The injured worker: assessing “return-to-work” status
DANIEL J. MAZANEC, MDAddress reprint requests to D.J.M., Director, Center for the Spine, U30, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
In workers injured on the job, the physical findings tell only part of the story. Physicians must also consider psychologic, economic, social, and legal factors when performing a return-to-work assessment.KEY POINTS
The most effective approach to avoiding long-term disability after most work-related injuries is a prompt medical evaluation and an early return to work. The process of safely returning a person to work includes performing a history and physical examination, assessing the physical demands of the job, educating the injured worker regarding the natural history of the injury, setting a return-to-work date, and recommending work restrictions if appropriate. An assessment of job satisfaction and of relationships with supervisors may be more helpful than physical findings in predicting return-to-work outcome. A formal evaluation of functional capacity can assist in this process and also assess the injured worker’s motivation to return to work. A comprehensive evaluation by a multidisciplinary team may be required in persons who have been out of the workplace for more than 3 months.