Hiring Right to Stop
50% of injuries the
FIRST Year!
Larry Feeler, PT, CEAS
“Industrial Physical Therapist”
Certified in Ergonomics
CEO WorkSTEPS and OPT
Lfeeler@grandecom.net
Jack’s Picture
DEFINITION:
System of ADA compliant
employment tests designed
to prevent injuries, control
injury related costs and
combat fraudulent claims.
American’s with
Disabilities Act (1990)
• Title 1 –
“Prohibits
employment
discrimination
against
qualified
individuals with
disabilities”
• Allows Testing
New-Hire Tests…ADA screens
are more comprehensive than
routine physicals…
Post offer: Allows
medical and essential
function testing
May select hardest
physical positions or
ones with highest
injuries
Must test ALL
applicants applying for
that position
New-Hire Post Offer
Testing….
• Matches EE’s strength to their
job
• Scientifically measures
“Baseline” motion and strength
• Measures significance of preexisting conditions to job
functions
• Screens for common cumulative
traumas
“Common Cumulative
Traumas :
• Torn Rotator
Cuff (Shoulder)
• Bad Backs
(Neurologic)
• Torn knee
ligament
• Carpal Tunnel
• Operated Parts
Post Offer Baseline Medical and Functional Screen
Employer offers job contingent upon
passing post offer screen
Employee passes Drug
Test
Post offer screens
baseline medical and
virtual essential functions
Employee undergoes
screen for another
more properly suited
position
EE fails JOB
Essential Functions
Employee fails Post
offer screen
Qualified disabled EE
requests reasonable
accommodation
No reasonable
accommodation made
Ability to revoke offer!
Saved potential injury.
Passes Post offer
medical risk and EF
Reasonable
accommodation made
EE strength and motion
“Matched to JOB”
Fails Medical Risk:
Must pay to see
personal MD.
Interactive Process
Ability to revoke offer!
Saved potential injury.
Ability to revoke offer!
Saved potential injury.
Individualized Assessment…
• Matches right
worker to job
• Reduces
disparate
treatment
• Provides
“measured”
photograph for
EXACT future
comparison
Companies Utilizing Testing:
National:
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Leggett and Platt
Chesapeake Energy
William Charles Const.
Knight Transportation
Hon Furniture
Frontier Airlines/ Comair
Waste Management
Cox Communication
Halliburton
DOW Chemical
MoDOT / Okla DOT
General Mills
Johnson Controls
Berg Electric
Hallmark Cards
Thousands More !!!
Local:
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City of Odessa/Ector cty
Warren CAT
Challenger Process
Nabors
Key energy
C C Forbes
Kirby West
Big Dog Drilling
H & P Drilling
NC Sturgeon Const
Viva Well Service
Blakely Construction
Bridges Equipment
Employer Nightmares:
New-hires
• Hiring EE’s w/o
matching them
physically to
their job
• Hiring EE’s w/
significant
medical
condition/s
Existing EE’s
• Not measuring
continued job
capability
(agility tests)
• Not requiring
post injury
comparison test
• Not proving
sincerity
Another Problem:
Worker’s Comp Assumes
• Worker’s are
perfect when
hired
• Worker’s never
grow old
• Whatever
happens to the
worker, the
employer caused
EPIDEMICS:
• AGING
• ARTHRITIS
• OBESITY
Back pain
• Mental Health
1:5 Amer Affected
HALF Am Depressed
Highest med prescrip
Combat Problems w Evidence:
Valid Post Offer Must Start with
Accurate Job Analysis…
Dynamic Qualifying Lifts:
Standard NIOSH
boxes
• 4 Postures
• Body mechanics
training
• Must lift enough
to attempt job
specific tests
Shoulder to Overhead
Screen Replicates Job…
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Posture
Repetition
Force
Aerobic Demand
“Virtual” Testing
Pretty….does it
have an engine ?
“Baseline” Full Body
Musculoskeletal Eval:
Evidence Based !!!!
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Posture
Range of Motion (IMP measures)
Joint Flexibility/ Wear and Tear
Strength and Heart Capacity
Palpation
Investigation of Damaged Parts
Medical evidence to support if
“not capable” for medical risk
POSTURE
Medical Tests
RANGE OF MOTION MEASURES:
According to AMA Guides
Apportionment
• Any “individualized assessment”
leading to quantified medical
measures of a pre-existing
condition
• “…ordering impairment and
supplemental benefits reduced
by 40%”
Chief Appeals Judge, Case #950268, Texas
PALPATION
Reasons ER may Withdraw
Job Offer:
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Missed appointment
Failed Drug Test
Won’t sign consent to test
Lied on Medical HX
TAM IX-7
Has a Bad Attitude regarding testing
Has a Significant Medical Risk
Deadline missed regarding
interactive process
• Can’t Lift Enough Weight
• Fail any Part of Job Specific Testing
• Accommodation ? = undue hardship
Return on Investment !!!
Stop one carpal tunnel, one back
injury, and one fraudulent claim.
Pays for individualized test on:
2000 EMPLOYEES
$$$ SAVINGS $$$…
• 50% AVE
REDUCTION
1ST YEAR !!!
• 79%
Soft Tissue Injury
REDUCTION
1st year testing
7,000 workers
Measured Return to Preinjury Status…..
• STOPS BENEFITS !!!
• Is facilitated by knowing
baseline strength and deficits
• Leads to faster RTW
• ALWAYS supersedes
speculation or UNMEASURED
OPINIONS (Porter v. Alumoweld)
WORK INJURY MANAGEMENT
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
Functional Testing Post Injury
Employee starts work!
Baseline data from
screen kept on file.
Employee gets
injured
Productive
employee
Employee goes to
physician
Release back to full
duty FFD to match
if questionable
Employee stabilizes
Productive
employee
Post Injury Fit For Duty
screen
Compare Initial
Baseline Data to
current status
Employee at same status
as pre-hire. Return to full
duty
Treatment/ Therapy with
RTW focus. Recondition,
accommodate temporarily ,
reclassify
Productive
employee
Sincerity of
Effort Test
Fail SOE,
Placed at full
Productive
employee
Employee returns to
work!
Events That May Legally
Trigger Fit for Duty Test:
• Reliable evidence of a performance
problem
• Reasonable belief employee is a
direct threat to himself or others
• Return to work after absence for a
specified number of weeks; Work
Related or Non WR
• RTW after physician release with or
without restrictions
• RTW after FMLA release from
physician
Policy 1-1
“Fit for Duty” Post Injury
• Effective date, EEs who suffer
WR or NWR injury exceeding X
lost days will be subject to FFD…
• …to determine extent of
disability
• …to determine job capability
• …to determine reasonable
accommodation
VALID EE
MAY HAVE TO
FIND BEST WAY
TO PERFORM JOB
SAFELY
MEASURED
CAPABILITY
EFFECTIVE RTW
Questionable
Employee
DISTRACTION BASED TESTING:
Non Emotional, Non Suprising, Non Hurtful
Simultaneous Bilateral Position
Peer review
Published
2004
Consistent
Inconsistent
SUMMARY:
• Develop content valid job tasks
• Must have full body “baseline” to quantify
pre-existing conditions
• Medical tests to clear safety issues
• Functional tests to measure ability
• ONE STOP SHOPPING: Drug, sleep apnea,
respiratory fit, breath alcohol, etc.
• Top down commitment of HR, safety,
personnel, management, etc
• Educate MD, INS, TPA about process
• Use SAME network to eval and treat
• Measured ability and sincerity after an
injury and before RTW ARE imperative
DATA IS POWER ..…
No Matter How You Use IT ! !
• BE ABLE TO
PUT THE
SCALES IN
YOUR
FAVOR … IF
YOU NEED
TO !!
Why Wouldn’t YOU
Test? Thank you!
THE END
Lfeeler@grandecom.net