THE LEADER in Work Injury Management & Prevention Systems

Work Solutions Insight June 2014 Newsletter

DSI Job Function Matching® brochure available: For work injury management specialists, employers and workers. Click Here

LinkedIn: click here to join the DSI Job Function Matching® group.


Clayton G. Van Balen, MD, MS, FACOEM, FAAFP, CIME
Medical Director, Employee Health Services
Sanford Health Corporation, Sioux Falls, SD

Best practices: Physician decision making in return to work - Collaborating with the
Physician in the Job Function Matching® Process

  • Dilemmas/barriers physicians face when making return to work decisions
  • Information from employers that will best help a physician in making a return to work decision
  • How Job Function Matching benefits the physician, employee and the employer
  • How to collaborate with the medical specialist in return to work decision making


CLICK HERE to join our LinkedIn group DSI Job Function Matching® for hiring; return to work and ADA compliance discussions. All questions, comments, and topics welcome!


Vocational Rehabilitation Program Evaluation: Comparison Group Challenges and the Role of Unmeasured Return-to-Work Expectations. 
Sears JMRolle LRSchulman BAWickizer TM.

J Occup Rehabil. 2014 Mar 30.

Purpose: Despite the importance and cost of workers' compensation (WC)-based vocational rehabilitation (VR) programs, outcome evaluations are rare, in part due to the scarcity of suitable comparison groups. The aims of this study were to assess (1) the adequacy of a commonly recommended internal comparison group, i.e., workers who were eligible for but did not receive services, and (2) return-to-work (RTW) expectations as a potential source of bias.

Methods: In this prospective cohort study, we used WC claims data and worker-reported RTW expectations to compare workers who received vocational retraining services to eligible workers who did not receive such services. Workers were surveyed after retraining eligibility determination, prior to the initiation of retraining activities. VR progress and RTW wage outcomes were followed for 3 years. The magnitude of confounding contributed by RTW expectations and other covariates was quantified.

Results: Workers who were somewhat or very certain they would RTW had significantly better outcomes. RTW expectations played a strong confounding role, reducing the retraining plan effect estimate by about 23 %, while education and physical capacity each changed the effect estimate by <5 %.

Conclusions: RTW expectations predicted long-term RTW outcomes and can play a strong confounding role if unmeasured. We found that the internal comparison group approach, commonly recommended for VR program evaluation, is inappropriate for WC-based VR evaluations. Ultimately, there is no simple solution to the challenge of identifying a comparison group; however, measurement of RTW expectations, an easily-measured multi-dimensional construct, may be a useful addition to the VR evaluation toolbox.

DSI Comments: The results of this study support the importance of planning for return to normal work duty immediately- actually from the day of injury if possible. DSI advocates beginning the job function matching process right away and reporting on the job functions/essential functions the worker can do often throughout the course of medical care. Keeping the worker’s expectations and focus on returning to full duty has always been a part of the DSI Job Function Matching® process. This reinforces the importance of communication between all parties: employee, employer, physician, case manager, insurer, and rehabilitation experts.



Disability Compliance Bulletin, Volume 48, Issue 9, April 3, 2014

Fahey vs. Twin City Fan Companies Ltd. 48 NDLR 144 (D.S.D. 2014)

A Job applicant for a forklift job revealed to the employer that he was blind in one eye. The employer failed to engage in a discussion re: accommodations and did not hire the applicant. The applicant sued under ADA Title I.

The employer used the direct threat argument, to no avail because 1) the employer failed to engage the worker in discussing possible accommodations (no interactive process), and 2) the employer did not ask for medical input until after the offer of hire had already been rescinded. The court ruled in favor of the applicant. The court found insufficient evidence to support that an individualized review had occurred. The court explained that direct threat analysis requires the employer to consider reasonable accommodation. The applicant had proposed driving the forklift with the use of a side mirror - which was how he drove his car.

DSI Commentary: Looking at this case we can see how important it is to have written evidence and professional input when making critical decisions regarding accommodation- even if the answer seems obvious. If the critical issue of whether this applicant had adequate vision to safely operate the forklift had been discussed with the applicant (and documented) and an occupational medical professional examined and advised before the decision of hire was made, there likely would not have been a court case.

This concept can be applied to job related physical/functional requirements as well. Documentation and validation of those requirements and functional testing (as in the DSI Job Function Matching® system) help accomplish the following: 
a. ensure that applicants are placed in jobs they possess the safe ability to perform 
b. place an employer in a proper position to objectively and specifically address individual accommodation issues for an applicant, with the assistance of a skilled and qualified job function evaluator.


Work Injury Management & Prevention Webinar Series
Each Educational Webinar is 90 Min. in Length
(1.5 contact hours)
Click here for list of topics and order form

Full Webinar Series: $495.00

  • 1 webinar: $60
  • 2-5 webinars: $50 each
  • 6+ webinars: $45 each


This cloud based software program facilitates the development of

  • DSI's Job Function Description™
  • Job Function Test™
  • Job Function Matching®
  • Ergonomic Opportunities

Major advancements are seamless use of job analysis information to populate the DSI Job Function Descriptions > Test > Job Matching and Ergonomic report. ADAAA compliance is high as there the testing is developed directly from the job description in essential function format. The DSI Job Function Matching format also facilitates reasonable accommodation information to be aligned directly with specific tasks. To learn more about DSI's Job Function Matching® system and to join our growing list of new software users, contact or call us at 270.245.1000.


April 12-14: Training: DSI Job Function Matching and FCA: WI - FULL   
April 25-27: Training: DSI Job Function Matching and FCA: KY - OPEN
April 28-30: 2014 Wisconsin Safety and Health Conference and Expo - DSI Instructor Nancy Bellendorf, OTR/L presenting" RTW and Disability Management : Strategies for Success" 
May 16-18: Training: DSI Job Function Matching and FCA: NY - OPEN
June 20-22: Training: DSI Job Function Matching and FCA: WI - OPEN 
July 11-13: Training: DSI Job Function Matching and FCA: KY - OPEN
August 21-23: Training: DSI Job Function Matching and FCA: NY - OPEN
September 19-20: DSI National Conference: Minneapolis, MN
October 3-5: Training: DSI Job Function Matching and FCA: KY - OPEN
November 5-8: PPS Annual Conference & Exhibition: Colorado Springs, CO - DSI CEO Ginnie Halling, PT and COO Curt DeWeese, PT presenting: "Expand your Practice; Assist Employers with Return to Work & Injury Prevention Strategy"
TBA: Training: DSI Job Function Matching and FCA: WI - OPEN

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