If you’ve done office ergonomic assessments before, you’ve probably encountered a doctor’s note. For many Ergonomists and healthcare professionals, deciding how to respond to doctor’s notes is one of the most challenging tasks in the assessment.
Of course, you have to think about the employer’s budget, the employee’s health and safety, and make sure that you assess the employees in a consistent manner. Occasionally, in any company, you’ll likely receive notes from employees notifying you that their doctor has prescribed them a piece of equipment. And in my experience, these notes usually come at a high price for the employer.
So when completing an ergonomics assessment, is it really best practice to try and access your client's doctor's report on the injury that they’re experiencing—if they’ve sought medical assessment that is? I ask as it’s common practice within occupational therapy to have access to medical records, which can be used to help guide intervention. So in this blog, I’m going to give 4 points that you need to consider when you’re in this situation. What I’m going to share with you below is based on my experience in the past 15 years.
1. Using a doctor's note will depend on the scope of what you're doing as an Ergonomist, and how you're doing it. From my past experience, I’ve found that having that extra information isn't really necessary. However, if you’re going to be using your client’s personal medical information, you’ll have to be extremely mindful of the Health Information Privacy Act. Every country has some element of this, some countries have even more than others. Issues related to ADA, OSHA, and worker’s compensation also come into play, which makes this more complicated. So whatever we're doing in our assessment, it's important to keep that in mind because that's another level of risk that we have to manage as consultants.
The only time that I've used personal health information in my ergonomics reports are situations related to workers’ compensation, complex return-to-work cases, and litigation cases. Those are the only times from my past experiences that I’ve really required it, and that it’s in my client’s best interest to use their private health information.
2. Adding that extra level of information doesn't add a significant amount of value in your assessment. Each time that I've had access to the client’s personal health information doesn't always mean that it added a significant amount of value to the process that I was doing. Accessing that information sure helped, but not all the time. Using that information will only add an additional level of complexity to your process. Some employees will give you a note recommending an equipment just because they want one, but don’t necessarily need it. So if you’re going to use their doctor’s report, make sure that you identify first what made the employee submit a note to you.
3. If your client shares personal health information with you freely, it's best practice not to include that in the ergonomics report. From my experience, there are some employees who are hesitant to share their personal health information with the employer. So if you include that information in your report, it might get jeopardized as it's easily shared in the organization. You can violate Personal Health Information Law that could bring so many negative implications to not only you as a consultant, but it can also have huge implications on the employer-employee relationship. And I've certainly seen, whether it's done on purpose or if it's a mistake, how easily information can be sent to the wrong person. This is especially true if you're working in a really large organization. It's a lot easier for everyone's sake to just stick to discomfort symptoms and put that in the report.
4. It’s best to stick to the process of asking specific questions on your client's discomfort and taking really thorough measurements. That’s really one of the easiest ways to get through an ergonomic assessment. That way, you can guarantee that you add as much value to your clients as you possibly can. Asking your clients specific questions can help to systematically address their issues in a way that fits their needs.
Most of the time, doctor’s notes could’ve been avoided if only the workstations were set up ergonomically in the first place. And if we can figure out the root cause of the employee’s discomfort is related to their workstation, we can make high-impact, low-cost solutions. To do that, there are several questions below that I recommend you to ask your clients. They are leading questions that are going to give you a lot of good information and can help you figure out what the root cause is.
An ergonomics assessment with an in-depth root cause analysis based on where that person is experiencing discomfort is always a good start. I suggest that you ask questions leading to the severity of their discomfort, what kind of symptoms they’re experiencing, and how often they’re feeling it.
One of the important questions you should keep in mind is asking them what could’ve contributed to the development of their discomfort. And that person might give you an answer like, “Ever since I got this new chair, I've noticed the discomfort in my shoulder.” This doesn’t mean that it's directly related, however, it's leading to the fact that maybe there's some discrepancies in chair height, or other elements in their setup that you can look at. You can gather really useful information from that. And whenever you're asking these questions, make sure that you really get down to what could be happening in that person's setup.
Another important question that I think is more valuable than getting specific doctor reports is asking your clients for potential solutions that they think would help reduce their discomfort. They might give suggestions like, “More standing in the day would be beneficial for me.” And if you help them be mindful of how they set up their day, you can add so much value. For instance, they could be standing when they're on a phone call, or you can devise a makeshift stand unit by putting boxes upside down.
There’s a lot of solutions that you can put into place that are high-impact and low-cost. The point of this is that it’s them that are coming up with the solution. And it's your job as the expert to pull out the most valuable things that they're saying, and ensuring that they're feasible, practical, and it could be related to their discomfort.
Instead of jumping into what the note recommends—such as buying a standing desk or a new chair, I encourage that you look at their workstation first and discuss alternatives. Expensive solutions don’t always solve the root cause of the situation.
Accessing your client’s doctor’s report and using it in your ergonomics assessment isn’t absolutely necessary. You can add value to your clients by doing a thorough ergonomics process that addresses the root cause of their discomfort. Those questions that I shared above can make your process a lot easier than accessing your client’s doctor’s note.
I hope that this article gave you some insights on how to respond to doctor’s notes when doing an ergonomic assessment. If you want to learn how other healthcare professionals are successfully adding ergonomic expertise to their practice, you can join my training. Just head on this link to get started.
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