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PART I

Taking the GUESS WORK out of
RETURN TO WORK
Presented by: Nathan Birtch
1

JOB MATCH
FAE

PDD /
PDA

2

Challenges

Return to work challenges faced daily
• Unclear what employees are physically
capable of
• Discrepancies between an employees
perception and their physical capabilities
• Unclear medical reports
• Vague FAF’s
• Psychosocial factors involved

Enjoy health through physiotherapy 3

Effects of disability on likelihood of return to
work

6 months 12 months 2 years
70%
60%
% Likelihood of

50%
return to work

50%
40%
30%
20% 20%
10% 10%

Amount of time off work due to disability


Timing of Intervention and Impact

Probability of RTW (in %) Probability of Returning To Work

100

80

60

40

20

0
0 3 6 9 12 15 18 21 24 36

Duration of absence (in months)


Costs of Disability

• In Ontario MSD’s account for 42% of all
lost time claims and 50% of lost time days
(averages from 1996 –2004)
• These claims represent approximately 27
million lost days
• Direct costs estimated at more than 3 billion
• Total costs estimated to be more than 12
billion (direct costs + indirect costs)


Lost Time Injuries by Injury Type 2009


The Iceberg Effect

Direct costs
• Wage Replacements
• Treatment
• Evaluations & examinations
• NEL/ FEL awards

Indirect Costs
• Lost Productivity
• Replacement workers / training
• Accident investigation
• Case management time
• Productivity/ Quality issues

Indirect costs – estimated to be 4 –7 x’s the
direct cost


• Direct and indirect costs related to
disabilities at the workplace are, on average,
approximately 17% of a company’s total
payroll costs


HELP!?!?!

JOB MATCHING

Matching the functional abilities of the worker
to the physical demands of the job


Job Matching Goals

• Determine suitability of return to
work
• Determine job placement of
worker in facility (new hires, etc)

• Solve the return to work puzzle and
decrease RTW costs!


JOB MATCH

PDD/ PDA FAE/
FAF
12

Components of Job Matching

PHYSICAL DEMANDS

FUNCTIONAL ABILITIES EVALUATION

FUNCTIONAL ABILITIES FORM (FAF)

PRE-EMPLOYMENT SCREEN


Components of Job Matching

PHYSICAL DEMANDS
• JDA, PDA, PDD, etc
• Objective values and measurements of what
is physically required of the human
• PDD handout


PDD an EXTREMELY VERSATILE
TOOL

• Assesses compatibility between a worker and a job
• Determines if worker is ready for return to work
• Determines if modified duties are necessary
• Acts as a standard for health and safety inspections
• Able to be used in conjunction with an ergonomic
assessment

15

PDD

• Assists in establishing a post-offer pre-
employment testing protocol
• Aids rehab professionals
• Acting as the starting point for developing a
job rotation schedule to reduce overall
physical load on a worker


PDD

Detailed information on:
Strength
Dexterity
Posture/ Positions
Mobility
Sensory Perceptual demands
Work Environment conditions
Energy Systems
PPE


How?

• Observation
• Video
• Measurements- forces, weights, distances
• Timed – frequencies, cycles, shift hrs


PDD

Pictures of tasks- break down into description, working heights,
movements required, and weights/ forces required


Physical Demands Description

• Each item is given a frequency –
• Rare- < 5% of the work day or up to 40 min/day
• Occasional- 6-33% of work day or up to 2.5 hrs/day
• Frequent- 34 – 66% of work day or up to 5 hrs/day
• Constant- 67 – 100% of work day or up to 7.5 hrs/day
• and a description including weights, forces ,etc


PDD


Avg cost of RSI/ MSD= $106,500
(direct + indirect 2007)

Physical Demands
Approx
$1050.00
22


FUNCTIONAL ABILITIES
EVALUATION


What is a FAE?
• An objective detailed assessment of an
employee’s ability to perform functional work
tasks


What is a FAE? (con’t)
• Lifting
Test client on • Carrying (bilateral/ unilateral)
• Push/ Pull (bilateral / unilateral)
• Reaching (multi-level)
• Hand dexterity
• Walking
• Stair climbing
• Balance
• ROM
• Grip Strength
• Strength testing
• Etc.


Use of tools and protocols based on published
research to ensure that the testing and the
outcome are:
• objective
• valid
• reliable
• defensible



• Consistency of effort checks throughout testing to
ensure maximal effort is put forth.
• Use of outcome measures to match perceived
capacity with actual physical capacity.


How a FAE is different than a FAF

FAF FAE
General More comprehensive
Consistency checks
Vague In conjunction with
Limited information for impairment testing
the employer State of the art
Can be subjective computerized ARCON
system
(depending on who fills Very detailed report of
out) information for employer
Very objective


Why have a FAE for my employee?

1. To determine if a person is ready to return to
work
2. To assess what jobs the worker is suited for
3. To clarify appropriate work restrictions
4. To clarify if modifications or accommodations
need to be made to prevent further injury
5. Assist with treatment recommendations
6. Assess the validity of a disability


JOB MATCH
FAE

PDD /
PDA

31

Biomechanical Testing
Performed by a Physiotherapist
Provides biomechanical diagnosis to plan
the nature of the testing
ROM testing, Strength Testing


Static Functional Testing
ARCON technology used to assess
lifting, pushing, pulling, grip and
force generation
Sufficient static force with good
body mechanics, qualifies the client
to proceed to dynamic functional
tasks
Heart rate monitor used at all times.


ARCON TESTING


How do you perform the evaluation? (con’t)

Dynamic Functional Testing
Conducted using functional
equipment in the lab (weights,
push/pull cart, toolbox etc.)
Custom lifting, pushing, pulling,
and carrying to match the
specific requirements of the job
Heart rate monitor used at all
Dynamic Lift
times


How do you perform the evaluation? (con’t)

Occupational
Testing
Testing designed
to assess job
specific tasks to
simulate work
environment
i.e.- assembly,
typing, painting,
etc


Test End Points

Self Limited By
Subjective Complaints Physiological
(Psychophysical)
Biomechanical Safety


How long?

1 Day FAE = 3 hrs 2 Day FAE = 3 hrs each day = 6 hrs

Time from evaluation to report- 10 business days


(direct + indirect)

Functional Abilities Evaluation
$750.00
39

FAF

• Who is it filled out by?
• Most physicians don’t actually test
functional ability (they don’t have the time!)


THE JOB MATCH



JOB MATCHING- HOW

Step 1
Needs Analysis- Look at:
- Injury stats
- # employees on modified duties/hrs
- Length of claims
- New hires- placement


Step 2-
Complete PDD
- Know the physical demands of the job that
are required of your employees/ potential
employees!


Step 3-
Complete FAE or FAF or Pre-employment
screen
- Know the functional capabilites/ limitations/
restrictions of your employees/ prospective
employees


Step 4- Match
• Determine if Functional ability of the
employee outlined in the FAE matches the
physical requirements of the job outlined in
the PDD.
• If YES, Job Match!


If NO, then not a match.
Further rehabilitation required
Work readiness program
Use job matching process for other less
physical jobs in facility
Ergonomic intervention to improve the job,
decrease physical demands of the job


What to do with all the Information

JOB MATCH?
JOB MATCH?

If yes, If no, can the job
return to work be modified or adjusted?

Based on current
functional ability level


(direct + indirect)

JOB MATCH
$1800
(PDD +FAE)

51

Questions and Answers


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Job Matching - Taking The Guess Work Out Of Return To Work

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