Company health care management strategies and policies and health care providers is an important part of the overall ergonomics program. In general, medical management emphasizes the prevention of impairment and disability through early detection, prompt treatment, and timely recovery. Medical management responsibilities fall on employers, employees, and health care providers.

The employer can create an environment that encourages early evaluation by a health care provider by:

• Providing education and training to employees regarding the recognition of the symptoms and signs of MSDs and the employers procedures for reporting MSDs

• Encouraging employees to report symptoms early so prompt evaluation by an appropriate health care provider can be provided

• Giving health care providers the opportunity to become familiar with jobs and job tasks

• Modifying jobs or accommodating employees who have functional limitations secondary to MSDs as determined by a health care provider

• Ensuring, to the extent permitted by law, employee privacy and confidentiality regarding medical conditions identified during an assessment

Employees should participate in the health care management process by: following applicable workplace safety and health rules, following work practice procedures related to their jobs, and reporting early signs and symptoms of MSDs.

Employees may be faced with conflicting job demands or requirements. Safe work practices or rules may conflict with pressures or incentives to be more productive.

The health care provider can support the employer's ergonomics program by:

• Acquiring experience and training in the evaluation and treatment of MSDs

• Seeking information and review materials regarding employee job activities

• Ensuring employee privacy and confidentiality to the fullest extent permitted by law

• Evaluating symptomatic employees including:
  • medical histories with a complete description of symptoms

  • descriptions of work activities as reported by the employees

  • physical examinations appropriate to the presenting symptoms and histories

  • initial assessments or diagnoses

  • opinions as to whether occupational risk factors caused, contributed to, or exacerbated the conditions

  • examinations to follow up symptomatic employees and document symptom improvements or resolutions

Health care providers who evaluate employees, determine their functional capabilities, and prepare opinions regarding work relatedness should be familiar with employee jobs and job tasks. With specific knowledge of the physical demands involved in various jobs and the physical capabilities or limitations of employees, the health care provider can match the employees capabilities with appropriate jobs. Being familiar with employee jobs not only assists the health care provider in making informed case management decisions but also assists with the identification of ergonomic hazards and alternative job tasks.

One of the best ways for a health care provider to become familiar with jobs and job tasks is by periodic plant walk-throughs. Once familiar with plant operations and job tasks, the health care provider should periodically revisit the facility to remain knowledgeable about changing working conditions. Other approaches that may help the health care provider to become familiar with jobs and job tasks include reviewing job analysis reports, detailed job descriptions, job safety analyses, and photographs or videotapes that are accompanied by narrative or written descriptions of the jobs.

Early Reporting and Access to Health Care Providers

Employees reporting symptoms or signs of potential MSDs should have the opportunity for prompt evaluation by a health care provider. In general, the earlier that symptoms are identified and treatment is initiated, the less likely a more serious disorder will develop. Employers should not establish policies that discourage employees from reporting symptoms. For example, programs that link a manager's earnings to the number of employees reporting symptoms may discourage supervisors from allowing symptomatic employees to be evaluated by the health care provider. Employees should not fear discipline or discrimination on the basis of such reporting.

Treatment

• Health care providers are responsible for determining the physical capabilities and work restrictions of the affected workers.

• The employer is responsible for giving an employee a task consistent with these restrictions.

• Until effective controls are installed, employee exposure to ergonomic stressors can be reduced through restricted duty and/or temporary job transfer.

• Complete removal from the work environment should be avoided unless the employer is unable to accommodate the prescribed work restrictions.

• Immobilization devices, such as splints or supports, can provide relief to the symptomatic area in some cases. These devices are especially effective off-the-job, particularly during sleep. They should not be used as prophylactic PPE to prevent the development of MSDs. Therefore, these devices should be dispensed to individuals with MSDs only by health care providers who have knowledge of the benefits and possible negatives of these devices.

Disclaimer: This material is for training purposes only. Its purpose is to inform employers of best practices in occupational safety and health and general OSHA compliance requirements. This material is not, in any way, a substitute for any provision of the Occupational Safety and Health Act of 1970 or any standards issued by OSHA.