WorkSTEPS

1. WorkSTEPS The Role of Function in Injury Prevention and Loss Control Programming Lindee Greer, PTA, CEAS WorkSTEPS Director of Training

2. DEFINITION: System of ADA compliant employment tests designed to prevent injuries, control injury related costs and combat fraudulent claims.

3. WorkSTEPS Model: Nat’l network of licensed medical practitioners 485 locations in 43 states (On demand relations with 1200 more) Viewed as an investment in long term safety of employees Largest industrial database in US—40 measures on over… 450,000 employees!!!!!

4. Legal Model Staff attorney since 1992 Jackson Lewis since 2000 One of largest law firms in US “White Paper” since 1999, Rev 04 State Law attorney consultants Legally compliant process

5. ENTIRE MISSION OF TESTING IS: To prevent injuries To protect EE’s To provide the best possible RTW conditions To maintain productivity and protect EE’s jobs

6. Testing Customized to Look At: Job specific strength Baseline full body function Medical risks as they relate to essential functions Common cumulative traumas such as back and upper extremity syndromes

7. What is a job analysis? A job analysis is the process of collecting information about a position to be filled that helps to identify the essential job functions and links them to the skills, education, and training needed to perform that job.

8. Physical Demands Analysis Essential Functions Material Handling – lifting, carrying, pushing, and pulling. Includes weight, height, frequency, distance, shape of load, and load characteristics. Non-Material Handling – sitting, standing, walking, bending, reaching, crawling, squatting, kneeling, climbing. Includes frequency, surface grade, balance, and distance.

9. Material Handling Components Name of object maneuvered Weight of object Dimensions of object Origin height Destination height Distance carried Force required to push or pull the object Repetitions object is maneuvered per minute, hour, shift, etc. (Use the WorkSTEPS job analysis table to collect this data)

10. Why Should a Job Analysis Be Performed? For the treating therapist – to target treatment appropriately For the employer – to eliminate ergonomic risks, to structure transitional duty programs, and to develop ADA compliant employment tests

11. Why Should a Job Analysis Be Performed? For the potential or existing employee – as a baseline for the individualized assessment to safely and accurately match the individual’s abilities to the physical demands of the job as a new hire, when returning to work after an illness or injury, or when requesting an accommodation for a disability

12. Types of Tests Available Pre-offer Agility- physical agility only Post offer –Most leeway Fit for Duty- Existing Uninjured EE Fit for Duty-Existing Injured EE Functional Capacity (FCE)- ordered by MD Psychological Testing

13. Post offer – Most leeway Employer may investigate past records for crime, driving, and work related injuries (Background checks) May ask applicant if they can perform specific job tasks May interview and pick the most qualified applicant Will hire them contingent upon passing the post offer physical and-or drug test.

14. Post-offer: WorkSTEPS LOCAL Test Provider Will: Ask medical questions / Hx Perform medical and functional evaluations Expand scope of evaluation and refer if needed Require safe performance of job related functions Give capable / not capable recommendation

15. Dynamic Lift Tests Functional Postures Instruction in Proper Lifting Techniques Standard NIOSH boxes Must lift enough to attempt job related tests

16. JOB SPECIFIC TESTS Posture Repetition Force Aerobic Demand “Virtual” Testing

17. “Baseline” Full BodyMusculoskeletal Eval: Posture Range of Motion Joint Flexibility/ Wear and Tear Strength Palpation Investigation of Damaged Parts Medical evidence to quantify pre-existing conditions

18. Apportionment Any “individualized assessment” leading to quantified medical documentation of a pre-existing condition Based on WorkSTEPS data: “Renders decision ordering impairment and supplemental benefits reduced by 40%” Chief Appeals Judge, Case #950268, Texas

19. Measured Return to Pre-injury Status….. Stops benefits Leads to RTW ALWAYS supersedes speculation or subjective reports

20. Complex “Individualized Assessment”… Reduces disparate treatment Doesn’t allow wrongful “labeling” Establishes “manifest relationship” of essential functions to job

21. Benefits to Employees Less likely to suffer MSD’s More likely to RTW sooner Able to maintain full or partial wages and remain productive Creates accountable medical Rx Increases motivation and productivity Reduces turnover !!! (Less retraining, sharing work, etc)

22. Benefits to Employer Promotes safe job performance Don’t pay for pre-existing conditions Only pay to rehab to baseline levels Test and treat in same network w/ same protocols (accountability) Don’t hire employees who aren’t strong enough or reclassify Don’t pay anything for doctor releases, hold harmless, and extra measures to clear a condition $30 saved for every $1 spent! Receive legally compliant policies and scientific data to control RTW

23. Return on Investment !!! Stop one carpal tunnel, one back injury, and one fraudulent claim. Pays for individualized test on: 2500 EMPLOYEES

24. Functional Testing PAYS for ITSELF: Significant $$avings Ability to test high risk newhires –Paid for by not hiring your next claimant / by matching strength to job. Cost negated by stopping 1 claim! Ability to test existing EE’s—Paid for by reclassifying, accommodating, conditioning, medical retirement, detecting symptoms early, job match Ability to ALWAYS test injured EE’s—Paid for by immediate accountability re symptoms, sincerity of effort, realistic goals (baseline) and ability to RTW in a measured capacity

25. Added Safety and Savings: Another 20% require medical clearance (at their expense –BP) and/or require additional tests Hold Harmless for controlled problems (Asthma, BP, Epilepsy) No added costs to the employer Provides safety to employee Protects employer from pre-existing responsibility

26. FFD – Existing, Uninjured Employee EEOC Enforcement Guidance: “Disability Related Inquiries and Medical Examinations of Employees Under the ADA” eeoc.gov

27. Enforcement Guidance States Existing employees may not be subject to “routine medical exams” unless the position directly impacts public health and safety. Physical fitness and physical agility tests are not considered medical exams.

28. Purpose of Fit for Duty Tests Classifies according to risk with pre-determined wellness intervention protocols Identifies who could benefit from work conditioning Stops MSD’s from progressing Allows employer to reclassify/accommodate Discovers disease processes

29. Employer Should Implement policy identifying the physically demanding positions that will be subject to routine fitness for duty tests. Identify the course of action that will be followed if deficits are identified. Educate employees to decrease negative perception of testing. Be consistent and fair---deficits identified in testing should never result in termination.

30. Fit for Duty—Post Injury “Under ADA, medical information or medical exams may be required when an employee suffers an injury on the job. Such an exam may be required when an employee wishes to return to work after an injury or illness, if it is job related and consistent with business necessity.” TAM VI-13

31. Fit For Duty – Post Injury: Allows ER to… Determine if the individual has a qualified disability. Determine if the person can perform essential job functions or effective accommodations. TAM V1-14

32. Post Injury Test Compares baseline to current status Defines exact deficit caused by injury Utilizes latest technology to determine depth of symptoms compared to diagnosis Has proven consistency measures (Peer review published) to prove or disprove symptom exaggeration Creates accountability, accurate goals and transitional return to work

33. Functional Capacity Evaluation (FCE) Ordered by physician (Pd by workers’ comp) Involves complex medical SHOULD include consistency and effort measures Work related Performed by post offer network WS one of 6 major national FCE vendors

34. Residual Job Functions: Focus on Capability !!! How long worker can drive, sit, stand or walk Climb ladder, steps or stairs Mop, sweep, dig, paint or deliver What they can carry, push or pull Anything else job related

35. Companies Utilizing WS: Lockheed Knight Transport Hon Furniture Nabors Drilling Frontier Airlines DFW Int’l Airport Comair Halliburton DOW Chemical MoDOT Toyota Motor Cox Communic Berg Electric Rubbermaid Austin Commercial MV Transit Fleetwood Madera ISD (CAL) Hundreds More!!!

36. Knight Transportation “Year to date, we have experienced a 70% reduction in the severity of claims as well as a 30% reduction in frequency of claims…translating into savings of several hundred thousand dollars.” Safety Manager

38. Why Wouldn’t YOU Test? Thank you! THE END