Continuing a discussion of what doctors don’t understand about light duty. What I will treat here very briefly is a subject that has come up and number of times recently and is a pernicious problem affecting employees in a way that is easily correctable.
Many doctors seem to not understand the function of the work status form. The function of that form in Texas Worker’s Compensation is simply to give the medical opinion from the doctor regarding the physical capacity of the injured employee to function in a work environment. It is not to exercise any sort of judgment about the work environment. It is not to give the employees instructions to do their regular work but to work around the problem areas using the restrictions. And it is not intended to communicate the fact of the position has an ongoing plan of care for the patient. Or the lack thereof.
Allow me to elaborate on those three areas. The work status form is a detailed document. It is a form that is detailed which should therefore than be matched by the attention to detail given to it by the physician. Sometimes doctors will get frustrated by the fact that the employer is not abiding by the restrictions given on the form or the employer is reading those restrictions in a very absurd and wooden way. The doctor may then just remove the employee from work. It’s important to understand the insurance adjuster and a judge really want to know what the employees work capacity is. A doctor’s opinion will lack credibility if someone who clearly can do some work is removed from work entirely as though the person were an invalid. If the doctor does not feel like the restrictions are being followed, there are other means of redress than removing the employee from work.
Although that may be an effective solution, it really doesn’t get to the heart of the matter regarding the abuse of the employee by the employer if that’s what’s going on. So in order for the physician to have the work status restrictions taken seriously, it’s important that those reflect the physical condition and not a judgment about the hostility perhaps of an employer towards the employee.
A second significant problem related to doctor perceptions about the work environment is that employers will simply accommodate the employee and allow the employee to do their regular work but minus certain tasks that are inconsistent with restrictions. Functionally that is not how are most employee-employer relationships work and not how most job environments work.
If the employee has restrictions of lifting only 20 pounds and the employee can lift 10 pounds regularly throughout the shift but has to lift 40 pounds three or four times a day, the doctor should not assume that the employee will just be able to skip over this work and pawn it off on someone else. Often this is a recipe for frustration and resentment on the part of the employer and even other employees. Employees may be tempted to violate the restrictions and lift extra weight in order to avoid incurring the wrath of coworkers and supervisors.
Doctors cannot fix this problem on their own. However, doctors should encourage the employee that under the law in Texas, if the employer cannot accommodate the restrictions in writing, then the employee is considered off work. If a doctor gives you restrictions and you can do 80% of your job within those restrictions but 20% would violate them, unless the employer gives you written light duty consistent with that other 20%, you generally will be considered off work until that happens.
Finally, a quick note on a phenomenon I have observed with a few doctors. This is either an abuse of the system by doctors who know better or a display of stunning ignorance on the part of the doctors. I have seen a number of doctors give an employee a release to return to work without restrictions not on the basis of any judgment of their physical condition, but on the basis of irrelevant issues such as the employee being placed at maximum medical improvement, the employee changing doctors, or the employee being discharged from the physicians practice due to a disagreement.
In one particularly frustrating case, an employee was released to return to work without restrictions by a doctor when the doctor’s staff had a disagreement about the timing of a medical procedure. There was a disagreement over a few week potential delay in the surgery at the request of the employee to get his affairs in order as he had no relatives nearby to attend to his situation. On the basis of this disagreement, the physician released the employee to return to work without restrictions and the insurance company stopped benefits.
Nothing changed about the employee’s condition. He was no more able to return to work. He was still in need of surgery and quickly moved to obtain another physician. But in the meantime, benefits stopped because of this retaliatory move by the doctor. The law does not contemplate that whether the doctor is continuing a doctor patient relationship in anyway affects the work status of the employee. The work status is solely a function of the mental and physical condition created by the injury and whether surgery is pending does not beer upon that question. Physicians need to be educated on the proper use of the work status form in light of relevant law. And employees need to be aware that an arbitrary release by a doctor does not void the potential entitlement to income benefits for an injury. Many times an attorney can guide judges to look past the work status form to see the objective indicators that an employee cannot perform required work activities in order to grant a finding of disability.
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