Part 2 Toolkit For Return To Work Injury Prevention Nb

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Your Toolkit for Return to Work and Injury Prevention

PART 2

Presented by: Nathan Birtch & Wilma Clarke

Physical Demands Descriptions

Ergonomic Assessments

Job Site Coaching

Post-Offer Pre-Placement Screenings

Independent Medical Examinations

Enjoy health through physiotherapy

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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


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Effects of disability on likelihood of return to work

6 months 12 months 2 years

10%

20%

30%

50%

Amount of time off work due to disability

% L

ikel

ihoo

d of

re

turn

to w

ork

20%

10%

40%

50%

60%

70%


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Costs of Disability

• In Ontario MSD’s - 42% of all lost time claims and 50% of lost time days

• Represent approximately 27 million lost days

• Direct costs - more than 3 billion

• Total costs - more than 12 billion (direct costs + indirect costs)


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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 thedirect cost


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Ontario’s Progressing Ergonomic Culture

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MOL launched Pains and Strains Campaign to increase awareness MSD’s

Jan 2006 Feb 2007

Occupational Health and Safety Council of Ontario (OHSCO) released an MSD Prevention Guideline for Ontario

OHSCO released an MSD Prevention Toolbox

Feb 2008

MOL conducted enforcement blitz. Checked for MSD hazards across Ontario. Visited 1,593 workplaces, issued 4,541 orders, 601 were related to MSD issues

Apr 2009

A similar MSD blitz completed, no results yet

Fall 2010

Are you prepared? Is your toolkit in place?


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Other factors to consider…


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Other factors to consider


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The Toolkit! - the SOLUTION employers need to combat rising disability costs

- Work Readiness Program- Functional Abilities Evaluation- Physical Demands Analysis- Ergonomic Assessments- Job Site Coaching- Post-offer Pre-placement Screening- Independent Medicals


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An objective evaluation of:

• The essential duties of a job

• The physical demands required of an individual

• Biomechanics of jobs (postures, forces, loads, frequencies)

• The job environment


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How?

All forces taken using a chattilon force

• Push

• Pull

• Grip

• Trigger

• Buttons


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How?

• Weights measured- scale

• Frequencies measured- cycle times, production rates, etc

• Distances, heights

• Joint angles and postures

measured using a

goniometer


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What can a PDD be used for?

• EXTREMELY VERSATILE TOOL!

• compatibility between a worker and a job

• Is worker ready for RTW?

• To determine if modified duties are necessary

• As a standard for health and safety inspections


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What can a PDD be used for? (cont’d)

• In conjunction with an ergonomic assessment

• To assist in establishing a post-offer pre-employment testing protocol.

• To assist rehab professionals

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PDD / PDA

JOB MATCH

FAE


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

Physical DemandsApprox

$1050.00


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PDD’s, Ergonomics and the MOL

• General duty clause from the OH&S actIdentify HazardsAssess riskEliminate and control risksEducate and trainEvaluateConsult with JH&S committee, etc


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MOL

• MOL can write orders for ergonomic risk• Employees can refuse work based on ergonomic

risk

• PDA’s help objectively quantify the demands on the human body

• Ergonomic Assessments compare the physical demands to current and reliable research


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• An evaluation of the risk of a specific job.

• Ergonomics fits the task to the worker not the opposite.

• Best performed in conjunction with PDD (if not already in place)

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Why use an Ergo assessment?

• To identify risks associated with a job

• To determine if there are design or environmental issues aggravating an injury

• To provide solutions for improper workstation set-up


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Why use an Ergo Assessment?

• Provide solutions for factors affecting RTW

• To show due diligence

• To be proactive instead of reactive


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How?

• Ergonomic tools- • chattilon force gauge• Scale• Goniometer• Time tests• Task analysis• SNOOK, NIOSH, RULA, and other research


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How?

• Recommendations given based on research and ergonomic principles to alleviate and eliminate risks

• Long term and short term recommendations


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Cost/ Savings of Ergonomics

• Total- Approx $1048.50

• If done in conjunction with a PDD

$495 in savings!!

• VS avg cost of RSI- $106,500

(direct + indirect)

….it’s a no brainer!


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Job Site Coaching


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Specific job or worker issue? – consider a Job Site Coaching assessment

Cost effective one hour onsite visit to:• Evaluate the workstation(s) setup • Evaluate postures, positions• Make adjustments to workstation and work structure• Coach worker on proper posture, lifting technique,

ergonomic principles• Complete report on JSC session with recommendations

Approx cost $390.00


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When to use Job Site Coaching

• Concerns that specific employees are prone to injury

• Observe improper mechanics/ postures that need corrected

• Suspect the way an employee works is contributing to injury or may in the future

• To help with RTW transition


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Post- Offer Pre-employment Screening


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Post-offer Pre-employment Screening

Why?

• To ensure your new hires can physically handle your jobs

• To assist with proper placement of your new hires

• To use when transitioning contract workers in to full time work

• To use when transitioning seasonal workers into full time

• To use when moving employees from one job to another


Components of a Post Offer Screen

Physical Screen- range of motion, flexibility, strength, proprioception, neurological testing- performed by a Physiotherapist

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Functional Screen- physical components (lifting, carrying, push/pull, etc)- 5- 12 tests performed by a Kinesiologist or PT.


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ARCON TESTING

•Static Strength tests•Grip strength tests•Dynamic lifting, pushing, pulling, etc tests•Customized to job demands


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Test End Points & Pass/Fail Criteria

Self Limited By Subjective Complaints (Psychophysical)

Physiological

Biomechanical Safety


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“A professional sports team wont hire a player if they can’t play the sport, why do we treat it differently with the working world?”


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Research

• Selectively employing workers who meet objective standards is shown to result in reduced incidence and severity of work related musculoskeletal injuries (Chaffin 1978)


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Case Study in Saving

• 220 new hires: 50% screened and 50% not

Of the 110 screened• 92 (83%) passed • 18 failed (16%)

RESULTS: Of those screened 1% injury rate during 4 years following

All 110 of control group (not screened) were placed in jobs that had offers

RESULTS: Of the control group – 23% injury rate during the 4 years following


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The Legal Environment

• Human Rights Legislation in Canada permits POS as long as:It is in direct relationship to individuals

capabilitiesIn direct relationship to the job being hired forTest must take place after a conditional offer is

in place


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Savings

• Average cost of one back injury- $78000

• Average cost of one UE injury- $55000

• Potential savings (18 injuries saved- case study)- up to

$1,404,000 long term


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Report Information

Physiotherapy MS Scan ROM/ Strength Qualification to PASS report- Pass fail criteria

and summary Overall Summary- report on functional status,

recommendations, fit or not fit for work


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Independent Medical Examinations


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IME

• An independent opinion regarding an employee’s medical state

• Provides baseline foundation from which to determine outcomes and implement further intervention if required

• Can be used in conjunction with an FAE if injuries are physical in nature


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Why use an IME?

• To assist if an employee has not returned to work

• To determine the legitimacy of a soft tissue injury that hasn’t resolved in 12-16 weeks.

• If question employee’s GP opinion

• Second opinion


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Remember!

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Remember!Physical Demands Descriptions

Functional Abilities

Evaluation


Job Site Coaching

Post- Offer Pre-Placement Screening

Independent Medicals

Work Readiness


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Meridian’s Toolkit will CLOSE THE GAP and SAVE YOU MONEY!

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Identify Mismatches

Rehabilitation

Can the employee’s function improve?

Accommodation

Can the job demand be modified?


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Questions and Answers

Documents

Part 2 Toolkit For Return To Work Injury Prevention Nb