Job matching can enhance an employer’s existing work injury management processes by preventing injuries and reducing work-related injury costs
By Curt DeWeese, PT
J. Paul Leigh, professor of health economics at UC Davis, wrote in his article, “Economic Burden of Occupational Injuries and Illnesses in the United States,” that the estimated cost of occupational injuries and illnesses is $250 billion, which outpaces the costs of cancer, diabetes, and stroke. According to the Bureau of Labor Statistics (BLS), musculoskeletal disorder (MSD) cases accounted for 34% of all injury and illness cases in 2012 and required a median 12 days away from work per claim.
Overexertion and slips, trips, and falls continue to be a leading cause of work-related injuries. The BLS also reports that injuries and illnesses resulting from repetitive motion resulted in a median of 23 days away from work to recuperate.1 The actual costs of these injuries can be staggering.
Need for Action
Employers realize they cannot sustain these lost days and associated medical and indemnity costs. They seek partners to improve the safety of their workforce, reduce injuries, and eliminate costs. Physical therapists are well-equipped to be that partner.
If therapists use an efficient process for performing job analysis, designing/delivering job-specific functional testing, and identifying specific work accommodations, they will have what they need to assist employers in their communities. They will also develop a new revenue stream for their practices, enhance their clinical outcomes, and increase referrals from employers. A job matching2 program can provide physical therapists the information and tools they need to engage in this role. An example of such a program is the one offered by DSI Work Solutions.*
Job matching is a streamlined process that begins with objectively evaluating jobs. The therapist documents what a worker does from both a task and physical demand perspective. Injury-prevention opportunities are identified during this process, and ergonomic improvements to reduce physical stressors and make tasks safer are suggested. The next step is to design the physical/functional evaluation that is used to determine an individual’s ability to safely perform the required tasks.
Utilizing post-offer, pre-employment functional testing of job candidates and return-to-work testing of workers post injury or illness identifies whether the individual is safely able to perform job tasks. I have been able to utilize my skills as a physical therapist when work accommodation (either short-term or long-term) must be considered. It is here that return-to-work statistics can be significantly improved.
Observe the Job On-Site
To fully understand the physical requirements of a job, a thorough analysis should include the following:
1) Review of current job descriptions, job hazard analyses, and standard procedures to understand essential job functions.
2) Interview both supervisors and workers to understand how the job fits in the larger process.
3) Observe the tasks performed, and verify the essential functions.
4) Collect objective measurement of forces required. Document required movements and body positions such as standing, bending, and reaching.
5) Determine the duration and frequency of each of the tasks performed.
This is the foundation of the job matching process that allows the PT to identify the physical and positional stressors that contribute to MSDs and injuries.
Organize and Present the Data Collected
Using the job matching process, the therapist develops a document using the information collected to define the physical requirements of the job functions. This document identifies the needed physical capabilities of workers, assists the employer to know what training is required of new-hires, and helps supervisors and safety professionals to know where physical stressors exist.
By documenting tasks with less physical demand as well as those with greater demands, the employer has a greater knowledge of what a candidate must do in the hiring process as well as a better understanding of what tasks are best suited for modified duty in stay-at-work and return-to-work cases. Once the document is complete, it is reviewed with the employees who perform the job to validate the document for accuracy.
ERGONOMICS: THE First Opportunity for Injury Prevention
As the analysis of functions is performed, the therapist often identifies forces that may be above accepted norms or awkward work postures that could contribute to
work-related musculoskeletal injuries. The therapist creates a list of ergonomic stressors that occur, and suggests ergonomic improvements to reduce the potential for injury. Oftentimes, a review of the company’s injury logs will pinpoint injuries to which these ergonomic stressors caused or contributed. Reviewing the costs associated with the injuries can be a mechanism
to support funding for the ergonomic improvements.
FUNCTIONAL TESTING: THE SECOND Opportunity for Injury Prevention
Understanding the physical requirements of the essential job functions is the foundation for functional testing that is compliant with the Americans with Disabilities Act. Job matching is the process of comparing a candidate’s physical abilities to the job requirements.
Post-Offer, Pre-Employment Testing
In the hiring process, functional testing provides the opportunity to make sure the candidate is physically able to perform the functions of the job. Functional testing offers a way for candidates to fully understand what is expected of them, and provides them an opportunity to ask questions. I have had candidates withdraw their interest after performing the post-offer test when they realized how demanding a job was. The therapist can provide instruction about safe technique and reinforce the need for safe behaviors. The employer benefits by placing safe and capable workers, but will also learn what would need to be accommodated if a function could not be fully performed.
Following a work-related injury or disability lost time claim, functional testing objectively shows the employee, medical provider, and employer what parts of the job can be performed as well as those that cannot be safely performed, and how/where to modify those parts of the job not currently met. This information matches the ability of the worker and the demands of the job, which can be the most effective method of injury prevention. The ability to safely place a candidate back to the original job, with or without modifications, helps the employee maintain an attitude of “ability” instead of “disability.”
Functional testing results can also drive the rehabilitation process, highlighting areas of weakness or deficit that can be improved. These items can then be retested at regular intervals to objectively measure progress toward work function goals. This is an effective method of cost containment to reduce lost work days for the employer, and helpful in returning the employee to full function in a safe and timely manner.
Work injury prevention requires a safe work environment, inherently safe work practices, and employees with physical capabilities that match the demands of the job. I have used a job matching program to help all parties involved in this process. With the proper tools and knowledge of the regulations and legalities of functional testing, physical therapists are clearly well-equipped to assist employers with getting work injury costs under control.
*Job Function Matching® is a process developed by DSI Work Solutions that includes components of prevention, rapid return to work, disability management, and job modification. The process involves the objective comparison of the worker’s functional ability with the functional demands of the job. PTP
Curt DeWeese, PT, owns Work Injury Solutions & PT, PC, and is COO of DSI Work Solutions. For more information, contact PTPEditor@allied360.com.