Orthopedic Clearance Versus Occupational Medicine Clearance
Who decides when an employee can safely return to work after an on-the-job injury? The employee? Their supervisor? The occupational medicine practitioner who evaluated the employee? Their orthopedist? Any or all of the above?
While orthopedists evaluate injured employees and assess whether they have recovered to return to work, in a workers’ compensation claim, it is the occupational medicine practitioner who needs to determine the employees’ ability to safely and effectively perform the duties of their job prior to being cleared to return to work.
“The orthopedist evaluates the injured body part(s) for function, strength, and range of motion,” says Robert Pedowitz, D.O., Vice President and Chief Medical Officer of Occupational Health and Safety at Hackensack Meridian Health. “In occupational medicine, we take a holistic approach. We look at whether a person’s overall physical and mental fitness to perform specific job duties safely and in accordance with their work environment.”
Who treats workers’ compensation injuries?
Companies often make arrangements with an occupational health practice to manage workers’ compensation claims.
When an injured employee files a claim, they’ll be sent to an occupational medicine practitioner for evaluation.
“If we suspect a fracture, we would refer them to an orthopedist right away,” Dr. Pedowitz says. “But depending on the nature of the injury, a referral to an orthopedist may not be needed. They might need conservative treatment like rest, ice, anti-inflammatory medication or physical therapy.”
If the injury doesn’t improve with conservative care and physical therapy, the occupational medicine practitioner may refer the employee to an orthopedist.
“In a workers’ comp case in New Jersey, the employee does not self-refer to an orthopedist; they need a referral,” Dr. Pedowitz says.
How orthopedists manage workplace injuries
An orthopedic specialist typically treats an employee until they achieve maximum medical improvement, when the injury no longer improves with additional treatment.
“When they achieve functionality of the joint, bone or muscle and have recovered enough to be able to work, the orthopedist will usually clear that person,” Dr. Pedowitz says. “But the orthopedist only clears someone based on their injury specifically, not on their ability to perform their job.”
How occupational medicine practitioners manage workplace injuries
When companies work with occupational health practices, occupational medicine specialists meet with employees who file workers’ compensation claims. These practitioners manage each worker’s injury and decide on their fitness to return to work.
“It’s an occupational medicine specialist’s job to determine what duties a person has, what their physical requirements are, and whether they can return to work safely and not get re-injured,” Dr. Pedowitz says.
Occupational medicine practitioners see a much bigger picture after an employee’s injury heals. If heavy lifting is part of their job description, the practitioner must determine whether they can lift 50-pound boxes regularly without getting hurt again.
They also consider other factors that could affect the ability to return to work.
“Workers may lose some of their focus on safety,” Dr. Pedowitz says. “When you’re not doing your job for three to six months, you sometimes get a little rusty, as you would with anything you don’t do every day.”
Some workers become deconditioned and need a rehab program to work their way back to doing their job. They might lift 25-pound boxes temporarily until they rebuild their strength.
“It’s like an injured athlete that’s been out of competition,” Dr. Pedowitz says. “You don’t go back in at 100 percent; you gradually get back to where you were pre-injury.”
How working with occupational health benefits employers
When occupational health practitioners manage workplace injuries, they ensure employees are medically, mentally, and physically ready to return to work.
“At Team Health, we’re best in class – we are the only Occupational Medicine program in the state of New Jersey to achieve the National Association of Occupational Health Professionals certification, and we strive to do the best for our clients,” Dr. Pedowitz says. “An orthopedist takes care of the employee, but we’re taking care of both the employee and the employer.”
To find out how Team Health’s occupational medicine practitioners can help your company manage workplace injuries and safely transition employees back to work, contact us at hmworks@hmhn.org.