Post-Offer, Pre-Placement Functional Testing

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Post-Offer, Pre-Placement Functional Testing
Kory Zimney, PT, DPT, CSMT
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What is it?

• Functional testing done post-offer of a specific
• job to all qualified candidates to
• ensure they can perform the
• essential physical demands
• of the job.

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Why do it?

• According to the U.S. Department of Labor 1 in
  every 10 workers is not physically capable of
  performing the essential functions of their job
  safely.

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Physical Capacity of the general population
Physical Demand Level (PDL) Male Female
Sedentary (level 1) 99 99
Light (level 2) 95 90
Medium (level 3) 66 50
Heavy (level 4) 33 10
Very Heavy (level 5) 10 0
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• Failure rate of testing
• Medium PDL is in the range of 5 - 8
• Heavy PDL is in the range of 9-12
• Very Heavy PDL is in the range of 18-23

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• Increase injury risk if not matching worker to
  physical demands of job
• Shoulder 2 versus 28
• Back 3 versus 33

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• Reduce injury risk
• Reduce severity of injuries
• Reduce cost associated with injuries
• Reduce turnover
• Baseline of any current impairment status

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• Reimer et al found that pre-employment screening
  combined with a worker fitness program for
  grocery warehouse workers significantly decreased
  injuries and injury-related expenses over a
  3.5-year period.
• Nassau demonstrated that pre-work placement
  screening and case management significantly
  decreased the severity of injuries.
• Gassoway and Flory documented that screening
  nursing assistants at a regional health center
  significantly decreased job turnover. The health
  center saved 6 for every 1 spent on screening.

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• Littleton provides the strongest evidence to date
  in support of post-offer screening, using the
  ErgoScience Post-Offer Screening protocol. They
  tested physical plant applicants at a major
  university hospital and found an 18, decrease in
  number of lost day cases and a 78 decrease in
  total injury costs. For every 1 spent on
  post-offer screening, the employer saved 18.

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• Post-offer, pre-placement functional capacity
  test (PPFT)
• Post Offer Physical Lifting Screens
• Functional Screen
• Back Screen
• Lifting Test
• Ability Testing
• Physical Capacity Profile

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What are the different components of the PPFT
that might be done?

• Baseline mobility and positional tolerances
• Movement screen or ROM testing
• Sit, stand, reach, bend/stoop,
• squat, climb, crouch, kneel,
• balance
• Aerobic testing

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What are the different components of the PPFT
that might be done?

• Lifting
• Various weights, heights
• Carry, push/pull, lifting
• Strength testing
• Isometric or Manual muscle testing

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Can we screen for potential repetitive trauma
(overuse injuries)?
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Whats the difference between tests

• Time needed to do testing (15-30 minutes)
• Baseline ROM, cardiovascular and strength data
• Future injury risk screening
• Current pathology screening
• Lifting tasks general versus specific
• Documentation of pre-existing impairments
• Cost

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What do you need to do to start testing?

• Functional Job Analysis (FJA)
• Accurate job description with measurement of
  essential job functions
• Essential functions are the basic job duties that
  an employee must be able to perform, with or
  without reasonable accommodation.
• Create a test that is fully compliant with the
  EEOC and ADA by ensuring the absence of disparate
  discrimination in the functional test design and
  delivery.

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Factors to Consider in Determining if a Function
is Essential

• Whether the reason the position exists is to
  perform that function,
• The number of other employees available to
  perform the function or among whom the
  performance of the function can be distributed,
  and
• The degree of expertise or skill required to
  perform the function.

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Factors to Consider in Determining if a Function
is Essential

• Your judgment as to which functions are
  essential, and a written job description prepared
  before advertising or interviewing for a job will
  be considered by EEOC as evidence of essential
  functions. Other kinds of evidence that EEOC will
  consider include

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Factors to Consider in Determining if a Function
is Essential

• the actual work experience of present or past
  employees in the job,
• the time spent performing a function,
• the consequences of not requiring that an
  employee perform a function, and
• the terms of a collective bargaining agreement

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Does everyone need to be tested?
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How is the Post-offer testing different from a
Fit for Duty Exam testing?
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