Post-Offer, Pre-Placement
Functional Testing
Kory Zimney, PT, DPT, CSMT
What is it?
Functional testing done post-offer of a specific
job to all qualified candidates to
ensure they can perform the
“essential” physical demands
of the job.
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Why do it?

According to the U.S. Department of Labor 1
in every 10 workers is not physically capable
of performing the essential functions of their
job safely.
Physical Capacity of the general
population
Physical Demand Level (PDL)
Male
Female
Sedentary (level 1)
99%
99%
Light (level 2)
95%
90%
Medium (level 3)
66%
50%
Heavy (level 4)
33%
10%
Very Heavy (level 5)
10%
0%
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Failure rate of testing:
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Medium PDL is in the range of 5 - 8%
Heavy PDL is in the range of 9-12%
Very Heavy PDL is in the range of 18-23%

Increase injury risk if not matching worker to
physical demands of job

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Shoulder: 2% versus 28%
Back: 3% versus 33%

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Reduce injury risk
Reduce severity of injuries
Reduce cost associated with injuries
Reduce turnover
Baseline of any current impairment status

Reimer et al found that pre-employment screening
combined with a worker fitness program for grocery
warehouse workers significantly decreased injuries and
injury-related expenses over a 3.5-year period.

Nassau demonstrated that pre-work placement
screening and case management significantly decreased
the severity of injuries.

Gassoway and Flory documented that screening nursing
assistants at a regional health center significantly
decreased job turnover. The health center saved $6 for
every $1 spent on screening.

Littleton provides the strongest evidence to date in
support of post-offer screening, using the ErgoScience
Post-Offer Screening protocol. They tested physical
plant applicants at a major university hospital and found
an 18%, decrease in number of lost day cases and a
78% decrease in total injury costs. For every $1 spent on
post-offer screening, the employer saved $18.

Post-offer, preplacement functional
capacity test (PPFT)
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Post Offer Physical
Lifting Screens
Functional Screen
Back Screen
Lifting Test
Ability Testing
Physical Capacity Profile
What are the different components of
the PPFT that might be done?

Baseline mobility and positional tolerances

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Movement screen or ROM testing
Sit, stand, reach, bend/stoop,
squat, climb, crouch, kneel,
balance
Aerobic testing
What are the different components of
the PPFT that might be done?

Lifting



Various weights, heights
Carry, push/pull, lifting
Strength testing

Isometric or Manual muscle testing
Can we screen for potential repetitive
trauma (overuse injuries)?
What’s the difference between tests

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Time needed to do testing (15-30 minutes)
Baseline ROM, cardiovascular and strength
data
Future injury risk screening
Current pathology screening
Lifting tasks general versus specific
Documentation of pre-existing impairments
Cost
What do you need to do to start
testing?

Functional Job Analysis (FJA)

Accurate job description with measurement of
“essential” job functions

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Essential functions are the basic job duties that an
employee must be able to perform, with or without
reasonable accommodation.
Create a test that is fully compliant with the
EEOC and ADA by ensuring the absence of
disparate discrimination in the functional test
design and delivery.
Factors to Consider in Determining
if a Function is Essential

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Whether the reason the position exists is to
perform that function,
The number of other employees available to
perform the function or among whom the
performance of the function can be
distributed, and
The degree of expertise or skill required to
perform the function.
Factors to Consider in Determining
if a Function is Essential

Your judgment as to which functions are
essential, and a written job description
prepared before advertising or
interviewing for a job will be considered
by EEOC as evidence of essential
functions. Other kinds of evidence that
EEOC will consider include:
Factors to Consider in Determining
if a Function is Essential
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the actual work experience of present or past
employees in the job,
the time spent performing a function,
the consequences of not requiring that an
employee perform a function, and
the terms of a collective bargaining
agreement
Does everyone need to be tested?
How is the Post-offer testing
different from a Fit for Duty Exam
testing?