Sprain and strain injuries continue to account for approximately 42% of all serious Workers Compensation (WC) claims. One of the keys to reducing exposure to WC costs is to eliminate as much sprain and strain risk from the business, this includes through the pre-employment medical process. Not only are you limiting risk to the business but also protecting the individual from the significant negative impact of the serious injury.
Organisations use a variety of pre-employment medical strategies and often there is a focus or pressure on just getting candidates to fill the roles as quickly as possible, which quite often leads to recruitment of high-risk individuals specific to the physical demands of the job. We see the three following on-boarding strategies most commonly with respect to the pre-employment medical.
- Rely on the candidate’s honesty – Organisation relies on the honesty of the candidate to answer a set of questions – depending on how these are answered will determine if that person is sent for a pre-employment medical. Again this relies on the honesty of the person applying for the job.
- Send Occupational Role Profiles, Job Descriptions or Job Demand Assessments to medical provider– The issue here is that each assessor will test each candidate differently, therefore, no accurate decision can be made on the suitability of the candidate. There is no standardised assessment for all pre-employment medical providers to use and if ever challenged in court it would be very difficult to defend.
- Sending a candidate for a standardised medical and functional assessment – Best option yet the quality and process is the key to stopping risk entering the business. A Pre-Employment Functional Assessment (PEFA) is the same as a musculoskeletal screen and functional capacity assessment. It is a series of tests that provide objective information about a worker’s functional capacity. Yet is often not done as a result of the perceived upfront costs. If we look at functional assessments, job specific testing should range from $150-$200 depending on the complexity.
Currently, these exist in three broad categories and here is where some of the gold lies.
Generic – Not worth the paper it is written on, as it has very limited scope to identify underlying or pre-existing musculoskeletal issues. Bend over touch your toes, lift the box, basic range of motion testing.
Hard – Again not really much value as it puts the candidate through lots of different tests of high intensity to expose and underlying pathology or injury. If a decision to not employ is made from this then there is clear exposure to discrimination due to the fact the organisation cannot map the assessment again the physical demands of the job and therefore cannot categorically show an inherent risk to the role.
Job Specific Functional Assessments – These are the gold standard for pre-employment functional and return to work assessments and will clearly indicate a person’s capacity specific to the physical demands of the job. These can be mapped again the physical demands of the job, go for 30-45minutes and use the principle of progressive overload to assess each high risk anatomical areas a number of different ways to create fatigue of that specific anatomical area.
Pre-employment functional assessments when done correctly can positively impact an organisations workers compensation exposure. Examples include an aged care provider reducing the total injury rate to new starters by 30% by simply implementing job-specific functional testing, a mining services company reducing lower limb sprain and strain injuries by 75% by implementing job specific testing with a focus on lower limbs.
For any industry that has some form of physical labour, a job-specific functional assessment is critical.