Transcript The Role of the Ergonomist at the WSIB

The Ergonomics Connection : Workplace Safety
and Insurance Board and Employers
Shelley Gibbons, CCPE, B.Sc. (HK)
&
Joanne Blake, Adjudicator, WSIB
Presentation Purpose
Goals :
• To improve communication between the workplace and
WSIB
• To improve decision making in return to work (RTW)
and entitlement
• To examine roles of WSIB Ergonomist and employer
Health and Safety Representatives: How do we work
together to effect a positive RTW?
• To improve independence in the workplace with RTW
issues
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• Understanding the challenges - medical
precautions
• Timeliness of decisions by the WSIB and the
Employer are important - need to ensure
communication of relevant information to
ensure this timeliness
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Presentation Outline
• The WSI Act and RTW
• WSIB Ergonomist involvement
• Interpreting medical precautions
• The employer’s role
• Reviewing and interpreting jobs
• Potential RTW best practices
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Duty to co-operate in return to work
Section 40 (1)
The employer of an injured worker shall co-operate in the early and
safe return to work of the worker by,
• (a) contacting the worker as soon as possible after the injury
occurs and maintaining communication throughout the period of
the worker’s recovery and impairment;
• (b) attempting to provide suitable employment that is available
and consistent with the worker’s functional abilities and that,
when possible, restores the worker’s pre-injury earnings;
• (c) giving the Board such information as the Board may request
concerning the worker’s return to work; and
• (d) doing such other things as may be prescribed. 1997, c. 16,
Sched. A, s. 40 (1).
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Duty to accommodate
Section 41(6)
• The employer shall accommodate the work or
the workplace for the worker to the extent that
the accommodation does not cause the
employer undue hardship. 1997, c. 16, Sched.
A, s. 41 (6).
- where the employer has a re-employment obligation
From www.ccohs.ca
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Suitable Work
Employers should attempt to provide suitable work
that:
• Is safe and within your worker's (functional)
physical capabilities
• Your worker has the skills to do (or can acquire
the skills to do)
• Restores your worker's pre-injury earnings as
closely as possible
From www.ccohs.ca
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The Ergonomist at the WSIB
• Currently 31 Ergonomists employed by the WSIB,
province wide.
• Offices in Windsor, London, Hamilton, Kitchener,
Toronto, Kingston, Ottawa, Sudbury, Sault Ste.
Marie, Thunder Bay
• Cover all industry sectors - automotive,
manufacturing, food, health care, services, etc.
From www.ccohs.ca
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When does the WSIB Ergonomist get Involved
WSIB Claims Adjudicator (decision maker) requests
assistance when:
• There is a disagreement between the workplace parties
that needs to be resolved
• The injured worker is experiencing some difficulty in
their job (pre-injury, modified or alternate job)
• There is a general lack of pertinent information on file
to allow for a decision
From www.ccohs.ca
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WSIB Ergonomist Outcomes
Review injured workers jobs and form an opinion on:
1)
Suitability
- opinion on whether job demands exceed the medical
precautions or could aggravate the worker’s injury
2)
Accommodations
- suggest accommodations in an effort to ensure the work is
suitable within medical precautions
3)
Compatibility
- opinion on whether risk factors exist in the job for a
particular injury
From www.ccohs.ca
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Medical Precautions
• Suitable work - the job must not exceed a
worker’s medical precautions
• Functional Abilities Form
• Standard WSIB medical precautions
• Official Disability Guidelines
• Regional Evaluation Centre (REC) – multidisciplinary health care assessment
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Standard Shoulder Precautions
• Avoid repetitive shoulder movement (R/L)
• Avoid heavy lifting - Lifting limitation
• Avoid above shoulder activity
• Avoid repetitive use of upper extremity against
resistance (R/L)
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Standard Neck Precautions
• Avoid repetitive neck movement
• Avoid above shoulder and overhead activity
• Lifting limitation
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Official Disability Guidelines
• SHOULDER/CERVICAL:
• Manual work:
• Reaching above shoulder not more than 12
times/hr with up to 15 lbs of weight;
• Reaching to shoulder up to 15 times/hr with up
to 25 lbs of weight;
• Holding arm in abduction or flexion up to 12
times/hr with up to 15 lbs of weight;
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Official Disability Guidelines
• SHOULDER/CERVICAL:
• Pulling and pushing up to 60 lbs 20 times/hr;
• Lifting and carrying up to 40 lbs 15 times/hr;
• Single upper extremity work using injured arm
for moderate work only (full use of non-injured
arm); possible immobilization by abduction
brace, sling, or clavicle brace;
• Climbing ladders up to 50 rungs/hr.
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Challenges with Medical Precautions
• Lifting limitations - What is heavy?
• Repetitive movements - What is repetitive?
• Movement limitations - How much movement is too
much?
• Time limitation - What is prolonged?
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Answering the Challenges
It’s a matter of providing pertinent information
• Important to remember every injury is different
• Important to remember injured workers vary in
measurements of body size (anthropometrics)
• Must include the injured worker in the process of
gathering pertinent information about the job and
determining return to work
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Look at force, posture and time factors
• The Ergonomist identifies if relevant risk
factors for work-related musculoskeletal
disorders (WMSDs) are evident
• Determine if force, posture and/or time factors
are increasing the risk of injury
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FORCE DEMANDS
• Activities of Lifting, Carrying, Pushing, Pulling,
Gripping, Pinching
• Describe the activities - weights, forces, size of
object, distance from body, coupling, frequency
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Awkward Postures
• Look at the involved joint
• Determine if the posture is neutral or close to
neutral
• Describe the range of movement of the
involved joint - e.g. upper arm is held away
from the front of the body, back bends forwards
to reach low levels
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TIME FACTORS
• Frequency of movements - how many?
• Duration of postures – for how long?
• Recovery or rest time between movements and
postures
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Force, Posture and Time Factors
• Look at how the force, posture and time factors
interact in activities/duties
• The risk of WMSDs is magnified when risk
factors exist in combination.
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Employer’s Role Prior to an Injury
• Know the jobs – what is being done, how it is
being done
• Understand the risk factors for work-related
musculoskeletal injuries
• Establish an ergonomics committee
• Communicate with the workers
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Health Care
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Employer’s Role After an Injury
• Early and safe return to work
• “Is the job within the worker’s medical
precautions?”
• Review the job with the worker - are there risk
factors that need to be addressed?
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Employer’s Role After an Injury
• Consider accommodations to Pre-injury job (what
caused the injury in the first place?)
• Review modified or alternate jobs for RTW
• Provide physical demands information to the WSIB for
identified job(s)
• Involve the worker for the best chance of success
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Physical Demands Information Form
PDIF 2830A
See www.wsib.on.ca (employers  forms)
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Gathering job information
• Look at WHAT is being done in the job
• Describe the “WHAT” under the job title,
job objective, job duties and job design
• E.g. Personal Support Worker
Home Care Worker
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Gathering Job Information
• Job Title: Personal Support Worker
• Job Objective: To assist residents with activities of daily
living
• Job Design; 8 hour shifts, assigned to a certain wing
• Job Duties:
- Get residents up in morning
- Take residents to washroom
- Make beds
- Bathe residents
- Feed residents
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Gather Relevant Physical Demands
• HOW is the work being performed
• Look at the “HOW” relevant to the area of injury
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Gather Relevant Physical Demands
• Force demands – lifting, carrying, pushing,
pulling, gripping, pinching – describe the
activity, include weights and forces
• Postures – neutral vs awkward postures
• Time factors - Frequency (how many times?)
and duration (how long?)
• Specific measurements are important Numbers, Numbers, Numbers
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Gathering Job Information
• Look at “how” job is being done relevant to the
area of injury
• E.g. shoulder
• Describe force demands – lifting, carrying,
pushing, pulling
• Describe postures – reaching , heights involved
• Describe time factors – frequency of lifting,
reaching, duration of holding the same
shoulder posture
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Interpreting the Information
Variety of programs, equations, tables, research findings
to help determine risk:
• NIOSH equation
http://www.cdc.gov/niosh/94-110.html
• Snook / Mital tables
• Rapid Upper Limb Assessment (RULA)
http://www.ergonomics.co.uk/Rula/Ergo/index.html
• Kilbom repetition guidelines (1994)
• Strain index
• Biomechanic software programs (4D watbak, 3D static,
Bakpak)
• Scientific references
(WSIB ergos have a reference document with ~200 citations)
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RTW Considerations
• Pre-Injury vs. Modified vs. Alternate job
• Review of pre-injury job regardless of RTW
• Working at their own pace
• Locus of control & value added work
• Variability of movement
• Communication with worker / medical
personnel
• One hand / One arm work
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Potential RTW Best Practices
• Complete PDIF – customize to your workplace
• Focus on Force / Posture / Time factors
• Review any job where worker claims to have an injury fix any problems
• Create a comfortable non-hostile work environment
• Review job in question across a few different workers
• Questions, Questions, Questions
• Where possible, try the job
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Potential RTW Best Practices
• Communicate, involve the worker
(have the worker present when reviewing the job)
• Review jobs in detail prior to offering to the worker consider the medical precautions
• Ensure everyone knows about RTW guidelines (include
the supervisors)
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RTW PLAN
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Return-to-work Plan
Interim return to work date: ________
Transitional job – (eg. Pre-injury accommodated) _________________
Review Date: __________
Target End Date: __________
End goal job – (eg. Pre-injury) ___________________
Employee’s Name: _____________________________
Phone No. ____________
Supervisor/Manager: ___________________________
Phone No. ____________
Treating Physician(s): ___________________________
Phone No.(s) __________
WSIB Claims Adjudicator: ________________________
Phone No. ____________
WSIB Claim Number ____________________________
Transitional return to work date ____________________
Description of Employees Job:
(Attach Physical Demands Report for Employees Job)
Transitional Work Plan:
Pre-Injury Job,
comparable work
Pre-Injury Job with accommodations
alternative work
(e.g., wages, hours, rotation, min’s/max’s,)
Medical Precautions
(Attach most recent Functional Abilities Report)
Description of Transitional Work
(Attach Physical Demands Report for Transitional Work)
Supervisor Comments
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Provide copies of RTW Plan to all interested parties.
___________________________________________
Supervisor/Occ Health/Administrator
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Date:
Worker Comments/Concerns
____________________________________________
Employee
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Sample letter to Treating practitioner
Dear Practitioner:
At 123 Healthcare Corporation, we are committed to returning valued team members to meaningful work
through the use of a fair and consistent return to work program, following a workplace or non-workplace injury
or illness. Your patient, __________, has injured herself at work. In order to assist her with a work hardening
program, we are using the following precautions for her low back condition:
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Use disability guidelines for soft tissue – low back strain
We ask your cooperation in the completion of the attached functional abilities form (FAF). After your
assessment, if you feel there are additional precautions to assist all parties understand her capabilities, please
list them on the attached FAF.
We will be providing her with the following work activities using the above soft tissue guidelines for her low
back:
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List duties
The work can also be accommodated, by reducing her work hour schedule, if necessary, to ease her back into
a full work schedule, modified work, alternative work or through a combination of the above. If you have any
questions with respect to this return to work program that is available for her next schedule shift, please give
me a call. Thank you for your valued input and assistance.
Jan Safety,
123 Healthcare Corporation
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Accommodation Resources
• Canadian Centre for Occupational Health and Safety
CCOHS (www.ccohs.ca)
• Health and Safety Associations (see www.wsib.on.ca
for association web links)
• Association of Canadian Ergonomists
(www.ace-ergocanada.ca/)
• Job Accommodation Network
(http://janweb.icdi.wvu.edu)
• Occupational Health Clinic for Ontario Workers
(www.ohcow.on.ca)
• National Institute for Occupational Safety and Health
(USA http://www.cdc.gov/niosh)
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Thank-you
Have a Safe Day
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