• Home
• Prevention
• Therapy
• Case Mgmt
• REFERRALS
• CASE STUDIES
• TESTIMONIALS
• EVENTS
• NEWSLETTER
• Contact Us

We are a proud member of the following organizations:

CLICK to view past issues and articles in the NEWSLETTER ARCHIVE . . .

November / December 2008

Table of Contents:

1. Post Offer Screens: How to Implement an Effective Program
2. What’s Hot in Ergonomics: Dealing with a Pain in the Neck
3. Think Safe! 13 Tips for a Long Life

---

CLICK to return to top

Post Offer Screens:

How to Implement an Effective Program

When you hire someone, it’s often difficult to tell by looking at them if they can safely perform all aspects of the job, particularly those jobs that are very physically demanding. The Post Offer Screen (POS) is a tool that is commonly used to provide employers with the information they need to hire well. Essentially, the goal of a POS is to better match the worker to the job by determining if they can safely meet the essential physical demands of that job. In the previous newsletter, we discussed criteria to help determine if a Post Offer Screen is right for your company. To summarize, a POS program may be right for your organization if:

• Significant number of employees are injured in their first year of hire, and/or
• High percentage of injuries for a particular job position or in a specific department, and/or
• High injury severity or injury cost for a particular job position
• High termination/turnover rate.

In this newsletter, we are going to focus on how to implement an effective Post Offer Screen program.

The first step to implementing an effective Post Offer Screen program is to identify the job positions you would like to include in the program. Each job position should then have a Functional Job Description developed. This job description should provide a detailed description of the physical demands of the job and include measurements of weights, heights, and distances. It should outline frequency, duration, and repetition of tasks, as well as, point out environmental conditions. This description will identify the essential functions of the job to be tested as part of the POS and assists in identifying Pass/Fail Criteria. It can also help the employer comply with the American’s with Disabilities Act. By giving the job applicant a Functional Job Description to review, the employer can then ask certain questions. For example, the employer may ask the applicant if he can perform the essential functions of the job with or without reasonable accommodation. If the applicant has a known/obvious disability that may interfere with performance of a job-related function, the employer may require the applicant to describe or demonstrate how he will perform a function, with or without reasonable accommodation.

The next step in implementing an effective POS program is to decide whether to have the POS performed on-site or off-site. The advantages of on-site include: use of real work environment and equipment, the employee performs components of actual job, and it is more reflective of what the individual will be doing once placed in the job. The disadvantage of on-site POS is that there needs to be access to the environment and equipment. When looking at an off-site POS, the advantage is that no access to the real work environment is needed. The disadvantages of an off-site POS are that the work activities are simulated in a clinic environment and the employee may not get a “true picture” of the job.

Once it is determined whether to perform the POS on-site or off-site, it is essential to work with a specially trained medical professional to create the POS for each targeted position. The POS should focus on the person’s ability to perform the job with or without accommodation, as well as, the person’s ability to perform the job without posing a “direct threat” to the health and safety of anyone. There are essentially 4 components of an effective POS: Medical Exam, Physical Exam, Functional Testing, and Results.

The first component of the POS is the Medical Examination. This is typically done by a physician, but can be performed by a therapist in many cases. Information is collected regarding any medications the applicant is taking, past injuries and current conditions. The employer must set the criteria for passing the medical examination. For example, if the applicant is applying for a job as a truck driver, one of the criteria for passing the medical examination may be no history of a seizure disorder.

The next portion of the POS is the Physical Exam. This is performed by the physician performing the Medical Exam (if there is one), as well as, the therapist performing the remainder of the POS. The applicant’s heart rate, blood pressure, range of motion, and general strength are assessed. The purpose of the physical exam is to get an idea of an applicant’s overall physical condition and any limitations that may interfere with the essential functions of the job. It also helps ensure the employee’s safety during the next step of the POS, Functional Testing.

Functional Testing is the 3rd component of the POS. The employer identifies various job-specific tasks and essential job functions that applicants will be tested on during the POS. The therapist then determines the methods that will best measure the applicant’s ability to perform these various tasks in a safe manner. After the Physical Exam, the therapist will have the employee perform various functional tasks, most of which are consistent with the job position for which the person has been hired. This may include lifting various weights to/from varying heights in the frequency found in the job. If the POS is done onsite, real work items will be used for the lifts. If the POS is done in a clinic, the work task will be simulated with a weight box or machine. Other non-material handling job related activities may also be tested: climbing, crawling, reaching, bending, squatting, etc.

Finally, the employer needs to determine the Pass/Fail criteria for the Results portion of the POS. These criteria may relate to either the medical/physical examination, or the functional testing portion of the POS. As we mentioned before, certain medical criteria may need to be met for an employee to comply with the conditions of employment. Companies have the right to exclude individuals from certain jobs if they pose a “direct threat” to the health and safety of one person or others. For example, if the applicant is applying for a job as a heavy equipment operator at a busy construction site, the employer may set the criteria that the person in this position cannot have a seizure disorder, since this may put others at risk. It’s always important to keep in mind that if an employer withdraws an offer of employment because of the results of the POS, that the reason for the withdrawal must be job-related and consistent with business necessity. The employer must also determine pass-fail criteria for the functional testing portion of the POS. Usually, these criteria are based off the essential functions of the job. The therapist will then determine the Pass/Fail Measurement. The applicant must be able to demonstrate competence at safely executing the essential functions of the job, with or without accommodation. If the applicant needs accommodation, the therapist can often assist the company in determining what accommodations may be necessary.

So, once you have the POS created, you are ready to administer the program. First, a conditional job offer is made to the applicant. Under the ADA pre-employment medical tests can only be given after a conditional offer of employment is made. Next, everyone being hired for the job for which the POS is set-up must partake in the POS. In order to eliminate the possibility of discrimination, it is not a selective process. The applicant is scheduled with the physician and/or therapist for the screen. If the individual passes the POS, they are hired. If the individual does not pass the POS, options may include considering reasonable accommodations, alternative job placement, or the applicant is not hired. If a qualified individual with a disability is unable to perform an essential function of the job, the employer needs to explore reasonable accommodations (as defined by the ADA) for this employee to perform this activity.

Besides being a condition of hire, a POS can serve other purposes as well. For example, a POS can be used to assess the abilities of a current employee transferring into a given job position. The POS must be given to ALL employees transferring into this position. For physically demanding jobs (such as a firefighter or police officer), the POS can be used as a fit for duty assessment for all employees on a periodic basis. It can also be utilized following an on-the-job injury or prior to return to work from a non-work related absence. Job-specific training can often be easily incorporated into the POS for most positions. During the POS the therapist can instruct the new hire in safe work techniques, proper body mechanics, and appropriate stretches to perform periodically throughout the work day to improve their body’s tolerance to work. This job-specific training is especially effective if the POS is done onsite, in the real-work environment. It sets expectations for employee compliance to proper work techniques and personal accountability.

The benefits of implementing a POS program are numerous. It can result in fewer injuries – particularly among your new hires. It will reduce Workers’ Comp costs by reducing injuries, it will decrease employee turnover – you won’t be hiring worker’s that can’t meet the physical demands of the job, so you won’t have to replace them when they get injured. This can save your organization a lot of time and money. Other benefits include increased productivity – a worker who has the physical stamina to perform the job is going to be more productive than one who is struggling to keep up with the demands. Also, because you will be better matching the worker to the job, there will be improved employee morale and job satisfaction. Implementing a Post Offer Screen program is a WIN-WIN situation for both the employer and the employee.

Would you like more information on quality Post Offer Screen Programs? Find out more information by contacting CISonsite at (866) 298-1312 or jpanozzo@cisonsite.com.

---

CLICK to return to top

What’s HOT in Ergonomics:

Dealing with a Pain in the Neck

Modified from Consumer Reports onHealth Volume 20 Number 8

Consider everything we expect a neck to do: connect the spinal column to the brain; pivot up, down, and sideways; protect tubes that link our mouth to our stomach and lungs; and support the head, which weighs, on average, about as much as a bowling ball.

Given those taxing and never-ending responsibilities – and the complex network of discs, ligaments, muscles, nerves, and vertebrae that make up the neck – it’s perhaps on surprise that up to 70% of us complain of neck pain each year. Damage to any of those structures can trigger not only neck pain but also symptoms that extend across your shoulders and down to your fingers. Even worse, the pain can linger for months and tends to recur.

But there is some good news for neck pain sufferers: New research combined with guidelines from an international task force have helped clarify how to prevent and treat the problem.

Do I need to see a doctor?

Not usually. You should see one right away only if the pain follows an accident or other trauma, or if worrisome symptoms accompany the pain. The trauma may have fractured a vertebra. Pain accompanied by fever, headache, nausea, or vomiting can indicate meningitis. And numbness, tingling, or weakness that extends to a hand can indicate a pinched nerve. Also see a doctor if the pain has lingered longer than a few weeks.

Can everyday activities cause neck pain?

Absolutely. Muscle spasms from activities such as hunching over a computer keyboard are a leading trigger of neck pain. Arthritis from the wear and tear of repeated motion is another common culprit. The new guidelines, from the Bone and Joint Decade 2000-2010 Task Force on Neck Pain, found that sedentary or repetitive work multiplied the risk of neck pain. So take breaks at work or while stuck in traffic to do the exercises described below. Or change activities that may have caused the problem. For example, adjust your computer monitor, use a telephone headset, and choose pillows that align your neck and spine.

Exercise for your neck

You should do these while sitting up straight. Hold each for 5-10 seconds, return to the starting position, and repeat on the other side.

Rotation stretch

Turn your head to one side until you feel your neck stretch.

Side stretch

Tilt your head toward your shoulder until you feel a stretch on the opposite side.

Neck Strengthener

Place your right hand on your right cheek, keeping your chin relaxed and slightly down. Without moving, try to turn your head against the resistance of your hand, as if trying to look over your right shoulder.

What’s good for routine neck pain?

The same exercises that prevent neck pain might help relieve it. Applying hot and cold packs also helps, as do over-the-counter anti-inflammatory medication. But don’t take such drugs for more than two weeks without seeing a doctor, since long-term use can be harmful and unresolved pain can indicate a more serious problem.

Posture matters!

Maintaining good posture is essential to avoiding or reducing neck pain. By keeping your ears over your shoulders and your shoulders over your hips, you will greatly reduce the amount of strain placed on the structures of your neck. Avoid bending your neck forward to look at the newspaper, while eating, and while working on the computer. When driving, adjust the seat of your car and your mirror such that you can rest your head against the headrest. In general, if you do need to look down at something, tip your chin down while maintaining an ears over your shoulders posture. This will minimize the amount of forward bending of your neck.

---

CLICK to return to top

Think Safe!

13 Tips for a long life

Adopted from Mayo Clinic HealthQuest

Did you know that your genes account for only about one-third of your aging process? The truth is your diet, exercise levels, habits and relationships play a significant role in how long you’ll live and your quality of life as you age.

What can you do to lengthen your life? Consider these ideas.

• Get regular medical checkups. Many risk factors and diseases are highly treatable when detected early.
• Get at least 30 minutes of exercise most days of the week.
• Eat a healthy, balanced diet. Eat 5 or more servings of vegetables and fruits, and emphasize whole-grain carbohydrates. Limit processed foods, refined sugar, salt, saturated fat and cholesterol.
• Develop and maintain a support network of family and friends.
• Don’t use nicotine. Smoking causes more premature deaths than does any other lifestyle behavior.
• Limit alcohol. For women, this means no more than one drink a day. For men, it means no more than 2 drinks a day.
• Maintain a healthy weight.
• Keep your immunizations updated. All adults, for instance, should get a tetanus-diphtheria booster every 10 years.
• Maintain an active mind. Take classes, keep a journal, join a book club or attend cultural events.
• Protect yourself from harmful UV rays. Wear protective clothing and sunscreen when outdoors, and don’t use tanning booths.
• Practice safe sex.
• Wear your seat belt.
• Wear protective headgear when your sport or activity calls for it.

If you've missed any of our previous newsletters, check the Archives

CLICK to return to top

• Employment
• Links
• Privacy Policy
• Terms & Conditions

Copyright © 2005 - 2009 Comprehensive Industrial Services, Inc. All rights reserved.