With the onset of the industrial revolution and the creation of workers’ compensation insurance, the need to determine the fitness for duty of the employee became critical to the employer. The underwriting process for insurance placed a greater emphasis upon the employer’s responsibility to make certain the worker was not placed at risk in performing the usual and customary job duties. A negative loss experience had, and continues to have, a correspondingly negative impact upon the cost of insurance for the employer with a work force placed at risk.
In returning individuals to work subsequent to medical treatment, reliance has historically been placed upon the physician to determine the residual abilities of the worker. In cases with limited or no residual disability, the answer is usually quite easy to obtain. However, injuries with a noticeable impairment and corresponding disability present a significant issue to the insurance company, the employer, and the employee. The overwhelming tendency is for the medical community to present the worker’s condition in technical, impairment-based medical terminology. What does a 30-degree loss of abduction and a 15-degree loss of internal rotation of the right upper extremity mean to a carpenter? To the employer, employee, and the insurance company, this does not tell us whether the carpenter can safely perform the job. And, if the worker does have some limitations, what functions will he or she be capable of safely performing?
It is also important to understand why and when functional testing should or could be conducted. A Functional Capacity Evaluation or Post Offer of Employment Test is a process that should be driven by the nature of the referral question. Whether the question is can an individual safely return to work following an injury (modified or not) or does the individual meet basic job demands required to perform their job safely must be addressed and answered. The Functional Testing system also recognizes varying complexities in the evaluation of function, and the need to address each issue on a customizable basis.
Work Hardening and Work Conditioning programs are designed to restore an individual’s capacity to the point he or she is able to return to work either at the pre-injury position or a new occupation for which the residual abilities are appropriately matched. Work Hardening programs are specifically matched to the occupation that is under consideration through the development of simulated work tasks that replicate those physical demands that will be encountered during the performance of the usual and customary job duties. Although it would be ideal to replicate the exact function or task required, the limitation most commonly encountered is the ability to provide the resources to perform the identical task (e.g., providing a train engine to simulate railroad engineer functions)
This test is performed, in compliance with the Americans with Disabilities Act, subsequent to the offer of employment by the employer to the job candidate. In the United States, the offer is considered conditional until the employee demonstrates the ability to perform the physical demands of the essential functions. Provides the ability to develop appropriate alternate or modified functions on a more expedient, cost effective basis if the worker is unable to perform the essential functions of the position. This will help to establish expedited communications for return-to-work potential and the identification of medical apportionment not attributable to the injury in question.
This evaluation is performed when the disability determination requires an outline of the capacity of the individual in relation to the impairment or impairments. It is a comprehensive evaluation used to determine the impact of an impairment on the individual residual capacity for work-related activities.
This type of testing is performed when a determination needs to be made as to the functional limitations/abilities of the individual directly related to the impaired body part of system. The test components may also be used in conjunction with a doctor’s report of impairment as independent third-party measurement that the physician may cite on an objective basis.
Worker’s Compensation Assumes:
Industrial Rehabilitation Successfully:
60 minute sessions
Repetitive movements that may include resistance, weights or cardio
Wear comfortable clothes that allow free range of movement, like athletic shorts and T-shirt
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