AMA Guides® Newsletter - Issue Archive

Articles

1. Compensability of Common Upper Extremity Conditions When Work Activities Are Repetitive

   J. Mark Melhorn, LuAnn Haley, Charles N. Brooks

   Pages 3–4

   DOI: 10.1001/amaguidesnewsletters.2016.NovDec01

   Abstract

   Repetitive illness sometimes is wrongly called repetitive injury or cumulative trauma, but the latter are misnomers because the employee cannot identify a specific injury as a cause of the symptoms. In workers’ compensation, such gradual illness claims may be compensable if the condition arises during the course of employment, which requires that it be caused by occupational duties, exposures, or equipment used on the employer's premises. Expert impairment evaluators face three requirements: they must know the best scientific evidence currently available regarding causation of the condition(s) in question, ie, generic causation; the facts of the individual case, ie, specific causation; and the legal threshold in the applicable jurisdiction for acceptance of a condition as work related. The AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition, is an excellent resource and provides the physician a blueprint for the assessment of causation in occupational injury and illness claims. The book adopts the methodology developed by the National Institute for Occupational Safety and Health and the American College of Occupational and Environmental Medicine. When asked to render opinions regarding causation, a physician is wise to consider this methodology in determining the work relatedness of the condition. Medical opinions based on an accepted methodology and the best scientific evidence will result in better patient outcomes.
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2. Job Validation Studies and Physical Agility Testing: Is the Vendor Telling You What They Think You Want or Are You Telling Them What You Need?

   E. Randolph Soo Hoo, Stephen L. Demeter

   Pages 5–11

   DOI: 10.1001/amaguidesnewsletters.2016.NovDec02

   Abstract

   Referring agents may ask independent medical evaluators if the examinee can return to work in either a normal or a restricted capacity; similarly, employers may ask external parties to conduct this type of assessment before a hire or after an injury. Functional capacity evaluations (FCEs) are used to measure agility and strength, but they have limitations and use technical jargon or concepts that can be confusing. This article clarifies key terms and concepts related to FCEs. The basic approach to a job analysis is to collect information about the job using a variety of methods, analyze the data, and summarize the data to determine specific factors required for the job. No single, optimal job analysis or validation method is applicable to every work situation or company, but the Equal Employment Opportunity Commission offers technical standards for each type of validity study. FCEs are a systematic method of measuring an individual's ability to perform various activities, and results are matched to descriptions of specific work-related tasks. Results of physical abilities/agilities tests are reported as “matching” or “not matching” job demands or “pass” or “fail” meeting job criteria. Individuals who fail an employment physical agility test often challenge the results on the basis that the test was poorly conducted, that the test protocol was not reflective of the job, or that levels for successful completion were inappropriate.
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3. Putting Job Loss in the Spotlight as a Poor (and Often Preventable) Health Outcome

   Jennifer Christian

   Pages 12–13

   DOI: 10.1001/amaguidesnewsletters.2016.NovDec03

   Abstract

   The author considers the hypothetical case of a worker disabled by an accident and spine fusion surgery that did not relieve the pain; he is offered opioids and spends his time in a recliner grieving the loss of his self-respect as a good husband, provider, and father. This outcome need not have been a foregone conclusion. Research has shown that, for adults, worklessness is harmful to both physical and mental health, as well as to marital, family, social, and economic well-being. Gaps in social fabric are creating job loss and work disability because none of the professionals who typically respond to workers with job disruption due to illness or injury specifically feels responsible for avoiding job loss. Besides being a personal catastrophe, health-related withdrawal from work (work disability) negatively effects society; the lost productivity of workers in the local and national economy, which accounts for the majority of the approximately $400 billion that federal and state governments spend to support working-age people with disabilities. All Americans deserve timely assistance to maintain their economic independence and enjoy the dignity that comes with having a job. Improved public policy, governmental efforts, and support from the private sector is needed to prevent needless disability.
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