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Covers RTW screening and obstacle/molehill questioning, role and appropriate scope of IME physicians, and how to communicate restrictions to employers with clear examples of light duty limits. Explains RTW workflow, functional capacity evaluation concepts, and pre-employment functional analysis.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/return-to-work-american-osteopathic-college-of-occupational-and-preventive-medicine-2015-mid-year-educational-conference/298113/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/return-to-work-american-osteopathic-college-of-occupational-and-preventive-medicine-2015-mid-year-educational-conference/298113.png","ImageObject",300,407,{"name":42,"@type":43},"Aldword","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-18",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What main issues should be considered when planning return to work after occupational injury?","Question",{"text":63,"@type":64},"Focus on risk, capacity, and tolerance. The material distinguishes risks to public safety and other workers, evaluates essential job functions, and addresses tolerance barriers that can undermine RTW decisions.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How can RTW screening questions help identify work barriers?",{"text":68,"@type":64},"Use the RTW screening test to ask how disease or limitations affect work ability and possible work-arounds. The obstacle question targets what specifically prevents working today, and the molehill sign evaluates whether a minor condition is causing major life impact, often indicating motivational factors.",{"name":70,"@type":61,"acceptedAnswer":71},"What is the appropriate role of IME physicians and how should employers receive restrictions?",{"text":72,"@type":64},"IME physicians may comment on work status, work capacity, needed restrictions, and potential accommodations, but they are not appropriate to directly release an examinee for RTW. Employers should be informed about diagnosis, whether work is related to it, safety concerns, dates for restrictions, and capabilities in employer-understandable terms.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},298113,1789751087,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":80,"read_time":145},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","American Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft Lauderdale, Florida  \n\n| Return to Work |  |  |\n| --- | --- | --- |\n| | | |\n| Carl Werntz, D.O., MPH |  |  |\n| WVU Occupational Medicine |  |  |\n\nBLACK BOX WARNING  \nIssues to Consider  \n•Risk  \n•Capacity  \n•Tolerance  \nBenefits of Work  \n• Income  \n• Benefits (Health Insurance, etc. )  \n• Camaraderie with co-workers  \n• Purpose  \n• Economic Independence  \nLikelihood of Return to Work  \nReturn to Work after Occupational Injury  \n0 4 8 12 16 20 24 28 32 36 40 44 48 52  \nWeeks Away from Work  \nRisk …  \n• To Public Safety  \n–Sudden Incapacitation  \n–Impaired function  \n–Inability to maintain Food Handler with open sore on their hand  \n–Pilot with increased sudden incapacitation risk  \n• To other workers / Employer  \nAmerican Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft Lauderdale, Florida  \nRisk …  \n• Of Medical Instability  \n–Recurrent Seizures  \n–RECENT Cardiac Procedures  \n–Recurrent Hypoglycemic Episodes  \nCapacity  \n• Essential Job Functions?  \n– Can patient actually do essential job functions?  \n– Complete emergency actions required by job  \n– ADA  \n• Need employer assistance with identifying truly essential functions  \n• Could they do majority of functions (>80%)  \n• Must be capable of all “essential functions”  \nRTW“Tests”  \n• RTW Screening Test  \n– Ask worker what impact disease/limitations will have on work ability, and potential work-arounds  \n• Grocery Store Test  \n– Consider: If patient owned small store without employees, could they be able to get to work and do job safely?  \n– If yes, then no reason to keep totally off work  \nRisk …  \n• To treatment efficacy  \n–Immobilization  \n–Medications  \n–External orthopedic appliances  \nTolerance  \n• The bane of most RTW decisions  \n• Potential Approaches  \n– Scribe whatever patient reports  \n– Educated Guess by provider  \n– Functional Capacity Evaluation  \n• Useful if you are concerned about patient actually having the abilities they report  \n• Less useful if you suspect patient can do more than they report they can do  \nRTW“Tests”  \n• The Obstacle Question  \n– Ask worker “what specifically is an obstacle keeping you from working today?”  \n– Then focus on overcoming these obstacles  \n• The Molehill Sign  \n– Consider: Is a fairly minor health condition having a major impact on the patient’s life?  \n– If yes, then MOTIVATION is likely a major issue, which can have many involved factors  \nAmerican Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft Lauderdale, Florida  \nRole of IME Physicians  \n• Appropriate to comment on  \n– Work status  \n– Work capacity  \n– Needed Restrictions  \n– Potential Accommodations  \n• NOT appropriate for IME doc to actually release examinee for RTW  \nCommunicating with Employers  \n• Restriction Examples  \n–May lift up to 25 Lbs Continuously  \n–May lift up to 50 lbs twice per hour  \n–Do not use right arm above shoulder level  \n–May not operate commercial vehicles  \n–May not drive  \n–Left arm to be in sling at all times  \nCommunicating with Employers  \n“Light Duty”  \nCommunicating with Employers  \n•Employer is Entitled to Know:  \n•Diagnosis  \n•Work-related or Not  \n•Capabilities of Worker  \n•Safety-based concerns  \n•Dates for any “Restrictions”  \nCommunicating with Employers  \n• Do you comment on their current job?  \n– If I know about details of job – then yes  \n– Ex: Hospital Nurse  \n• Lifting limit 25 lbs  \n• May perform all nursing skills  \n• Will require assistance with patient lifting  \n– Goal is not to tell employer what to do . . .  \n. . . But to tell employer what worker can do in terms the employer can better understand  \nRTW Flow (2000 Style)  \n• Injury Lets look at this  \n• Medical Care  \nprocess . . .  \n• MMI  \n• FCE  \n• Vocational Rehabilitation  \n• Search for job within the FCE-determined restrictions  \n• RTW in an appropriate j","cbCaivn0ROOYE0uI","https://ap.wps.com/l/cbCaivn0ROOYE0uI","pdf",416141,11,"English","# Return to Work - Issues to Consider\n## Risk\n## Capacity\n## Tolerance\n# Likelihood of Return to Work\n## Return to Work after Occupational Injury\n# RTW “Tests” and Problem Framing\n## RTW Screening Test\n## Grocery Store Test\n## Obstacle Question\n## Molehill Sign\n# Roles and Communication\n## Role of IME Physicians\n## Communicating with Employers\n## “Light Duty” Examples\n# RTW Flow (2000 Style)\n# Functional Capacity Evaluation (FCE)\n## What Questions an FCE Can Answer\n## Intuitive Benefits of Functional Capacity Testing\n## Assessing Work Capacity and Pre-Employment\n## Generalities about FCEs and PEFA","[{\"question\":\"What main issues should be considered when planning return to work after occupational injury?\",\"answer\":\"Focus on risk, capacity, and tolerance. The material distinguishes risks to public safety and other workers, evaluates essential job functions, and addresses tolerance barriers that can undermine RTW decisions.\"},{\"question\":\"How can RTW screening questions help identify work barriers?\",\"answer\":\"Use the RTW screening test to ask how disease or limitations affect work ability and possible work-arounds. The obstacle question targets what specifically prevents working today, and the molehill sign evaluates whether a minor condition is causing major life impact, often indicating motivational factors.\"},{\"question\":\"What is the appropriate role of IME physicians and how should employers receive restrictions?\",\"answer\":\"IME physicians may comment on work status, work capacity, needed restrictions, and potential accommodations, but they are not appropriate to directly release an examinee for RTW. Employers should be informed about diagnosis, whether work is related to it, safety concerns, dates for restrictions, and capabilities in employer-understandable terms.\"}]","Return to Work - American Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference | PDF",28]