AOHP 2015 National Conference

Topic Overview: Fitness for duty may be due to a multitude of factors; not only physical conditions or functional impairment, but also possibly substance abuse and/or mental health conditions. The occupational health (OH) clinician is expected to apply clinical expertise and judgment to determine if the employee’s behavior and/or performance issues are related to a medical condition rendering them unfit to work in a safe and healthy manner. 

Once an employee has been identified as potentially being unfit, the OH clinician serves as the liaison between management, the employee, the employee’s provider and potentially an independent medical examiner. It is essential for the OH clinician to have a good understanding of the various regulatory standards that guide this interactive process,  including the OSHA General Duty Clause, the Family and Medical Leave Act (FMLA,) the Americans with Disabilities Act (ADA) and HIPAA.

To ensure the best outcome for both the employee and the institution, the OH clinician must have a firm understanding of the regulatory, operational and safety issues in the workplace involving the employee. In addition, the OH clinician needs to understand the importance of measuring fitness objectively and, in most cases, of having an independent determination of fitness that is acceptable to both the employee and employer.

Objectives:

1. Explain the differences among physical, mental health, and substance abuse fitness for duty issues.
2. Explain the legal issues surrounding fitness for duty issues.
3. Recognize the role of the Independent Medical Examiner (IME) and the value of the Functional Capacity Exam (FCE.)
4. Describe the role of the occupational health clinician throughout the fitness determination process.