Ergonomics

Question 1

What are the benefits provided to workers for return-to work services?

Answer 1

1. Workers who cannot return to their jobs due to an injury may qualify for additional training, retraining, or self employment programs.
2. The goal is to return injured workers to substantial gainful employment, as soon as possible after an injury occurs

Question 2

What are the death benefits provided to workers?

Answer 2

1. Surviving spouse/dependents receive 2/3 of the deceased worker’s gross wage, up to a maximum of 110% SAWW. Total benefit must not exceed $197,000.
2. Funeral Expenses are payable up to $6,500.
3. Guardian Scholarships are awarded in the amount of $3,000 for a max of five years to cover tuition costs.

Question 3

when were workers comp laws established in ND?

Answer 3

1919

Question 4

Before workers compl laws, what were the potential outcomes of a work injury?

Answer 4

1. Assumption Of Risk: workers assumed and accepted risk
2. Fellow-Servant Rule: employer not responsible if one employee was negligent causing another’s injury
3. Contributory Negligence: employee was negligent no matter how slight they were and how great the employer was

Question 5

Established in 1994 to combat employer, provider, and injured worker fraud; Investigators act on anonymous tips, WSI staff referrals, and VeriComp Software reports;To date, SIU has saved the fund an estimated $15.5 million; Fraud: Employee, Employer, Provider

Answer 5

Special investigations unit (SIU)

Question 6

Benefits are provided to workers for accidental injury; Benefits include wage loss, medical and death benefits; A covered employee is defined by law; Fault is immaterial; Employees give up the right to sue the employer for damage; Employee retain the right to sue negligent third parties; Employers are required to be insured

Answer 6

ND Workers Compensation Act 1919

Question 7

what are the new therapy opportunities due to the ergonomic initiative grant?

Answer 7

1. Set up Programs
2. Perform Ergonomic Assessments
3. Help with Safety Programs
4. Help with Job Descriptions
5. Less BAD PATIENTS

Question 8

When is the ideal timeline to begin treating an injured worker?

Answer 8

within 24 hours

- at the convenience of worker and employer

Question 9

More vigorous ther ex; Neuromusculoskeletal status is in end phase of physiologic healing

Answer 9

reconditioning phase

Question 10

Involvement of injured worker in more functional activities; Graduated ther ex; Improve objective measures; Functional training to increase ability to perform task related to community and work reintegration

Answer 10

post-acute phase

Question 11

Immediate post-trauma; Focus on control and reduction of localized inflammatory response, joint and soft tissue swelling or restriction, and stabilization and containment of the injury

Answer 11

acute phase

Question 12

Progressed through all other phases but not yet ready to return to work because of identifiable physical, functional, behavioral or vocational deficits; FCE may be used to define limitations; May enter work hardening or simply back to full duty

Answer 12

return to work phase

• make sure accommodations fit restrictions
• review accommodations with the employer and employee
• progress restrictions as patient improves
• make sure you document functional limitations as they correspond to work requirements
• If disabled from work from 6 months, only 50% chance of ever returning
• If off one year the odds are only 25%

Question 13

What are the principles to treat the acutely injured worker?

Answer 13

1. Management of lost time and minimizing disability
2. Neuromusculoskeletal injury management
3. Facilitations of timely and appropriate referrals
4. Minimizing injury/reinjury incident rate (ergonomic recommendations, education, etc.)

Question 14

What is the number one reason why people don’t want to return to work?

Answer 14

fear of reinjury
- Educate injured worker on what to do in case of an exacerbation: Ice, Ibuprofen, Rest, Exercise (Stretch First, Strengthen Second)

Question 15

A highly structured, goal oriented, individualized treatment program designed to return the person to their work; an interdisciplinary program that uses real or simulated work activities designed to restore physical, behavioral and vocational functions

Answer 15

work hardening

• going back to a specific job
• simulating their work in therapy, in clinic 4-6 hours a day

Question 16

A work related, intensive, goal oriented program specifically designed to restore an individual’s systemic, NM, and cardiopulmonary functions to get them as good as they can get

Answer 16

work conditioning

- going back to any old job

Question 17

What are the observations of the client you should make while doing work hardening and conditioning?

Answer 17

1. level of participation of pt
2. consistency and level of effort
3. behaviors that interfere with physical performance
4. body mechanics
5. safety

Question 18

When would you terminate a work hardening patient?

Answer 18

1. Goals and expected outcomes have been met
2. Client has or develops problems to program can’t address
3. Medical contraindications
4. Client fails to comply with requirements of participation
5. Reached a plateau
6. Services discontinued by referring source (special investigator caught them doing something they said they’re unable)

Question 19

What information would you include with a work hardening or conditioning summer at d/c?

Answer 19

• Notify employer, doctor, insurance carrier
• Provide following information:
  1. Reasons for termination
  2. Clinical and functional status
  3. Recommendations regarding return to work
  4. Recommendations for follow-up services

Question 20

When would you terminate a work conditioning patient?

Answer 20

1. Goals and expected outcomes have been met
2. Client develops behavioral or vocational problems which are not being addressed and interfere with program
3. Medical contraindications
4. Client fails to comply with requirements of participation
5. Reached a plateau
6. Services discontinued by referring source

Question 21

What are the aspects of educating a patient on lifting mechanics?

Answer 21

1. how to lift correctly
2. Don’t presume they know how
3. May have to start with no weight
4. Disc Pressures

Question 22

Term used to describe a specific clinical behavior in which the client’s pain and disability are out of proportion to the medical impairment and/or movement patterns

Answer 22

symptom exageration

• Blankenship – “Client is exhibiting a non organic component to the medical impairment or disability
• never say malingering in note

Question 23

What are the PTs responsibilities in a worker’s comp case?

Answer 23

1. Evaluate objectively - report the facts, if they exhibit waddell’s signs, report they need psychological eval
2. Treat organic problems
3. Don’t treat behavior problems – especially with modalities
4. Help patient confront real issues or refer to appropriate medical professions
5. Base decisions on objective data

Question 24

What are waddell’s non organic signs of pain? 3 of 5 positives = need for further psychological eval

Answer 24

1. Tenderness – usually localized to a particular structure (Superficial- light touch; Non Anatomic)
2. Simulation – give impression looking at something and in fact your not (Axial Loading; Rotation)
3. Distraction – should be non-painful, non-emotional, and non-surprising (SLR- nerve tension at 30, SI at 70)
4. Regional Disturbances – numb or give-way (Weakness – cogwheeling or give way; Sensory – non dermatomal)
5. Overreaction- disproportionate verbalization, facial expressions, muscle tension, tremor, and even at times sweating or collapsing

Question 25

if someone is not giving full effort ton 5 position grip test, what abnormalities would you see on the plot curves?

Answer 25

1. Flat 2. Declining 3. Rising 4. Up/Down - everyone should give a normal bell shaped curve; even person with carpal tunnel

Question 26

purpose is to provide an objective measure of a client's safe functional abilities compared to the physical demands of the job

Answer 26

functional capacity evaluation (FCE) - done to: Return to work and job placement decisions; Disability evaluation; Determination of work function with non work related illnesses or injury; Determination of function in non-occupational settings; Intervention and treatment planning; Case management and case closure

Question 27

What are the FCE types?

Answer 27

1. Blankenship – 1 Day Test; Functional testing component and Behavioral profile component 2. Key Assessment 3. Isernhagen – 2 Day Test; 3 hours 1st day – 2 hours 2nd day; More reliable than “one shot testing” 4. Joule – 2 Day Test

Question 28

what are the two categories of functional activities as defined by IRAC?

Answer 28

1. material handling | 2. non-material handling

Question 29

defined as that state in which primary healing is complete, or the progression of the primary healing is not compromised

Answer 29

medically stability - pt should be at maximal medical improvement - 160/95 – hold FCE - 100 BPM heart rate hold

Question 30

what is the first symptom that you look for when doing an assessment in an FCE

Answer 30

fatigue | - comes before pain

Question 31

What are the contraindications to an FCE?

Answer 31

1. Not medically stable 2. Performance of the test would compromise client safety or medical condition 3. Communication barriers preclude understanding instructions, communicating concerns, and interpreting reactions during the FCE

Question 32

slide 93,95 check it out

Answer 32

``` Sedentary = 10 light = 20 ```

Question 33

A scientific study of the relationship between work and the work environment; Incorporates physiological and physical engineering principles to enhance safety and efficiency; Frequently used to look at jobs which have caused injury or have the potential to cause injury

Answer 33

ergonomic analysis - To identify causes of ergonomic stressors and develop strategies for control - To develop functional job description - To design post offer screenings - To determine rest recovery times - To develop training methods - To design rotational schedules

Question 34

Utilizes principles of ergonomics to analyze the components of a job specific to a particular employee

Answer 34

Job site analysis - To gather data on a job for development of a treatment plan for a work hardening plan - To compare an injured workers functional abilities with job task demands in effort to return to work or document incompatibility - To recommend modification to equipment or work habits to enhance an employee’s tolerance to job tasks - To assess options for reasonable accommodations - To assess equipment and environmental factors

Question 35

One on one on site coaching with an employee upon return to work

Answer 35

job shadowing/coaching - To provide documentation of compliance or non-compliance with recommendations - To assist with implementation of techniques learned in work hardening - Reinforce the correct utilization of techniques learned – build confidence

Question 36

What are the preparations needed to perform a job analysis?

Answer 36

1. Receive prior authorization of payment 2. Review job demands with worker 3. Contact supervisor; To schedule and review demands 4. Have background info about job or industry 5. Conference with employer prior to observing so as not to interfere with overall productivity

Question 37

what is the purpose of Post offer physicals?

Answer 37

1. Identify high risk jobs 2. Perform job analysis 3. Determine test design 4. Validation of testing - Must meet ADA guidelines and be work related - Must be done to everyone in that job classification

Question 38

What is ergonomics?

Answer 38

"the science of fitting jobs to people" | - Ergonomics uses knowledge of physical abilities, limitations & human characteristics that apply to job design

Question 39

considers the tasks, equipment & environment to provide efficient use of worker capabilities while ensuring that job demands do not exceed those capabilities

Answer 39

ergonomic design

Question 40

What can proper ergonomics do for a company?

Answer 40

1. Improve Efficiency 2. Increase Production Capability 3. Reduce Workplace Injuries 4. Lower Workers’ Comp Costs 5. Reduce Absenteeism

Question 41

What are the essentials of an ergonomic plan?

Answer 41

1. Written plan – employer and employee participation 2. Hazard information and reporting – near miss reports 3. Work risk analysis and risk control 4. Training 5. MSD Management 6. Program evaluation

Question 42

What are the ergonomic buzz words?

Answer 42

1. Cumulative Trauma Disorders (CTDs) 2. Repetitive Stress Injuries (RSIs) 3. Repetitive Motion 4. Injuries(RMIs) Problems of the muscles, tendons, or nerves of the neck and upper limbs that are caused, precipitated, or aggravated by repeated movements or exertions of the body

Question 43

medical conditions that develop gradually over a period of time; do not typically result from a single instantaneous event; Occur on a daily basis; Result from repeated motion or sustained posture

Answer 43

muscular skeletal disorders caused by: Bending, Climbing, Crawling, Reaching, Twisting, Overexertion, Repetitive Exposure

Question 44

What are the risk factors that result in MSDs?

Answer 44

1. Environmental (heat, cold, lighting, vibration, tool design, noise) 2. Activity factors (repetitive movement, exertion, poor posture, improper gripping)

Question 45

What factors do you need to take into consideration with force and exertion in ergonomics?

Answer 45

1. Weight 2. Bulkiness 3. Speed

Question 46

Resting the forearm, wrist or hand on hard or sharp surfaces can compress and damage muscles, nerves, and blood vessels

Answer 46

contact stress | - carpal tunnel, end range ext = as bad as end range flexion, ulnar deviation = bad as well

Question 47

What are psychosocial issues that need to be considered with ergonomics?

Answer 47

1. Interactions with co-workers 2. Job Satisfaction 3. Work Culture 4. Time Pressures 5. Electronic Monitoring 6. Performance Measures 7. Task rotation

Question 48

What factors increase repetition hazards?

Answer 48

1. Number of cycles per minute 2. Force required 3. Posture

Question 49

What are the 3 ways for hazard controls?

Answer 49

1. Engineering Controls 2. Administrative Controls 3. Work Practice Controls

Question 50

What are engineering controls to reduce injury?

Answer 50

1. Re-design of work station 2. Re-design of tools 3. Lighting modification 4. Vibration control 5. Noise Control 6. Automation 7. Mechanical Lifting 8. Material Flow

Question 51

What are administrative controls to reduce injury?

Answer 51

1. Employee rotation 2. Job task enlargement 3. Adjustment of work pace 4. Redesign of work methods 5. Alternative tasks 6. Rest breaks

Question 52

What are work practice controls to reduce injury?

Answer 52

1. How are employees lifting product 2. Are microbreak exercises being done 3. Are breaks being taken 4. Are safety protocols being followed 5. Are employees using good body mechanics 6. Work smarter not harder

Question 53

The purpose of the __________ is to reduce or eliminate cumulative-type injuries at the workplace. What typically begins as minor aches or pains, if ignored, has potential to develop into costly claims.

Answer 53

Ergonomic Initiative

Question 54

What are the on site services provided by the ergonomic initiative?

Answer 54

1. on-site ergonomic assessments in which potential or existing problems will be identified 2. ergonomic recommendations and interventions 3. assistance with the selection of appropriate ergo equipment 4. employer and employee ergo training

Question 55

What is included in the ergonomics "hit list" when evaluating an office setting?

Answer 55

1. “Turtleneck”; 2. Hungry head; 3. Slumped posture; 4. Elbows out; 5. Reach out of “easy reach” zone; 6. Work outside the “comfort zone”; 7. Shoulder(s) too high/low; 8. Twisting of neck or back; 9. Wrists outside of neutral position; 10. Squinted eyes

Question 56

indicators of eyestrain

Answer 56

1. Dry Burning Eyes 2. Blurred Vision 3. Delayed Focusing 4. Altered Color perception 5. Headaches 6. Look at Monitor Refresh Rate 7. 20-20-20 Rule (every 20 minutes, you should work 20 feet away from you for 20 seconds)**

Question 57

What are all the pieces of an office that you need for an office ergonomic assessment?

Answer 57

1. Seating - belly up 2. Work surface - forearms must be supported, with elbow just off 3. Keyboard/Mouse - mouse needs to be close 4. Monitor - eyes at the top ⅓ unless they have bifocals 5. Telephone 6. Additional accessories 7. Work/Rest Schedule 8. Manual Material Handling