Return to Work

The AmeriSys Return-to-Work program, includes identifying return-to-work opportunities and appropriate use of outside vendors. We have found the "grocery store test" to be very helpful in determining if a person is able to work. The test is very simple: If the person was the owner of a small grocery store, would he/she be back at work? If the answer is yes, then the reason for not returning to work is not medical but some other reason. The telephonic case-managers will conference with the employer/carrier when a need for an appropriate outside vendor has been identified.

Regarding a program for return to work:

1. The telephonic case-manager will be the primary resource in RTW;
2. We have qualified personnel available to do a site review on individualized as needed basis.
3. The telephonic case-manager requests a job description from the insured;
   • If one exists, it can be presented to the doctor; or
   • If one does not exist, the telephonic case-manager will communicate to the treating physician the requirements of the position or initiate a vocational specialist referral to develop a job description.
4. The telephonic case-manager will assess the availability of: -Light duty work; or Traditional duty work.
5. Once the job analysis has been obtained, the telephonic case-manager or vocational specialist will presents it to the doctor.
6. If the doctor modifies the job analysis, the telephonic case-manager or vocational specialist discusses the changes with the insured to see if accommodations can be made.
7. Job offer is made to the injured worker by the insured

Follow up with the injured worker is done by the telephonic case-manager and tolerance of the position is communicated to the treating physician.

Vocational Services

Ergonomic Job Analysis & Job Description

With the ever-increasing demands of today's occupations and new legislation governing the workplace, the ergonomic job analysis is necessary in the prevention and management of injury and disability. This is accomplished by matching worker capabilities with occupational demands and providing this information in a manner consistent with systems developed by the Federal Government. Our Nationally Certified Consultants visit each worksite to observe and gather data regarding the job being performed. This information can be utilized in the recruitment, promotion, job modification, training, performance evaluation and safety program development.

Providing these in an Essential Function format demonstrates the employer's understanding of the basics and the desire for compliance with guidelines of the ADA.

Activities Include:

• Essential Function Identification and Analysis
• Physical Demands Analysis
• Environmental Conditions Analysis
• Worker Characteristic Components Analysis

Benefits

• Prevention of workplace injuries
• Facilitates early return to work
• Identification of transitional work opportunities
• Useful in the recruitment, placement and promotion of employees
• Identification of training needs
• Compliant with The Americans with Disabilities Act

AmeriSys has the capability to provide "vocational rehabilitation services". Vocational assignments can become costly and are not entered into without consultation with the insured. Nevertheless, we have found vocational assignments to be helpful at the following times:

1. Recuperation: Many times it is clear from the beginning that the injured worker will not be able to return to his/her regular duty job, even with reasonable accommodations. It is often helpful to have a vocational counselor meet with the injured worker to discuss possible future avenues to RTW, many of which may necessitate academic upgrading.
2. Ergonomic Checks : This type of referral is needed to check a person's job while they are still working or when they are returning to work from carpal tunnel syndrome surgery, etc. Ergonomic checks involve reviewing the worksite with the person to ensure that the work station is ergonomically correct for that injured worker. E.g. standard desks available in the 60's & 70's were ergonomically correct for a person 6'2" tall.
3. Job Accommodation: This type of referral is appropriate whenever a RTW is being attempted and it looks like the doctor may be on the fence. The vocational counselor will do a job analysis (if one does not already exist) or perhaps a video job analysis for the doctor's review. Any accommodation suggested would be, "reasonable" to assist the individual in RTW.
4. Job Modification: Sometimes this is called Job Re-Engineering because it is so involved. A referral in cases like this is done when it is in everyone's best interest to try to get the person back to his/her job (e.g., an injured worker who is young but severely disabled). A vocational counselor can view the job (at a lot less cost than a rehabilitation engineer) to see if there is potential for the job to be modified or re-engineered to fit that individual. An excellent example of this is Florida's Department of Transportation's work with a paraplegic bat-wing mower driver. They had his bat-wing mower (a modified tractor) engineered to allow him to work the tractor and also to do the under-the-hood pre and post work checks.
5. Reemployment Assessments: These types of referrals are made when it looks like an injured worker will continue to remain out of work. These referrals are addressed in 440.491 Florida Statutes.
6. Vocational Evaluations: These types of referrals are similar to, but more comprehensive than, a Reemployment Assessment. They involve testing, a formalized transferable skills analysis and vocational planning.
7. Full Duty Releases: Often while a person is recuperating his/her job will be filled and there will not be a job to return to, even after they receive a full duty release. In such cases, a vocational referral has been extremely useful in pointing the person toward future avenues of employment. These are rarely done; however, they almost always prevent the attorney rush that happens when a person thinks his/her future is hopeless.
8. Assist with PTD Defense: It becomes critical at some point in a PTD claim that efforts be made to see if there are jobs that the person can do. Often, this can be done by a review of the medical information and work history (from the job application, etc.) but other times it must be done in the form of a Reemployment Assessment with job descriptions sent to the doctor. A major insurer's lead attorney said he had never lost a case where he had a job offer from the employer of record. A vocational counselor can offer a new set of trained eyes to see if something can be developed in this area.
9. Project Social Security Approval/Disapproval: Due to evidentiary constraints (i.e., the ALJ having to accept as factual the individual's subjective complaints), no one can predict with 100% accuracy what the SSA ALJ will do in every case. Nevertheless, many of our vocational counselors have also worked as SSA Vocational Experts and can make a very good projection of what will probably happen in a particular case. It is often helpful to know that in advance.