• Fitness for Duty Considerations in Disabling Occupational Low-back Pain
• Management of Debilitating Injuries in a Large Industrial Setting
• Evaluation of the Cervicodorsal Spine
• Functional Capacity Evaluation and Disability Management

Fitness for Duty Considerations in Disabling Occupational Low-back Pain

Richard E. Johns Jr.

Individuals who develop a work or non-work-related medical condition in the course of employment generally recover and return to full-duty status. There are, however, a small number who develop chronic diseases, delayed recovery syndromes or other similar disabling conditions. These difficult situations raise the question of whether the individual continues to be a qualified employee for the job he/she was hired to perform. Workers who develop stationary medical conditions with residual impairment, functional limitations, chronic pain syndromes or permanent medical restrictions represent significant medical, legal and ethical challenges for the treating or evaluating physician as well as the employer. Occupational low-back pain (OLBP) is not only one of the most commonly encountered of these type of conditions in the industrial setting, but also represents a significant disability challenge when material handling activities are considered essential functions of the job. This paper presents an appropriate medical, legal and ethical approach to identifying workers with OLBP risk and assisting the employer in either matching them to essential functions of jobs they may be qualified to hold or moving them into an appropriate disability pathway.

Keywords: Occupational back pain; Disability; Employee; Job; Matching

 

 

 

 

1996;7(3):167-174

Management of Debilitating Injuries in a Large Industrial Setting

John Frederic Green

It has long been the goal of the occupational health specialist to avoid significant impairment or disability from debilitating injury at the work place. This paper is a description of effective and ineffective management strategies with disabling work injuries. Starting proactively with a preventive safety and health program, many of these injuries can be prevented or lessened significantly. When injury does occur, we must examine what can be done to ensure speedy recovery. The elements of prevention, including personal protective programs, ergonomics and pre-placement exams are reviewed. Injury care from early intervention with careful planning of case management involving all providers is also examined, as is the use of rehabilitation for early return to work including work conditioning and work hardening. Also included is how disability guides and a transitional work program can increase rapid recovery. Ultimately, although each element is essential as part of a good management program, the key to success lies in a good employee/employer relationship.

Evaluation of the Cervicodorsal Spine

David Charles Randolph

 

The proper evaluation of the cervical and dorsal spine is discussed, along with a presentation on various mechanisms for completing this evaluation in terms of making assessments on functional impairment. A discussion regarding testing and evaluation techniques is also provided.

Functional Capacity Evaluation and Disability Management

David Charles Randolph

 

The practical and theoretical basis behind the use of functional capacity testing is described. There is a description regarding the need for distinction between impairment and disability, necessitating the use of objective tests such as contained in a Functional Capacity Evaluation. A description regarding the mechanics of contemporary functional assessment is made, along with a statement of validity of the evaluation as well as practical considerations when considering why a Functional Capacity Evaluation should be performed.