NAVIGATING TREATMENT GUIDELINES

1. NAVIGATING TREATMENT GUIDELINES WORK LIMITATIONS OCTOBER 14, 2011

2. WORK LIMITATIONS • The physician decides work limitations • It is part of every visit • Use a standard form • Limitations must be medically based • You tell the patient what to do • The employer decides on accommodating the limitations

3. DETERMINING WORK LIMITATIONS • Basic Occupational Medicine • What is the level of FUNCTION • Ask them what they do at home • Look at what is injured • Ask them to demonstrate • Limitations should decrease over time

4. DO YOU SELL WORK SLIPS? • If a patient came to your office and said I will pay you for a prescription for 100 Percocet, you would call security to throw him out. • If a patient says “I don’t want to go back to work”, look at him the same way.

5. “OFF WORK” • RETURN TO WORK IS THERAPEUTIC • Is it just about the pain? • Is the patient at bed rest? • Is the patient drugged? • Is the patient doing things at home?

6. VOCATIONAL REHABILITATION • Joint effort of physician, employer and vocational expert • Patient commitment is critical • Uses Dept of Labor classifications • Specific job evaluations • This is about permanent accommodations