How to Correctly Document Your Patient’s Job Description

Getting A Job Description Is A Hassle

Yes it is.

Imagine This

Adjuster M.A. from a major insurance carrier writes in today after reviewing a RateFast PR-4 report created on one of her injured workers. The worker is a firefighter who has been provided shoulder limitations precluding lifting and carrying more than 10 pounds, no pushing or pulling more than 11-25 pounds, no climbing ladders and no crawling. The report comments that, “Ability to return to her usual occupation is deferred pending the carrier providing a formal job description (RU 91 Format)”.

It’s obvious this injured worker cannot return to their job… Or is it?

When we talk about job activities, what people are expected to do, and what they don’t do all the time is casually listed in the clinic, but it’s what written down in the official job description that counts.

The Real Question

An accurate job description is actually a pretty rare event in the impairment report writing business. Probably less than 5% of claims have a usable job description. This is frustrating because one of the most important questions to be answered in a medical legal report or PR-4 report is, “Can the employee return to their job?”

Employees Don’t Know What Their Jobs Are

An employee’s understanding of his or her job is often very different than the official job description. A job description may include an activity that is rarely required, but is considered essential to perform the job safety and correctly.

…And Employers Don’t Either

To cause further frustration, the employer will sometimes provide the carrier an “administrative” job description and not an actual physical activity job description (RU 91). An administrative job description talks about job requirements such as personal temperament, educational requirements, and ability to concentrate, complete tasks etc. For orthopedic injuries, an administrative job description doesn’t cut it.

Get the RU 91

The RU 91 format is a systematic, standardized review of physical activities, specific weights and endurance requirements that guide the medical examiner. It should also be signed by both the employee and employer to confirm agreement.

And let’s not forget the Americans with Disability Act. Here it is required for an employer to make “reasonable accommodations” for employees with disability for the essential activities of the job. Think about this… How can we do that without looking at an actual job description? The answer: we can’t.

So, let’s get back to our adjuster’s question. The most correct approach for return to work opinion is based on a job description review. It may or may not change the opinions of the medical examiner, but everyone will have a better understanding of the final determination about return to work if there is a firm guideline cited in the report (RU91). Yep, we need the job description to give a correct and complete opinion on the return to work evaluation.

This simple systematic approach to thinking about the job description will pay dividends in the way of avoiding legal delay and confusion in the management of claim.

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