WorkWell Prevention & Care’s Functional Capacity Evaluation

Functional Capacity Evaluation V.2 - A Sound Strategy An integrated approach to injury management and return to work The Winning Formula Current research, evidence and clinical rationale Proprietary decision support tools 1-day and 2-day testing formats Standardized for broad ability determination; flexible enough to test specific work related abilities Global network of health professionals International research team of clinicians and researchers  

Functional Capacity Evaluation V.2 - Competitive Advantage A distinguished international research team has led to the introduction of an enhanced FCE WorkWell’s FCE V.2 is: Operationally efficient Legally defensible Medically sound Analytically based  

Functional Capacity Evaluation V.2 - Competitive Advantage The WorkWell advantage is clear Addition of a 1-day standardized CORE FCE Enhanced FCE activities in WorkWell’s internationally recognized 2-day FCE Easier to use with flexible formats Algorithms to assist decision making related to scheduling 1-day or 2-day FCE Rigorous for Medical Legal FCEs; comprehensive for Disability FCEs

Functional Capacity Evaluation V.2 - Competitive Advantage Many FCEs on the market… Are subjective and pain-based Do not compare the worker’s abilities with the job Rely on standardized formulas and norms, rather than individual abilities Produce cumbersome reports that make it difficult to make effective return to work decisions Do not have published reliability and validity studies

Functional Capacity Evaluation V Functional Capacity Evaluation V.2 – Navigating Return to Work Decisions WorkWell helps meet unique challenges The Physician is often forced to make a return to work decision based solely on subjective information about an employee’s capabilities and the physical requirements of the workplace The Employer, when presented with restrictions, must try to determine what jobs or parts of jobs an injured worker can perform safely The Employee is not able to participate fully in the return to work process, as he/she is often unsure what activities he/she can perform safely without risk of re-injury

Functional Capacity Evaluation V.2 – Measurable Outcomes WorkWell’s FCE: Better By Design Based on clinical research Compares worker’s abilities with required job demands A comprehensive, 2-day FCE to accurately and reliably determine the worker’s ability to work over time when needed 1-day CORE FCE for non-chronic diagnoses Tests for maximum strength without fear of injury Focuses on abilities rather than limitations Produces clear summary report understood by all parties

WorkWell’s FCE has produced unrivaled outcomes for over 15 years Functional Capacity Evaluation V.2 – Measurable Outcomes WorkWell’s FCE has produced unrivaled outcomes for over 15 years 6-month Historic Outcome Study Results 60% of workers returned to work without further treatment or intervention 50% reduction in open Workers’ Compensation cases in one year for one employer site These were considered to be chronic cases, as the average time off work at the time of the FCE was 10 months. Studies indicate very low return to work rates for workers who are off work six months or more; therefore, these are very positive results.

Functional Capacity Evaluation V.2 – A Comprehensive Approach With WorkWell’s FCE Physicians have confidence in the FCE results; the WorkWell FCE will identify when and in what capacity the patient can safely return to work Insurers refer hundreds of FCEs to WorkWell Providers every year because they know the WorkWell FCE will give the objective information needed to close cases Attorneys can trust the findings; they need an FCE that will stand up to legal scrutiny

Functional Capacity Evaluation V.2 – Sample Job Match Grid Critical Demand from Job Description FCE Abilities Job Match Standing/Walking - Frequently Walking - Frequently Standing work - Frequently Yes Lift up to 50# between 17” and waist Lifted 50# - job specific testing Forward bending - Occasionally Crouching or Kneeling - Occasionally Crouching - Rarely Kneel/half-kneel - Frequently No Sitting - Rarely Sitting - Frequently Elevated work - Rarely Elevated work - Occasionally Employee: Isabelle Green Date: Wed, May 15, 2005 Company: Helping Hands Home Job Title: CNA Successfully preventing worker injuries from occurring is key. To do this, you need to define the job and make sure the individual can do the job.

Functional Capacity Evaluation V.2 – Sample FCE Grid The interpretation of WorkWell’s standardized functional testing is based on assumptions including normal breaks, basic ergonomic conditions and that the tested functions are not required more than 2/3 of a normal working day. If a function is required continuously, job specific testing should be performed.   Client Name: Isabelle Green Test Date: 5/15/05 Interpretation of observed function regarding activity during a normal working day: (% = time classification per working day) "Unable"  Never "Maximum" or "Significant Limitation" Rarely (1-5%) "Heavy" or "Some Limitation"  Occasionally (6 -33%) "Low" or "Slight/no Limitation "  Frequently (34-66%) Lifting, Strength (lbs) Never Max. Heavy Low Limitations Recommendations Waist to Floor (11”) 40 25 15 Waist to Crown (Hands at handles) 30 10 (Preferred Method) Front Carry (Long) 65 55 20

Functional Capacity Evaluation V.2 – Sample FCE Grid Posture, Flexibility, Ambulation Never Significant Limitation (Rare) Some Limitation (Occ) Slight/No Limitation (Freq) Limitations Recommendations Elevated Work Weighted X Forward Bend Standing Decreased trunk endurance Modify activities ie, use seat/stool for optimal positioning Crouch Limited LE strength with deep squat/crouch positions Limit to short durations; use seat/stool/kneel for more optimal positioning Kneel/Half Kneel Sitting Standing Work

Functional Capacity Evaluation V.2 – Summary Report for Bottom Line Recommendations Return to Work: Physical abilities match job requirements Worker Modification: Address strength, motion, endurance deficits through work rehab Work Modification: Reduce poundage Reduce frequency Alternative positions Worksite Modification: Raise boxes 12 inches off floor Ergonomic chair/equipment Fit tool handles to client’s hands

Functional Capacity Evaluation V.2 – FCE Abilities & Job Description Return to Work is Clear with WorkWell’s FCE Example One FCE Abilities: Lift 20#, bend, no overhead work Job Description: Lift 10#, bend, no overhead work Example Two Job Description: Lift 40#, bend, overhead work

Functional Capacity Evaluation V.2 – Job Match Grid Sample CRITICAL JOB DEMANDS PHYSICAL WORK STRENGTHS JOB MATCH Walking: frequently Yes Floor to waist lift of boxes and pails: 1-35# occasionally Floor to waist lift: 25# occasionally No Front carry of boxes, tools, etc: 1-40# occasionally Front carry: 60# occasionally One handed carry (R or L): 1-40# R: 20# L: 55# Stand: occasionally Stand: frequently Squat: occasionally Squat: frequently Forward bend standing: occasionally Forward bend standing: frequently

Functional Capacity Evaluation V.2 – A Sound Strategy WorkWell’s Standardized 2-Day FCE is: Designed for chronic cases Accurate in cases involving nerve root irritation or specific disease processes Rigorous enough for medical legal cases Comprehensive for Disability Determination

Functional Capacity Evaluation V.2 – A Sound Strategy WorkWell’s 1-Day Standardized CORE FCE, when appropriate Establish general ability level Diagnosis specific/body area specific testing Baseline Progress Testing Job specific testing to ensure job match  

Functional Capacity Evaluation V.2 – A Sound Strategy A continual improvement process is clear in our commitment to enhance programs through evidence-based decision making. Thank you for choosing the leader in the science of occupational health.

WORKWELL SYSTEMS FCE Static Push Static Pull Hand Coordination (Round Blocks from PCE) Elevated Work Weighted; performing threading activity Waist to Floor, starting position Waist to Floor Lift, heavy effort Crouch; performing hand activity