How pre-employment strategies can help limit workers compensation liability

Sprain and strain injuries continue to account for a significant portion of all serious workers compensation (WC) claims. One of the best ways to reduce your exposure to increased WC costs is to eliminate as much risk from the business as possible, including through the pre-employment process. This not only negates the impact on the organisation but also on the individual.

During the pre-employment phase, there is often a focus on getting candidates on board as quickly as possible. However, this needs to be balanced with ensuring the right candidates are hired. Simply hiring to get ‘bums-on-seats’ can lead to recruitment of high-risk individuals specific to the job’s inherent physical demands.

The following three pre-employment processes are most commonly used across all industries, with only one having a reliable impact on WC costs.

1. Relying on the candidate’s honesty — Organisations rely on candidates to answer their questions honestly. These answers can determine whether candidates are sent for a pre-employment medical. **Again this relies on the honesty of the person applying for the job…**
    
2. Sending occupational role profiles, job descriptions or job demand assessments to a medical provider — The issue here is that each assessor will test each candidate differently; therefore, no accurate decision can be made on the candidate’s suitability. There is no standardised assessment for all pre-employment medical providers to use and if ever challenged in court, it would be very difficult to defend.
    
3. Sending a candidate for a standardised medical and functional assessment — This is the best option, however, the assessment’s quality and processes are the key to stopping risk entering the business. A Pre-Employment Functional Assessment (PEFA) is the same as a musculoskeletal screen and functional capacity assessment. It is a series of tests that provide objective information about a worker’s functional capacity. Yet, it is often not done as a result of the perceived upfront costs. If we look at functional assessments, job specific testing should range from $150–$200, depending on the complexity.

Currently, PEFAs exist in three broad categories, here is where some of the gold lies.

Generic — “Bend over, touch your toes; lift the box and basic range of motion testing”. Not worth the paper it is written on, as it has very limited scope to identify underlying or pre-existing musculoskeletal issues.

Hard — Not really much value as it puts the candidate through several high-intensity tests to expose any underlying pathology or injury. If a decision not to employ a candidate is made from these tests, then there is clear exposure to discrimination due to the fact the organisation cannot map the assessment against the physical demands of the job and therefore cannot categorically show an inherent risk to the role.

Job-specific functional assessments — These are the gold standard for pre-employment functional and return to work assessments and will clearly indicate a person’s capacity specific to the physical demands of the job. These can be mapped against the physical demands of the job, go for 30–45 minutes and use the principle of progressive overload to fatigue and assess each high-risk anatomical area in a number of ways.

When done correctly, pre-employment functional assessments can positively impact an organisation’s WC exposure. In fact, a study completed by one of Australia’s largest drilling organisations found that employees who completed a job-specific functional assessment and were rated as low risk were four times less likely to have a sprain and strain injury than those who did a generic functional assessment.

For any industry that has some form of physical labour, a job-specific functional assessment is critical.

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