Medical Management | Ergonomics

In general, health care management emphasizes the prevention of impairment and disability through early detection, prompt treatment, and timely recovery. Medical management responsibilities fall on employers, employees, and health care professionals (HCPs). A medical management program can help to either eliminate or substantially reduce the risk of development of ergonomics-related problems and symptoms through early identification and treatment.

Identifying and addressing signs and symptoms at an early stage helps to slow or halt the progression of the disorder. When MSDs are caught early, they are more likely to be reversible, to resolve quickly, and not to result in disability or permanent damage. Early intervention plays a big part in reducing the need for surgery.

Employer Responsibilities

An employer's basic obligation is to make MSD management available promptly to employees with work-related MSDs. In other words, MSD management means that you have established a process for assuring that employees receive timely attention for it, including, if appropriate, work restrictions or job accommodation and follow-up.

Where there is no onsite HCP, an individual should be designated to receive and respond promptly to reports of MSD signs, symptoms, and hazards. Where there is an onsite HCP, he or she would be the likely person to have responsibility for MSD management, including referral as appropriate.

An effective MSD management program has:

1. A method for identifying available appropriate work restrictions and promptly providing them when necessary;

2. A method for ensuring that an injured employee has received appropriate evaluation, management, and follow-up in the workplace;

3. A process for input from persons contributing to the successful resolution of an employee's covered MSD; and

4. A method for providing relevant information and communicating with the safety and health professionals and HCPs involved in the process.

Employee Responsibilities

Employees should participate in the health care management process by:

• Following applicable workplace safety and health rules,

• Following work practice procedures related to their jobs, and

• Reporting early signs and symptoms of MSDs.

Employees may be faced with conflicting job demands or requirements. Safe work practices or rules may conflict with pressures or incentives to be more productive.

Health Care Professional Responsibilities

Health care professionals who evaluate employees, determine employees' functional capabilities, and prepare opinions regarding work relatedness should be familiar with employee jobs and job tasks. With specific knowledge of the physical demands involved in various jobs and the physical capabilities or limitations of employees, the HCP can match the employees' capabilities with appropriate jobs. Being familiar with employee jobs not only assists the HCP in making informed case management decisions but also assists with the identification of ergonomic hazards and alternative job tasks.

The health care professional should:

• Acquire experience and training in the evaluation and treatment of MSDs.

• Seek information and review materials regarding employee job activities.

• Ensure employee privacy and confidentiality to the fullest extent permitted by law.

• Evaluate symptomatic employees including:

  • Medical histories with a complete description of symptoms,

  • Descriptions of work activities as reported by the employees,

  • Physical examinations appropriate to the presenting symptoms and histories,

  • Initial assessments or diagnoses,

  • Opinions as to whether occupational risk factors caused, contributed to, or exacerbated the conditions, and

  • Examinations to follow-up symptomatic employees and document symptom improvements or resolutions.