BDMS Occupational Health


WORK FITNESS AND DISABILITY INTEGRATION

The physician has the knowledge and skills to determine if a worker can safely be at work and complete required job tasks. The physician has the knowledge and skills necessary to provide guidance to the employee and employer when there is a need for integration of an employee with a disability into the workplace. The OEM physician has the expertise to determine work fitness based upon the work capacity of the worker and the functional requirements of the job.

1.   Design and implement integrated systems of disability prevention and management.

  • Develop protocols for early identification of the disabled employee and the risk factors for delayed recovery.
  • Assure quality in the diagnostic process.
  • Establish and apply protocols for the implementation of appropriate therapeutic plans.
  • Design systems to identify and manage the impact of psychological conditions, substance abuse, and family stresses on the natural history of illness and injury.
  • Track progress against prognostic indicators.
  • Identify and manage delayed recovery.
  • Communicate recommendations for temporary (transitional work) or permanent accommodations for disabled workers.
  • Prescribe preventive maintenance plans for recovered employees and track compliance.

2.   Design protocols for pre-placement and return-to-work evaluations.

  • Implement stay at work and early return to work protocols.

3.   Design and implement protocols to evaluate employees for conditions creating an undue risk to self or

others in the workplace, in compliance with the Americans with Disabilities Act (ADA).

  • Explain and make clinical decisions as well as placement/accommodation recommendations relating to the concept of “direct threat” as defined under the ADA.
  • Translate impairment assessments into safe work functional capacity statements for the use of employers in placing employees in jobs.
  • Express impairment in terms required by relevant legal or benefit systems.

4.   Address employment concerns for patients with medical conditions such as:

  • cardiac conditions such as hypertension, coronary artery disease, heart failure, arrhythmias, etc.
  • post-treatment, including post-operative, of musculoskeletal injuries.
  • neurologic conditions such as seizure disorders, cerebrovascular accidents, neuromuscular disorders, and mental impairments.

5. Conduct evaluations to determine fitness for duty in compliance with applicable regulations including the ADA.

  • Perform fitness for duty examinations and baseline clinical assessments for workers with potential for exposures to include:
  • Heavy exertional work or work that stresses the musculoskeletal system.
  • Other physical hazards.
  • Chemical hazards.
  • Biological hazards.
  • Travelers.
  • any other environment or capacity where concern is identified.
  • Perform Department of Transportation (DOT) examinations.
  1. Assess impairment ratings in accordance with the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment.
  2. Recommend appropriate accommodations and job placements for pregnant employees.
  3. Identify and manage the impact of psychological conditions on ability to work and on the natural history of occupational and environmental illnesses and injuries.
  • Take a psychiatric and psychosocial history and perform a mental status examination.
  • Specify restrictions and accommodations for employees with psychiatric conditions, in compliance with the ADA.
  • Specify restrictions and accommodations for employees taking psychotropic medications.
  • Identify and treat or refer individuals with psychopathology aggravating and/or presenting as other medical conditions.