never agree to this!

Organized labor should always be viewed as a partner in RTW efforts.  Restrictions may apply depending on the collective bargaining agreement.  Every effort should be made to include labor in this process as the union benefits when its members are working and being productive.

• The injured worker is too old to attempt RTW

Americans are staying in the workforce longer due to a number of different factors.  Regardless of the age of an employee, it is important to remember they add value not only to the mission of the company, but it also increases workplace morale.  Every attempt should be made to include older employees in the process.  It may even be an opportunity to keep them off Social Security Disability via the “Ticket to Work” program.

Conclusions

All interested stakeholders are responsible for RTW efforts in workers’ compensation matters.  This includes being creative and seeking to overcome common obstacles that prevent the implementation of an efficient program.  By keeping all parties involved in the process, one can reduce workers’ compensation program costs and promote a better workplace.

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 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.

When a physician is treating an employee for a back injury or other job related injury, the decision on when to return the injured employee to work is often a subjective decision. The physician who is unsure of the employees physical capability will often turn to the physical therapist for an objective opinion of the employees ability for work. The physical therapist will provide a Functional Capacity Evaluation (FCE) by administering various tests to determine the employee’s functional capacities and limitations.

Comprehensive Examination and Evaluation

The FCE is a comprehensive examination and evaluation by the physical therapist that objectively measures the employees level of functioning. The testing will document the employees ability, or the lack of ability, to perform the essential job related task over a specific time frame. The FCE will provide objective information to the physician in several areas:

1. the employee’s functional abilities and job demands
2. the disability evaluation
3. when to return the employee to work
4. whether or not the employee can return to the job held prior to the injury
5. the employee’s functional abilities away from the job
6. to information to design a rehabilitation plan, if needed
7. the need for other medical intervention and/or treatment

While most workers compensation adjusters and employers will look at a FCE as a way of proving the employee is able to return to work, it serves a much greater function.   The results of the FCE will often limit the disability rating of the employee, preventing the physician from assigning a higher disability rating than is justified. Furthermore, the FCE will determine physical limitations the employer will need to know to modify the employee’s job, preventing a needless re-injury of the same body part.

Job Specific & General Purpose FCE

There are two types of FCE, the Job Specific FCE, and the General Purpose FCE. The Job Specific FCE measures the employee’s ability to perform the task and physical demands of a specific job. It can be performed at the physical therapist’s clinic, but the physical therapists can go with the employee to the actual job site and evaluate the employee’s ability to do the essential task of the employee’s job. The job-specific FCE will determine if the employee can safely do his prior job or if modifications of the required work are needed.

The General Purpose FCE is normally used when there is no longer a job for the employee to return to or when the job functions have not been determined. The General Purpose FCE consists of a group of standardized test and measurements that can be used to establish the employee’s overall physical capabilities. The results of the General Purpose FCE can be used to evaluate the employee’s ability to perform specific jobs that may come available to the employee.

Determine Medical Status of Employee 

Prior to starting the FCE, the physical therapist will review the medical records of the employee to determine the medical status of the employee. The physical therapist will establish a baseline for the employee based on the known job demands. The job demands of the employee will be characterized per the US Department of Labor’s “Selected Characteristics of Occupations as Defined in the Revised Dictionary of Occupational Titles” as:

1. sedentary – exerting up to 10 pounds of force occasionally,
2. light – exerting up to 20 pounds of force occasionally or up to 10 pounds of force frequently
3. medium – exerting 20 to 50 pounds of force occasionally or 10 to 25 pound of force frequently
4. heavy – exerting 50 to 100 pounds of force occasionally or 25 to 50 pounds of force frequently
5. 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

Both the Job Specific FCE and the General Purpose FCE measure the employee’s ability to perform various motions, movements, and skills. The ability to do the accomplish the physical demands of the job will be measured in these areas:

1. Balancing           Carrying                  Climbing                 Crawling
2. Crouching          Far vision                Feeling                   Finger dexterity
3. Fingering           Handling                 Hearing                   Kneeling
4. Lifting                Manual dexterity   Motor coordination Near vision
5. Pulling               Pushing                  Reaching                Sitting
6. Standing            Stooping                 Talking                    Walking

Again, using the US Department of Labor guidelines, the employee’s tolerance level during an eight hour work day for the above activities is categorized as:

1. Not Present (Never) – The activity does not exist in the job (example: Crawling could be classified as Not Present in the job)
2. Occasionally – The activity exists less than 1/3 of the time (example: Climbing – occasionally)
3. Frequently – The activity exists from 1/3 to 2/3 of the time (example: Carrying – frequently)
4. Constantly – The activity exists 2/3 or more of the time (example: Walking – constantly)

Document Evaluation Results 

When performing the FCE, the physical therapist is responsible for ensuring the test are appropriate for the employee and the test can be done safely. The physical therapist will review the musculoskeletal condition of the employee as reported by the treating physician.   The physical therapist will screen the employee for any underlying medical pathology that would limit or prohibit the employee from participating in the FCE.

Upon completion of the FCE, the physical therapist will document the evaluation results. The FCE report will confirm the employee can return to work without job modifications or will confirm the employee can return to work with specific job modifications, or the need to delay the employee’s return to work.   The FCE may also address the need for work hardening or other interventions that would improve the employee’s physical abilities. Properly utilized, a FCE can provide the treating physician with the necessary information to return the employee back to work.

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.

Interested stakeholders in the workers’ compensation process are constantly seeking ways to reduce program costs.

One area includes the discontinuance of workers’ compensation benefits for school employees and teachers suffering from the effects of a work injury during the summer break period.  While statues and case law interpretations vary in each jurisdiction, employers and insurers are generally limited in their ability to discontinue or suspend various workers’ compensation benefits for school employees during this time of year – even if they have no plans of looking for work while under restrictions on their activity.

Schools Out – Time to Discontinue Work Comp Benefits?

While the school year typically runs from late August through late May, employees of school districts around the country sustain work-related injuries every day.  The ongoing effects of those work injuries do not magically disappear for summer break.  Sadly, those hot summer days a teacher, paraprofessional or administrative staff employee would like to spend at a beach, can be spent at home convalescing.  Proactive members of the claims management team might view this as an opportunity to discontinue ongoing wage loss and vocational rehabilitation benefits.  Unfortunately, this is often not consistent with many state workers’ compensation laws via case law interpretation.

One case on point comes from Minnesota, where a school district sought to discontinue ongoing wage loss benefits at the conclusion of a school year.[1]  The rationale for the discontinuance was based on the premise the employee did not intend to work during the summer months, and the result was no loss in wages.  A compensation judge rejected this argument and affirmed by the Minnesota Workers’ Compensation Court of Appeals.

In affirming the reinstatement of wage loss benefits, the court noted that “A teacher who has no summer school duties is presumably free to pursue other part-time or short-term employment.  Therefore, a teacher with a work injury might be entitled to continuing wage loss benefits through the summer if the teacher is totally unable to work for medical reasons attributable to the injury or has injury-related restrictions that affect is his or her ability to secure other employment.”

In sum, wage loss benefits are typically payable as long as the employee has a disability related to the work injury. The basis for this decision is also applicable to other forms of workers’ compensation benefits, including vocational rehabilitation.

Staying Proactive to Avoid the Summertime Claims Blues

Being away from work can cause the summertime blues in anyone – especially people who work in an educational environment.  Now is the time for claims professionals handling claims related to school employees to be proactive on these matters to reduce their exposure and ensure improper discontinuance of benefits is not made.

• Investigate whether the school employee is engaged in seasonal employment. People who work in a school environment may be likely to work seasonal jobs during the summer months.  This can include individuals suffering from work-related  Efforts to investigate these matters may also include the use of surveillance if there is credible information the employee is working and not reporting their work activities.

• Make efforts to return the injured school employee to work. Proactive return to work efforts should be made on every claim.  This is especially the case for school employees where wage loss benefits could be paid for an extended period of time.  Suggestions include developing a “Work on Loan” relationship a local non-profit, volunteer agency, or other light duty work inside school district buildings and facilities.

• Monitor the status of claims involving school employees and stay in contact. Lack of communication between the employer/insurer and employee leads to conflict, fear and  Staying in contact with the injured worker provides for effective communication and minimizes problems.

• Determine if the school employee is cooperating in vocational rehabilitation efforts. Summer break and time off from school does not give an injured school employee a vacation from their recovery and achieving their vocational rehabilitation goals.  Various workers’ compensation benefits can still be discontinued or suspended for failure to cooperate with a rehabilitation plan.

Conclusions

School employment and summer breaks create an opportunity for interested stakeholders to stay engaged with employees and reduce workers’ compensation program costs.  While most benefits typically remain payable during summer breaks, there are opportunities for motivated members of the claims management team to engage injured employees and minimize their exposure.  This includes claim monitoring, engagement and ongoing efforts to return an employee back to work.

[1] Qualy v. Special School District No. 1, 1994 WL 421773 (MN WCCA).

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 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.

You have implemented a corporate return-to-work program, but your projected workers’ compensation savings haven’t yet materialized. Supervisors are telling you they can’t get employees back to work, and even if they could they don’t WANT them to return to work. We’ve all heard it.

It may be time to examine the impact of collateral resources, often resulting in employees out on workers compensation receiving more income and benefits than they would have if they were working.

Common Disincentives to Returning to Work:

1. Salary and Wage Continuation: Some companies pay 100% of salary in lieu of having an employee collect workers compensation for injuries of short duration.

2. Occupational Injury Pay Supplements: Many firms pay supplemental benefits to make up the difference between workers compensation benefits and regular earnings.

3. Open-Ended Job Return: Instead of holding jobs open indefinitely, employers should hold jobs open for a specific time period, such as six or nine months.

4. Vacation and Sick Time: Companies frequently allow vacation and sick time to accrue for employees on workers compensation. Some even allow employees to “borrow” more sick time if they need to stay out of work longer.

5. Short-Term Disability: In some companies, disabled employees receive STD benefits in lieu of salary after six weeks. But the standard definition for disability may differ from workers comp, allowing an employee to collect both.

6. Perk Continuation: Employers often maintain ancillary benefits and privileges such as car allowances, club and professional dues, company store privileges and periodical subscriptions for employees on disability.

7. Loan Protection Policies: Individual insurance policies are available to pay mortgages and consumer loans such as car loans and credit card debts in the case of a disability.

8. Unemployment Compensation: In a few states, an employee receiving workers comp also can qualify for state unemployment benefits.

9. Pension and Retirement Plans: If these plans do not allow for the offset of workers comp benefits, an employee can receive workers compensation benefits and a full pension.

10. Product Liability Actions: An employee can file an action against the manufacturer of a product that injured him to collect damages. The employer should seek reimbursement for workers comp payment from any such settlement.

3 Questions to Eliminate Return to Work Disincentives:

1. What Benefits are Injured Workers Getting By Not Working?

Many companies fail to look closely enough at their internal wage and benefits structure before embarking on programs to reduce workers compensation costs. There are numerous collateral income benefits and sources providing built-in disincentives to remaining injury-free or returning to work as soon as possible.

For example, a major newspaper was considering an expensive incentive program to motivate employees to return to work, but a careful examination of the company’s situation revealed the reason employees were not returning to work was because they earned the equivalent of 115% of their pre-injury earnings when the stayed out of work.

In another case, an injured construction company employee received long-term disability (LTD) payments after 26 weeks of disability, in addition to workers compensation benefits. The total of these benefits exceeded his pre-injury earnings.

And, his childcare and commuting expenses also were greatly reduced while he was home.

2. Examine Extra Insurance Your Employee May Have

If an employee has purchased credit disability insurance, he or she may have eliminated house and car payments while being unable to work.

As such, he refused his employer’s offer of a transitional duty job at full salary because his LTD and credit disability policies would have terminated the benefits.

3. Get your Departments to Work Together to Design WC Policies.

In a large company, the directors of human resources, industrial relations, workers comp and employee benefits and compensation must all be involved in designing, administering and maintaining policies. Incentives to remain at and return to work must be built into the management systems. Disincentives must be removed from all direct and indirect sources.

Substantial savings can be achieved when a company coordinates its salary, benefits and compensation programs, so employees don’t earn more by staying out of work. If not properly coordinated, a company’s employee benefit and compensation programs may inadvertently serve to extend workers compensation absences.

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.