1. Post-Offer, Pre-Placement Functional Testing Kory Zimney, PT, DPT, CSMT

2. What is it? • Functional testing done post-offer of a specific job to all qualified candidates to ensure they can perform the “essential” physical demands of the job.

3. Why do it? • According to the U.S. Department of Labor 1 in every 10 workers is not physically capable of performing the essential functions of their job safely.

4. Physical Capacity of the general population

5. Failure rate of testing: • Medium PDL is in the range of 5 - 8% • Heavy PDL is in the range of 9-12% • Very Heavy PDL is in the range of 18-23%

6. Increase injury risk if not matching worker to physical demands of job • Shoulder: 2% versus 28% • Back: 3% versus 33%

7. Reduce injury risk • Reduce severity of injuries • Reduce cost associated with injuries • Reduce turnover • Baseline of any current impairment status

8. Reimer et al found that pre-employment screening combined with a worker fitness program for grocery warehouse workers significantly decreased injuries and injury-related expenses over a 3.5-year period. • Nassau demonstrated that pre-work placement screening and case management significantly decreased the severity of injuries. • Gassoway and Flory documented that screening nursing assistants at a regional health center significantly decreased job turnover. The health center saved $6 for every $1 spent on screening.

9. Littleton provides the strongest evidence to date in support of post-offer screening, using the ErgoScience Post-Offer Screening protocol. They tested physical plant applicants at a major university hospital and found an 18%, decrease in number of lost day cases and a 78% decrease in total injury costs. For every $1 spent on post-offer screening, the employer saved $18.

10. Post-offer, pre-placement functional capacity test (PPFT) Post Offer Physical Lifting Screens Functional Screen Back Screen Lifting Test Ability Testing Physical Capacity Profile

11. What are the different components of the PPFT that might be done? • Baseline mobility and positional tolerances • Movement screen or ROM testing • Sit, stand, reach, bend/stoop, squat, climb, crouch, kneel, balance • Aerobic testing

12. What are the different components of the PPFT that might be done? • Lifting • Various weights, heights • Carry, push/pull, lifting • Strength testing • Isometric or Manual muscle testing

13. Can we screen for potential repetitive trauma (overuse injuries)?

14. What’s the difference between tests • Time needed to do testing (15-30 minutes) • Baseline ROM, cardiovascular and strength data • Future injury risk screening • Current pathology screening • Lifting tasks general versus specific • Documentation of pre-existing impairments • Cost

16. What do you need to do to start testing? • Functional Job Analysis (FJA) • Accurate job description with measurement of “essential” job functions • Essential functions are the basic job duties that an employee must be able to perform, with or without reasonable accommodation. • Create a test that is fully compliant with the EEOC and ADA by ensuring the absence of disparate discrimination in the functional test design and delivery.

17. Factors to Consider in Determining if a Function is Essential • Whether the reason the position exists is to perform that function, • The number of other employees available to perform the function or among whom the performance of the function can be distributed, and • The degree of expertise or skill required to perform the function.

18. Factors to Consider in Determining if a Function is Essential • Your judgment as to which functions are essential, and a written job description prepared before advertising or interviewing for a job will be considered by EEOC as evidence of essential functions. Other kinds of evidence that EEOC will consider include:

19. Factors to Consider in Determining if a Function is Essential • the actual work experience of present or past employees in the job, • the time spent performing a function, • the consequences of not requiring that an employee perform a function, and • the terms of a collective bargaining agreement

20. Does everyone need to be tested?

21. How is the Post-offer testing different from a Fit for Duty Exam testing?