Workers' Comp: Can They Do The Job?
Functional capacity testing can cut claims and costs, but it must be done carefully.
Patricia Smith
Senior Editor
Fleet managers know all about DOT medical exams to determine if a truck driver is physically qualified to safely operate a commercial vehicle. But today, more and more are considering another step in pre-employment screening: functional capacity evaluations to determine if potential new hires have the strength and agility to perform the physical demands of the job.
One goal is injury prevention. Another is reduced workers' compensation claims.
Kevin Schmidt, vice president and general manager of Aliso Viejo, Calif.-based WorkWell Systems, equates injury prevention to a three-legged stool. One leg is a safe workplace which, for drivers, centers on equipment. "Truck manufacturers have tried to take the dangers out of the equipment," he says, "but there's only so much they can do."
The second leg is safe work practices. In trucking, that typically involves training to reduce risk.
The third leg is qualified drivers. In addition to actually operating the vehicle, many driving jobs require lifting, pushing or pulling heavy objects, and other tasks commonly associated with work-related injuries. Thus tests to screen out drivers who can't safely perform those tasks can prevent injuries and reduce workers' comp claims.
Swift Transportation has been using WorkWell designed functional capacity evaluations for a couple of years. Workers Comp Manager Ken Davis admits that it doesn't make him popular with recruiters.
"It has definitely decreased the number of recruits coming in the door because some don't apply knowing they have that test to deal with," he says.
Nevertheless, the program has yielded some convincing results. Swift policy dictates that all work-related accidents be reported to the workers' comp department, even if nobody was injured. The company grew in 2004 but accidents decreased 9% from 2003. Claims that had to be handled by the third-party workers' comp administrator were down 21%. In other words, explains Davis, Swift not only had fewer incidents but a much smaller portion of those incidents were serious enough to require treatment.
"That's a big savings in administration fees," he says, but it also means savings in things that are harder to measure, such as lost productivity when drivers are sidelined due to injuries. "Because we're hiring a better workforce, they're running more miles for us," he notes.
Schmidt admits that pre-work physical screening testing doesn't sit well with recruiters or even many fleet managers. "It's counter-intuitive," he says. "Nobody in the trucking industry wakes up in the morning looking for reasons to turn away qualified drivers."
To help sell its services, WorkWell has developed a financial model that uses a carrier's own operating data to calculate the cost of an injury in terms of lost productivity and workers' comp claims.
"It clearly shows that you lose money when you hire people who won't last the first year because of injury," Schmidt states. "We think that, on a company by company basis, we can prove that hiring unqualified drivers hurts your operating ratio."
There are also legal concerns. "If the intention is to hire drivers who are physically qualified, who are safe and don't get hurt, you're probably OK," says Gerald Cooper, an attorney with Scopelitis, Garvin, Light & Hanson. "Unfortunately, there are probably going to be companies that will abuse the testing, using it as a way to sidestep workers' comp, Americans With Disabilities, or other applicable laws." Those companies, he adds, not only get themselves into trouble but "they're the ones that establish bad case law," which can ultimately affect everyone.
As Cooper stresses, there are no absolute protections, but the potential for legal problems can be reduced if functional capacity evaluations are based on precise job descriptions and scientific analysis of the required tasks.
Schmidt says they have seen companies attempt do-it-yourself functional screening just by having candidates lift crates or carry heavy objects. "Discrimination comes in when the test doesn't actually replicate the job or it's not consistently applied to everybody coming into the company," he explains.
For the Swift program WorkWell developed standards and tests that are unique to the carrier's various operations. Evaluations are done by licensed physical or occupational therapists trained in the specific methods and standards of each client. No private health information is released to the employer. The company is only told if a driver has passed or failed.
Schmidt stresses that pre-employment functional testing is a screening tool, not a physical development or physical therapy program. Therapists are willing to spend some extra time discussion strength building exercises or offering other improvement suggestions, but most drivers who can't pass the test simply walk away. Many don't even get that far.
Functional evaluations are part of a screening process drivers undergo after Swift has made a conditional offer of employment, but all applicants are told up front that a physical capabilities test will be given. Davis says about 10% to 12% of drivers who take the test don't pass. If you add drivers who bow out of the application process when they're informed of the physical capabilities test, the failure rate could be as high as 20% to 25%.
Back-To-Work Testing
Functional capacity evaluations for pre-employment screening are gaining attention, but the concept is even more popular for post-injury or back-to-work programs.
Workers' comp experts say the longer injured workers stay off the job, the more likely they are to become permanently disabled. Thus it's important to get them back into the workplace as quickly as possible, even if the initial assignment is modified or light duty. Proponents say functional capacity evaluations can help companies manage that return-to-work process.
Swift often requires a post-accident evaluation to determine whether or not an injured worker can safely perform the necessary functions of a job. "Having a baseline is very helpful for the physician," Davis notes.
Post-injury evaluations are not the same as those given to conditional hires. For instance if a driver has injured an arm, Swift may do a mini-evaluation to measure functional capacity as it relates to that injury. "They've already proved to us that they can meet the demands of the job as a whole, so it's just a question of whether or not they can meet it after their injury," he explains.
Like pre-employment screening, post-accident functional evaluations come with cautions. "They should only be used when the treating physician says the worker has reached maximum medical improvement," advises Cooper. "Then they should be used to determine what that person can really do and whether or not they can safely go back to work."
Functional testing used too aggressively or improperly can actually backfire, he cautions. For instance, a company that suspects a worker is faking an injury may step in too quickly with a functional evaluation - and end up paying to be told that the worker can't go back to work. That could lead to alternative employment and pay differentials, or even re-training for a different job or career.
"The only time you test an injured worker is when you believe it's necessary to help him get released to a temporary assignment or back to full duty," advises Schmidt. "What you don't want to do is test for the sake of testing. We go to great lengths to design return-to-work testing only to be used on selected injuries we profile, in certain situations in certain points in time."
The area where functional testing walks the tightest line is screening of existing workers. According to Cooper, there are only two situations where an employee might be able to test existing employees without stepping into discrimination and workers' rights issues: when an employee is returning to work after an illness or work-related injury, or when a worker's deteriorating physical condition clearly presents a danger to themselves or to others.
Down the line, however, we may see "risk profiling" as the next generation of functional testing. "When you think about it, safety managers treat everyone the same until somebody is injured," Schmidt points out. "They all get the same boots, or goggles or training. If you could measure a person's risk for musculoskeletal or soft tissue injuries, and see which people are breaking down faster, you could direct the prevention resources you're already using to the people who need it most."
Ways to Save
Because workers' compensation is regulated by the states, employers don't have much leeway when it comes to benefits and program details.
But you do have some control over the premiums you pay. Following are some suggestions for managing workers' comp costs.
Establish a loss prevention program. The more accidents your employees have, the more you'll pay for workers' comp insurance. Analyze the company's accident history to pinpoint problem areas and take preventive action.
Among drivers, many injuries are the result of overexertion while loading or unloading freight, adjusting equipment or securing loads. Thus a loss prevention program might focus on proper loading/unloading techniques. If claims records show a high number of injuries sustained climbing in or out of truck cabs, a refresher course on proper cab entry/exit is clearly in order.
Even simple physical fitness routines, like stretching before strenuous tasks, can help prevent injuries. But don't just hand drivers a set of standard stretches. Hire a fitness expert or physical therapist to develop routines for the specific work your drivers do.
Make it company policy to report all accidents or injuries, even seemingly minor ones, to a supervisor and/or safety manager. Investigate the cause and circumstances of every incident.
Stay on top of claims. Make sure injured workers receive prompt and adequate medical evaluations and treatments. Even if state laws allow workers to select their own doctors, someone should accompany them on the initial visit to make sure they get there safely.
If you make the arrangements, be sure to select medical services that understand your operation and injury issues.
Stay in touch with injured workers. Call frequently to see how they're doing. Visit if possible. Let them know they're needed and missed.
Get them back to work as quickly as possible. Even if it's modified or light duty, insurance experts and rehabilitation professionals say getting injured employees back into the workplace can enhance recovery and keeps them involved. Any return-to-work program should be coordinated with the employee's physician or a consulting health care professional that specializes in work-related injuries. And don't forget about workers on modified duty. The goal is to safely phase them into their old job, not to lose them in a permanent light duty assignment.
Audit your workers' comp records. In most cases, calculations for workers' comp premiums start by multiplying payroll by the state rate for the job classifications. Then modifiers like experience ratings come into play.
Make sure payroll information is correct and employees are properly classified. Review data the insurance company is using for actual and expected loss levels. Check loss reports. Look for reserves that are too high or paid claims that are still open. Make sure medical bills are audited to eliminate duplicate or excessive charges.
Insist on help. If you buy workers' comp through a broker, don't wait for them to offer help. Among other things, they should be able to help you audit workers' comp records and take action when mistakes are discovered. Many are also very good at setting up loss prevention programs and even helping with worker training.
Know the laws. Unfortunately, this is a complicated task for most trucking companies since you're likely to be subject to the workers' comp statutes of many states. Knowledgeable brokers and insurance companies can help. It's also wise to review your operation and workers' comp risks with a knowledgeable attorney.
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