Your intro to workers’ comp: Functional testing
By Steven Harrison, DC

How many of your colleagues are actively involved in the workers’ compensation market? Probably very few.

Although many doctors of chiropractic have treated workers’ compensation patients over the years when they show up unsolicited at their clinics, few have made concerted efforts to target this market and build this area of their practice.

Because chiropractic services are needed in the industrial market, a chiropractor with a plan and patience can capture a fair share of it.

To understand how chiropractic can benefit employers and workers’ comp carriers, it’s necessary to first understand the employer’s challenges.

When a worker is injured, the injury costs the employer through:

• Wages paid to the employee while on disability;
• Malingering;
• Loss of productivity;
• Medical expenses (immediate and sometimes ongoing);
• Overtime wages paid to co-workers to pick up the slack; and
• Attorney’s fees.

Your goal is to work collaboratively with the employer to reduce the likelihood of workplace injury, and, when workers are hurt, to get them back to work safely as soon as possible.

BEST BET: FUNCTIONAL TESTING

One way you can do this is through functional testing. Not all employers experience workers’ compensation problems; however, most companies with jobs requiring repetitive bending, stooping, and lifting do. Companies with these types of jobs can benefit from functional testing in a number of ways:

• Better job placement. By law, employers can require pre-employment (but post-offer) testing to make sure an employee is able to perform a job. Functional testing identifies individuals who are at high risk for a particular job — that is, workers who are physically incapable of doing a job.

• Baseline data. By doing functional testing, you also capture baseline data on new employees about their various physical capacities — lifting, turning, gripping, range of motion, etc. Should an employee become injured, this baseline information is invaluable because the employer is responsible only to bring the patient back to preinjury status.

• Realistic RTW recommendations. Functional testing equipment can also be used to set realistic and objective return-to-work (RTW) recommendations. Without the objective measures functional testing provides, RTW recommendations are subjective instead of objective, based on a demonstration of abilities.

• Reduce number of malingerers. Testing can also weed out malingering patients by detecting invalid efforts in certain areas of testing.

• Focused treatment. Finally, those who are truly injured can receive the finest musculoskeletal treatment in the office. The equipment helps you manage the patient’s care objectively.

To do functional testing:

1. Identify high-risk jobs. Working with the safety manager, review injury statistics and identify those jobs that have high-risk potential — that is, those in which most injuries occur most frequently and for the highest costs.

2. Acquire job descriptions. Ask for job descriptions of those high-risk jobs. Then observe workers doing the jobs.

3. Determine critical factors of the jobs. Such factors include lifting, turning, bending, twisting, range of motion, muscle strength, and grip strength.

4. Design the functional test. Use the equipment to simulate the physical demands of the job.

5. Conduct the tests. Test according to the needs of the employer.

With patience and a plan, you can capture your share of the workers’ compensation market. Corporate bureaucracy moves slowly, so be patient. Employers are looking for and want what you have to offer, but often require change within their systems. It may take a year or more to get a program up and running, but when it is in place, it becomes a nice adjunct to any practice.

Steven Harrison, DC, runs a multidisciplinary practice and is a senior coach with Breakthrough Coaching. He can be contacted by e-mail at  sharrison@mybreakthrough.com or through the Web site, www.mybreakthrough.com.