How Physical Abilities Testing Can Stop Your Next Work Comp Claim

JODI MATHY
Senior Claims Consultant

Physical abilities testing is a type of fitness for duty exam. Fitness for duty exams help employers identify the "wrong" worker — that is, the worker who is physically unready or unable to perform the essential functions of a job. This "wrong" worker could be your next work comp claim!

Frequently, fitness for duty exams are used to determine whether an employee is ready to get back to work following a medical leave. In comparison, physical abilities testing is used to screen candidates before hire to determine whether they can perform the essential functions of a desired job.

PAT is brief snapshot of a worker's ability to perform the critical physical demands of the position. Physical abilities testing takes the essential job functions and boils them down into testable activities that worker performs. These tests are highly individualized and specific to the job — definitely not one size fits all.

Physical abilities tests are useful post-offer, pre-employment tests. They can also be helpful in determining if a quality candidate with a limitation could be reasonably accommodated to perform the essential functions of the job.

Step No. 1 is an ADA-Compliant Job Analysis

The meat of a physical abilities test for a specific job comes from the ADA-compliant job analysis, which is extremely detailed. Basically, the analysis calls out the frequency, height, and positions that a worker must be able to tolerate. It measures everything an employee has to do — measuring what gets lifted, pushed, pulled, carried, and positional demands.

A compliant analysis involves a third-party objective documentation of tasks (performed by a physical therapist) that's verified by management and the union (if applicable). Verification means that both groups accept the validity of the job description and agree that what the job entails is accurately represented. That way, there's no argument in the future over the essential functions of a job.

The ADA analysis includes a job summary, followed by physical job requirements (the essential functions). For instance, if it's a job that requires lifting, the job requirements will include: the weight to be lifted, the frequency of lifting, and what objects are being lifted. Other physical requirements to be recorded include walking, sitting, crawling, climbing, crouching, fine motor skills, pincher grip (and more — you get the picture); how often this movement occurs (occasionally, frequently, constantly); and a detailed description of when this movement is necessary (for instance, crawling under a truck if the job is truck mechanic). The analysis also includes descriptions of equipment used. As you can see, It's hard to over-document in an ADA-compliant job analysis!

What may surprise some employers is that a job analysis also includes pointing out sensory requirements and environmental conditions of the position. Sensory requirements include depth perception, hearing, and near and far vision, among other sensory categories. Environmental conditions describe the spaces in which a worker performs the job, including the amount of time spent indoors and outdoors, exposure to extreme heat and cold, elevated surfaces, and work space lighting, among other condition categories.

After examining a well-prepared job analysis, the reader should be able to close his eyes and vividly picture what doing the job is like. It's a tall order, but the details recorded in an analysis protect the employee from injury and the employer from work comp claims.

The analysis appendix can also include definitions of physical demand level (sedentary, light, medium, heavy) and metabolic equivalent levels (METs), which compare the energy used to perform various activities to a resting state. For example, desk work is up to 2 METs, whereas shoveling is up to 10-plus METs. Frequency of essential functions (whether the activity is performed rarely, 0 to 5 minutes per 8-hour shift, to constantly, 5.26 to 8 hours per 8-hour shift) also appears in the appendix. This context is useful for further explaining the demands of a job.

Which Positions Should Have Physical Abilities Testing?

Employers prioritize which positions deserve physical abilities testing. Jobs that have a history of injury, have been identified as most physically demanding, and have a history of high turnover related to difficulty may be ripe for PAT. PAT development starts with a physical therapist reviewing an existing job description. Next, the therapist documents the demands of the job for an ADA-compliant job analysis. Then the employer's management and union (if applicable) review the job analysis, suggest appropriate changes as necessary, and finally accept the analysis.

From the job analysis, the physical therapist develops physical abilities testing protocol. The physical abilities test itself is brief — only 15-20 minutes — and usually covers the toughest physical parts of the job. To get a standard physical abilities test for a specific job, an employee who is familiar with the job runs through the proposed PAT protocol, determines whether the protocol reflects the job, and suggests revisions if necessary. After revisions, the job's PAT becomes part of an employer's post-offer, pre-employment physical process, and successful completion of the PAT results in placement recommendation.

PAT has many benefits. The documentation of physical demands is extremely useful to the doctors who treat an injured employee. In physical abilities testing, a physical therapist gets to talk to an employee about specific ways to reduce physical risk on the job, which helps to prevent work comp claims. The testing goes far beyond telling an employee that he needs to bend his knees when he lifts. PAT ties back to fitness for duty exams, too. The job description that comes out of the PAT process can help doctors determine whether an employee is ready to get back to work. Most important, though, physical abilities testing is an opportunity for education of employees. The cheapest injuries are the ones that don't happen, and PAT can help make sure a worker is up to the physical challenge.

Why Alternatives to PAT Come Up Short

Yes, there are alternatives to physical abilities testing. It's easy to understand why an employer might hesitate to start a PAT program, considering how detailed an ADA-compliant analysis needs to be. We urge clients and prospects, however, to strongly consider physical abilities testing. This is because some common alternative tests that employers use fall short. Here's a brief look at alternatives to PAT and why they don't measure up:

Static lift testing: In static lift testing, a force gage set at a specific height. The employee pull on the gage, which doesn't move, and the force of the lift is measured. The goal of this test is to mimic a situation in which a worker needs to pull on something that's tough to move. It's easy to reproduce this test, but it's potentially dangerous because it encourages poor lifting technique. It's also not job specific. The static lift may show that an employee can pull 50 pounds at knee height, but it doesn't reveal how well that employee can get into different positions, lift to certain heights, and so on.

50-pound box lift: This could be slightly more job specific. But how informative is a single lift? Physical abilities testing may only take 15-20 minutes, but it gives a very good idea about how a person moves around. Physical therapists look at total quality of motion, and a single lift doesn't provide a good picture of this. The application of lifting a 50-pound box also likely is limited in a job with many demands. What's more, if the person administering the test is not a physical therapist, he or she might not be a good judge of quality of motion, and the a lift test can't give meaningful insight into proper physical movement that prevents injury the way a physical therapist can.

Isokinetic testing: In isokinetic testing, a worker is attached to a machine that measures the force of physical movement. The isokinetic machine looks like a chair, and the employee's leg is strapped in to measure the force the employee can generate with the limb. Advocates of this type of testing say it's valid because the machine can determine whether the worker is putting forth full effort. A downside is that the isokinetic testing equipment can be expensive. What's more, isokinetic testing really doesn't look like anyone's job (being strapped to medical equipment — no way!), and because of this, it's likely that an employee could challenge whether the results of an isokinetic test truly reflect the ability to do a job.

Physical abilities testing is time consuming and resource intensive on the front end. But the long-term cost savings of preventing work comp claims most certainly outweigh the challenges of a job analysis, the cornerstone of PAT.

How has your organization approached physical abilities testing and other fitness for duty exams? What strategies have you implemented to manage work comp risk? Please sound off in comments!