FCE’s and JDA’s through the assistance of a physical therapist can determine your strengths, abilities, weaknesses and needs. It can establish the level of physical performance within your tolerance.

An FCE typically includes:

An in-depth questionnaire is used to determine other conditions and specific limitations you may have, whether directly or indirectly related to your job duties.

Real and Simulated Work such as lifting, pushing/pulling, squatting with and without weights, overhead activities and endurance activities, such as maintaining a position for a specified length of time or walking for a specified distance, plus any other work-specific activities you may perform when at work.

An FCE can last several hours to a couple of days, depending on the scope of testing. It is important during your testing that you be honest and truthful. You have the right to refuse to continue any test procedure at any time. However, if appropriate and safe, the Therapist may ask you to continue despite minor pain. It is only during this period that a proper assessment of the degree of functional ability or disability can be made.

The FCE can be very beneficial in finding appropriate work for an injured worker. The exact restrictions and limitations can open doors to jobs or opportunities that may have been excluded but for the FCE.

For injuries occurring after 10/1/95 temporary total disability benefits shall cease if the employer refuses an offer of work that is consistent with the rehabilitation plan. If no plan has been filed; TTD ceases if the employee refuses an offer of gainful employment that the employee can do in the employee’s physical condition. Once temporary total disability benefits had ceased for failure to accept a job offer it may not be recommenced.

Suitable Gainful Employment

Under Minn. R. 5220.0100, subp 34. “Suitable gainful employment” means employment which is reasonably attainable and which offers an opportunity to restore the injured employee as soon as possible and as nearly as possible to employment which produces an economic status as close as possible to that which the employee would have enjoyed without disability. Consideration shall be given to the former employment and the employee’s qualifications, including, but not limited to, the employee’s age, education, previous work history, interests, and skills.

The Court has also looked at such other factors including family, disruption of employee’s normal work patterns, commute, relocation, and others in determining if a job offer is suitable gainful employment.

Employee’s Physical Condition

The job offer must be for work at the employee “can do in the employees physical condition.” Ultimately, whether a particular job is physically suitable for constituting a question of fact. The employer has the burden of proving that the job offered was physically suitable and that the employee’s refusal was unreasonable.

The refusal of a job offer will only terminate TTD benefits. It does not automatically affect other benefits.

As you can see, refusing a suitable job offer can severely affect your entitlement to wage loss benefits. Make to consult with your attorney and/or QRC before turning down a job offer.

Wage Replacement Benefits

Temporary total disability benefits (TTD). TTD benefits are a form of compensation available to an injured employee who is unable to work because of the work injury, or who is released to work with restrictions but is unable to find work within those restrictions. The TTD rate is two-thirds of the employee’s gross wage at the time of the injury, subject to certain maximum and minimums.

Temporary partial disability benefits (TPD). TPD benefits are partial wage loss compensation for an injured employee who is back to work but is earning less than the date of injury wage due to the effects of a work injury. TPD is calculated at two thirds of the difference between the pre-injury wage and the employee’s current ability to earn.

Permanent Total Disability Benefits (PTD). PTD benefits are wage loss compensation where the injured employee’s physical disability causes the employee to be unable to find anything more than occasional employment resulting in insubstantial income. This means that the worker cannot secure a steady job and earn a living from work. The rate payable for PTD benefit is two-thirds of the employee’s gross weekly wage at the time of the injury.

Functional Impairment or Permanent Partial Disability Benefits (PPD)

Permanent partial disability or “permanency” is a payment for the loss of use of, or the loss of body function. These benefits are paid according to the compensation schedule established by the Workers’ Compensation Division. The amount and duration of the benefit are controlled by the permanent partial disability rating. It may be payable in one lump sum or in weekly increments. In cases where there is no specific schedule for that injury, the courts have allowed what is called a “Weber” rating. Under Weber, a doctor may provide an alternative permanent disability rating.

Medical Benefits

The employer and insurer are responsible for payment of “reasonable and necessary” medical treatment, which will aid in curing or relieving the effects of the work injury. Covered treatments include hospitalization, surgery, physical therapy, occupational therapy, chiropractic services, injection therapy, chronic pain management and many other forms of medical care. The right to receive these benefits may be impacted by the Minnesota Workers’ Compensation Treatment Parameters depending on various factors including whether the injury is admitted or denied.

Vocational Rehabilitation Benefits

Vocational rehabilitation benefits are designed to assist the injured worker returning to former employment or to a job related to that employment. In the alternative, rehabilitation services assist the injured employee to return to a job in another work area, which produces an economic status as close as possible to that enjoyed but for the disability. This assistance may include direct job placement, on-the-job training or formal retraining. Rehabilitation services can include the use of a Qualified Rehabilitation Consultant (“QRC”) to help with medical management, return to work, and job placement.

When you have specific questions about the workers’ compensation benefits available to you contact the DOLI or an attorney. Most attorneys offer free consultations however you want to make sure you choose the right one.

In these tough economic times, Minnesotans are increasingly concerned about job security and affordable health care. Two bills being considered by the Legislature would provide comprehensive health care and paid sick leave for all Minnesotans.

The Minnesota Health Security Act would greatly expand the number of people covered by state sponsored programs as well as extend services provided to include vision, dental and mental health. Free health care would be extended to children by 2010 and then to adults by 2012. While not entirely free for adults, the bill would implement a sliding payment scale so that medical expenses would not exceed more than five percent an individual’s or family’s income.

The Healthy Families, Healthy Workplace Act would allow all working Minnesotans to accumulate one hour of paid sick leave for every 30 hours of work with a maximum of nine days a year. Small businesses with 10 or fewer employees would only be required to provide five days of paid sick leave.

More health coverage
According to a study conducted by the Minnesota Department of Health last year, 374,000 Minnesotans, including 77,000 children, have no health insurance. With unemployment rapidly increasing this number is expected to increase in the coming months. The Kaiser Family Foundation recently found that “a one percentage point rise in the national unemployment rate would add 1.1 million to the ranks of the uninsured nationwide.” This could spell physical as well as financial ruin to families across the state and further strain the current state-run health care programs.

Pat Lamb, a St. Paul resident and long-time activist and community organizer, recently participated in ACORN and Take Action Minnesota’s lobby day at the Capitol. Lamb, age 62, is now retired and living on her own in St. Paul Public Housing. She is a recipient of Medicare and a number of services provided through Minnesota Care, one of the three publicly subsidized health care programs currently operating in Minnesota. While Lamb has suffered from numerous medical complications all her life, a series of eye surgeries recently threatened her independence. Luckily she was able to apply for an “independent living skill worker” to help her with daily tasks, such as setting up medical appointments and grocery shopping.

“I don’t know what would happen if they cut her. I can’t sustain myself on faith alone,” Lamb said. She also expressed her desire to expand similar health care services to other Minnesotans. “In my building there are many people with physical disabilities and don’t receive any assistance. I’m one of the lucky ones. People work hard but sometimes they need help.”

Catherine Dahir was recently laid off from her job at Reeves Park, Inc., a Minneapolis based jewelry manufacturer, and fears she will not be able to continue payments on her health care plan and home mortgage. In the middle of a costly divorce, Dahir says she needs support. “I don’t want to rely on the system but I have worked ever since I was 14 even with three severe spinal injuries and now I don’t have anyone to turn to.”

Members of ACORN and Take Action believe people like Lamb and Dahir should not have to choose between their health and their home and are urging legislators to pass the Health Security Act.

State Rep. Jeff Hadden, DFL-Minneapolis, said, “Personally I’m a universal health care advocate and I believe that we need radical reform in the health care system. I don’t see the Minnesota Health Security Act as an end in itself, but as a step towards a single payer system. I am supporting the current bill for practical reasons and for children.”

Time off when you’re sick
Forty-one percent of workers in Minnesota- more than one million- lack paid sick days, according to the U.S. Bureau of Labor Statistics. The Healthy Family Healthy Workplace Act would require employers to provide paid time off.

Ashley Vera, a senior organizer with ACORN, discussed her own experiences as a worker and as a mother. “When my kids were little and got sick I had to bring them to day care because missing a day to take care of them would mean losing my job.”

The legislation would have a significant impact on industries like restaurants which often do not provide paid sick leave. In these cases, ACORN argues that paid sick leave is more than an ethical matter, it’s also an issue of public health.

In speaking with legislators, ACORN members promoted the bill as a piece of health care reform with no cost to the state and with added benefits to businesses. In places where similar legislation has been passed, such as San Francisco, businesses actually found an increase in worker productivity and overall job satisfaction.

Alessandra Fuhrman is a student at Macalester College who is interning this semester with Workday Minnesota.

(Proposed legislation to provide health care and paid sick leave
| Workday Minnesota)

More than 400 police officers have participated in a study with the National Institute of Occupational Safety and Health.  The Science Daily Reports more than 400 police officers have participated in the study to date, with the researchers aiming for 500. Results from the study shows, among other findings, that officers over age 40 had a higher 10-year risk of a coronary event compared to average national standards; 72 percent of female officers and 43 percent of male officers, had higher-than-recommended cholesterol levels; and police officers as a group had higher-than-average pulse rates and diastolic blood pressure.

Cortisol, also known as a stress hormone, can be harmful to the body when released during stress.  When Cortisol is released into the body from stress it opens a person to coronary disease.

If a police officer suffers a heart attack, the police officer may be entitled to workers’ compensation benefits.

Under Minnesota Workers’ Compensation Law, there is a statutory presumption of the causal relationship of work stress and heart attacks suffered by police officers. In order to invoke this presumption the following must occur

1. the police officer at the time of employment must have had a legitimate physical examination that negatived any evidence of heart disease; and
2. the medical report must have been filed with the police department.

A police officer who is rendered unable to do any work because of a severe heart impairment can also qualify for Social Security disability benefits.

(photo| Flickr)

The general purpose of rehabilitation is to help injured workers to return to their former employment or to modified employment that will bring them as close as possible to their pre-injury economic status.

Rehabilitation services are provided through the help of a qualified rehabilitation consultant (QRC). A QRC can help with modifying an existing job to your restrictions, assisting with a job search with a new employer and possibly retraining for a new job.

If rehabilitation services are thought to be helpful, you are to request an initial consultation with a QRC.

An initial rehabilitation consultation is to be provided to you upon request. Once a consultation is requested, the employer must provide a QRC unless a waiver is filed by the employer.

You have a right to choose a QRC at the beginning of rehabilitation services or within 60 days following the filing of the rehabilitation plan.

If you are having problems getting rehabilitation services contact an attorney and/or the Minnesota Department of Labor and Industry.

]]> http://compwonk.com/2009/02/06/rehabing-back-to-work/feed/ 0 http://compwonk.com/2009/01/28/foreign-born-workers-face-difficulties-in-obtaining-workers-compensation-benefits/ http://compwonk.com/2009/01/28/foreign-born-workers-face-difficulties-in-obtaining-workers-compensation-benefits/#comments Wed, 28 Jan 2009 14:00:44 +0000 Jerry Sisk http://compwonk.com/?p=476 For many foreign born  workers, obtaining medical treatment following a work injury can be extremely difficult. This can be due to misconceptions about the culture and language barriers.

Let me give you an example.  The other day I was sitting in on a statement of my client to an insurance adjuster and their interpreter.  Fortunately, for me and my client I had someone from my office sit in on the conversation.  I found that often times the insurance companies interpreter, who was being paid by the insurance company, failed to accurately interpret my client’s statements. It became frustrating not only for my client but also for the adjuster.

I think  that if it is determined that an employee is foreign born or even undocumented a sense of mistrust develops between the parties. Now, I do not think it happens all the time but for some if the employee is willing to lie about his social security number it is assumed he would be willing to lie about his work injury.  Obviously, this type of inference is just wrong.

Roberto Ceniceros wrote an article in Business Insurance concerning the difficulties associated with providing workers’ compensation benefits to undocumented injured workers. Some of challenges noted in his article are:

• Fraudulent social security numbers
• Language issues.
• Wrong home addresses
• Distrustful family members
• Impoverished living conditions leading to possible infection following surgery
• Different phone numbers
• The injured worker returns to his/her country

One of the items discussed in the article was “building a trusting relationship” with the claimant. I agree that trust needs to be an important factor but I also think that one should also keep an open mind when dealing with foreign born workers.   Language barriers can often cause difficulties communicating with employers, medical professionals, and rehabilitation specialists.  Moreover, undocumented workers rarely have the means to obtain insurance or the means to obtain medical treatment if the injury is denied by the insurer.

All these issues should be taken into consideration and it should not be immediately assumed the foreign born worker is lying or malingering.

Communication is one of the keys to a successful recovery and return to work in any case.

ErgoRehab Blog recently posted an article concerning some of the occupational ergonomic risk factors involved in possible repetitive or Gillette type injuries. The risk factors are as follows:

1. High Task Repetition and Inappropriate Work / Rest Cycles: A job is classified as highly repetitive if the cycle time is less than 30 seconds, or if a task or motion is performed more than 50% of the time it takes to complete the work cycle. Work and rest cycles are the intervals of time measured during one complete task revolution or cycle. The more repetitive the task or cycle, the less recovery time there is for the muscles and tendons. Inappropriate rest/work cycles are work cycles that do not allow time for sufficient recovery and micro trauma can accumulate, leading to cumulative trauma disorders.
2. Forces and Forceful Exertions: Both static and dynamic loading increases muscle contraction strength and duration, thus reducing circulation to the muscle fibers and increasing recovery time requirements. Static loading is a greater risk factor than dynamic loading, since static loading results in increased muscle fiber recruitment and fatigue and decreased blood perfusion. Forceful exertions produce increased muscle effort in response to high task load, leading to more rapid muscle fatigue and overuse which can lead to upper extremity injuries.
3. Positions of the Wrist and Arm and Awkward Postures: Repetitive wrist flexion and extension increase intra-carpal tunnel pressures in the wrist. In addition, awkward postures overload muscles and tendons and load joints in an asymmetrical manner, imposing a static load to the musculature thus reducing nerve and muscle blood flow. Activities that use repetitive finger motions with the wrist in an extended position in constrained postures, such as playing a musical instrument, typing or the use of pinch grips also increases intra-carpal tunnel pressures and thus reduces nerve and muscle blood flow which may lead to upper extremity injuries.
4. Mechanical Stress Concentrations / Contact Trauma: Weight bearing with the wrist in an extended position such as gymnastic sports or bicycle riding. Direct pressure contacting the base of the palm or the palmar surface of the fingers such as in frequent or continuous use of tools with hard or sharp edges, or short handles can cause direct compression against peripheral nerve fibers, leading to upper extremity symptoms.
5. Vibration: Vibrating hand-held tools can cause toxic vibration reflex and constrict blood vessels, which may damage nerve fibers in the upper extremity.
6. Exposure to Cold: Working in cold environments and/or handling cold tools affect the circulation to the upper extremity.
7. Gloves: Use of gloves reduces tactility, increasing the amount of force required to hold or manipulate a given object. This risk increases with poor fitting of the gloves and with glove thickness.
8. Lead: Constant contact or exposure to lead has been shown to impair maximal motor and sensory nerve conduction velocities of the medial nerve which may cause Carpal Tunnel Syndrome of the wrist.
9. Work Stress and Job Satisfaction: The perception of the workload, work pressures and job satisfaction may alter the individual’s response to early signs of fatigue and discomfort.

The risk of developing upper extremity cumulative trauma disorders and injuries increases with the number of ergonomic risk factors present. Jobs that combine high force and high repetition pose the greatest risk.

It is important that you discuss your job duties with your doctor if you believe you have a work injury. Also, it is important that you notify your employer of your injury, as failing to notify your employer may cause you lose out on work comp benefits.  It may be necessary to consult with an attorney to assist you in determining whether you have a work related injury.

Costs & Causes of Injuries to the Upper Extremity|  ErgoRehab Blog

Under Minn. Stat. 176.101, temporary total disability compensation shall cease if the employee:

1. Refuses an offer of work that is consistent with the rehabilitation plan; or
2. If no plan has been filed, the employee refuses an offer of gainful employment that the employee can do in the employee’s physical condition.

The key is that once temporary total disability compensation has ceased, it may not be recommenced.  Clearly, refusing a job offer can be potentially devastating on your benefits.

It is important in cases where the employer is offering employment to you that if you, your doctor or your QRC believes it is not suitable, that you consider all your options before turning it down.  Retaining an attorney in this situation may be helpful in determining whether the job should be accepted or rejected.

(photo: Sox First)