A Physician's Guide to Return to Work

Dedication iiiPreface xiAcknowledgments xvAbout the Editors xviiContributors xxiChapter 1 Why Staying at Work or Returning to Work Is in the Patient's Best Interest James B. Talmage, MD J. Mark Melhorn, MD 1Consensus Statements 2A Review of the Literature 3Chapter 2 How to Think About Work Ability and Work Restrictions: Risk, Capacity, and Tolerance James B. Talmage, MD J. Mark Melhorn, MD 7Risk 7Capacity 9Tolerance 10How to Evaluate Work Ability: A Seven-Step Process 14Summary 15Chapter 3 How to Negotiate Return to Work J. Mark Melhorn, MD 19The Return-to-Work Decision Makers 19Defining Negotiation and Agreement 21The Five Steps From Injury to Resolution 21The Time Off Work and Return-to-Work Issue: Lost Work Days 25Return-to-Work Guides 26Negotiation Strategies for Return to Work 29Useful Responses to Three Common Attacks 32Summary 33Chapter 4 Return to Work: Forms, Records, and Disclaimers J. Mark Melhorn, MD 39Communication: The Issues That Should Be Documented in Physician Records 41Four Screening Tests for Establishing Functional Capacity Guides 44Establishing Reasonable Functional Capacity Guides or Work Guides 45Sample Linkage Forms 48Additional Forms 53Writing Functional Capacity and Return-to-Work Guides 53Summary 56Chapter 5 Evidence-based Medicine Elizabeth Genovese, MD, MBA 59Study Types 60Potential Flaws in Study Types 64Statistical Analysis 65Analyzing and Applying Study Results 68Summary 69Chapter 6 Causation Analysis Elizabeth Genovese, MD, MBA 73Hill Criteria for Causation Analysis 73Addressing Causation 76Apportionment76Causality Determination 78Summary 80Chapter 7 Functional Capacity Evaluation: Is It Helpful? David C. Randolph, MD, MPH Trang H. Nguyen, MD Phillip Osborne, MD 83The Purpose of the Functional Capacity Evaluation 84The Elements of a Functional Capacity Evaluation 85Validity and Reliability of the Functional Capacity Evaluation 89Using a Functional Capacity Evaluation to Make Return-to-Work Recommendations 90Summary 91Chapter 8 The Medical and Legal Aspects of Return-to-Work Decision Making Paul F. Waldner, JD Lezzlie E. Hornsby, JD 95Promoting the Return to Work: The Physician's Responsibility 97Knowing the Job Requirements and Knowing the Law 98Some Statutes That Apply to Return-to-Work Determinations 99Physician Liability in Making Return-to-Work Decisions 107Summary 111Chapter 9 Can This Patient Work? A Disability Perspective John L. LoCascio, MD 113The Disability Decision Maker 115Defining Disability 115The Core Idea 115The Decision Maker in Context 116The Physician's Role 118Basic Concepts and Terminology 118Patient Interview: Defining Pertinent Functional Capacities 121Estimating Functional Capacity 122Supporting Symptoms in Excess of Findings 123Objective and Subjective: Different Issues, Different Tests 124Dimensions of Consistency 124Disability Applications and Supporting Medical Data 125Psychiatric Claims for Disability 125Examples of Attending Physician Statements 126Physical Demand Levels from the Dictionary of Occupational Titles 129Summary 131Chapter 10 Medications, Driving, and Work Gerald M. Aronoff, MD Michael Erdil, MD Natalie P. Hartenbaum, MD, MPH 133Magnitude of the Issue 134Potential Risks 134Decision Making 137Specific Medications 139Summary 144Chapter 11 How the Primary Care Physician Can Help Patients Negotiate the Return-to-Work/Disability Dilemma Mark D. Pilley, MD 149Understanding the Role of the Primary Care Physician 149Avoiding the Impact of Delay 151Improving Chances for Successful Return to Work: Sample Cases 151Summary 160Chapter 12 Working With Common Spine Problems James B. Talmage, MD Robert H. Haralson III, MD, MBA 163Presumed Disability 163Lumbar Disk Herniation Resulting in Radiculopathy 165Mechanical Non-specific Low Back Pain 170Summary 177Chapter 13 Working With Common Upper Extremity Problems J. Mark Melhorn, MD 181Presumed Disability 182Shoulder: Rotator Cuff Impingement Syndrome 182Shoulder: Rotator Cuff Tear 187Elbow: Lateral or Medial Epicondylitis 192Elbow: Ulnar Nerve Entrapment 195Wrist: Carpal Tunnel Syndrome 197Wrist: De Quervain's Tenosynovitis 203Finger or Thumb: Trigger 205Nontraumatic Soft-Tissue Disorder 207Summary 210Chapter 14 Working With Common Lower Extremity Problems Robert H. Haralson III, MD, MBA 215Presumed Disability 215Sprains and Strains 219Fractures 221Dislocations 223Total Joint Arthroplasty 225Arthroscopic Knee Surgery 228Summary 229Chapter 15 Working With Common Cardiopulmonary Problems Mark H. Hyman, MD 233General Considerations in Cardiopulmonary Assessment 233Risk in Cardiopulmonary Disease 240Coronary Artery Disease 240Hypertension and Hypertensive Heart Disease 254Reactive Airway Disease/Chronic Obstructive Pulmonary Disease 257Summary 260Chapter 16 Working With Common Neurologic Problems Edwin H. Klimek, MD 267Physician-Certified Absenteeism for Neurologic Illness 267Neurologic Illness: General 269Headache 269Epilepsy 274Brain Injury 276Multiple Sclerosis 278Polyneuropathy 281Summary 283Chapter 17 Working With Common Rheumatologic Disorders Yvonne Smallwood Sherrer, MD 289Nonobjective Factors in Assessing Work Disability 290Rheumatoid Arthritis 292Systemic Lupus Erythematosus 295Osteoarthritis 297Risk 299Capacity 300Tolerance 300Summary 301Chapter 18 Working With Common Psychiatric Problems John D. Pro, MD 305The Problem of Mental Illness in the Workplace 305Evaluating Mental Impairment 306Social Security Administration's Criteria for Total Disability 309Major Depression 311Pain Syndrome With Medical and Psychological Factors 312Posttraumatic Stress Disorder 314Adjustment Disorder 315Excusing the Patient From Work 317Initiating Treatment Planning 317Returning the Patient to Work 318Summary 319Chapter 19 Working With Common Functional Syndromes: Fibromyalgia and Chronic Fatigue Syndrome James B. Talmage, MD 321Social Security Administration's Criteria for Total Disability 322Risk 322Capacity 323Tolerance 323Summary 324Chapter 20 The Social Security Administration Disability System Edward B. Holmes, MD, MPH 327Clarifying Misunderstanding of the Social Security Administration Disability System 327The Differences Between Impairment and Disability 329Overview of the Social Security Administration Disability System 330What the Physician Needs to Know 331Writing a Medical Source Opinion About Function 334Weighing of Source Opinions About Function by the Social Security Administration 335Summary 336Index 337

\ From The CriticsReviewer: J. Thomas Pierce, MBBS PhD(Navy Environmental Health Center)\ Description: This book aids in teaching physicians and healthcare providers how to think through the issues of "risk," "capacity," and "tolerance" when negotiating return-to-work and stay-at-work issues with patients. \ Purpose: It is aimed at helping primary care physicians and care providers navigate return-to-work issues. Its purpose is served by including a concise compilation of current data to improve return-to-work decision-making.\ Audience: The audience for this book is split among physicians and other healthcare providers, legal counsel and research staffs, and human resources professionals.\ Features: The book includes a step-by-step guide regarding return-to-work decisions. It takes on the difficult issue faced by workers' compensation managers such as "Can I work despite my (fill in the blank)?" The authors and editors believe they have provided realistic answers based upon current science. The book's highlights include a concise compilation of current data and frequent questions faced by physicians and other associated with workers' compensation. It is organized into 20 chapters, 12 chapters on return to work and functional capacity evaluation, evidence-based medicine and legal aspects of decision making, causation analysis, disability perspectives, medications and driving and Social Security. The eight other chapters are system-specific (spine, extremities, cardiopulmonary, neurologic, rheumatologic, psychiatric and chronic fatigue-associated).\ Assessment: I particularly like the fact that the editors took on such as broad range of problems — not only spine and upper extremity concerns, but also those of cardiopulmonary and rheumatologic systems. The book uses not only eminently qualified editors, but a distinguished cast of chapter authors for the 20 chapters.\ \ \ 4 Stars! from Doody\ \