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A series of articles emphasizing practical
knowledge you can't find in practice guides
and interviews with experts who share
their techniques for effective and efficient
case management
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Articles emphasizing practical knowledge you can't find in
practice guides
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Profiles of people who changed workers’ compensation
law.
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• Warren Schneider
• Marjory Harris
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< Continued from Page 1
LC 4660 also states that the injury / illness shall be
described utilizing the A.M.A. Guides, 5th Edition. As
discussed in the Guides, they cannot be used to make
direct estimates of “work disability”, but are intended
for more general use as an estimate of “whole person
impairment” and an “individual’s overall ability to
perform activities of daily living”. The Guides do
describe a process for determining functional
limitations or “work restrictions”, i.e. what a worker
can and cannot do and how activity might aggravate
the medical condition.
The A.M.A. Guides and the A.M.A.’s Disability
Evaluation, 2nd Edition identify the larger issues
surrounding determination of “disability” and “earning
capacity”. These factors are listed as follows:
• an individual’s age, education, acquired skills, knowledge, and work performance;
• an individual’s motivation and adaptation to change;
• work requirements;
• work environment;
• state of the job market;
• local economic conditions;
• past earnings and future potential earnings.
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The role of the Vocational Rehabilitationist (VR) is accurately characterized in the
above A.M.A. publications as “bridging the gap” between “work limitations” and
“disability” as reflected in diminished earning capacity. In order to form expert
opinions regarding diminished earning capacity, a Vocational Rehabilitationist
must sequentially evaluate an individual in terms of what they can offer a potential
employer. Thus, the basis for an opinion regarding diminished earning capacity
must be built upon a foundation of “Employability”.
The A.M.A. Guides defines Employability as follows:
“The capacity of an individual to meet the demands of a job and the conditions of
employment associated with that job as defined by an employer, with or without
accommodation” (p. 318).
The A.M.A. definition of Employability speaks to a specific match between a given
worker and a job within a specific work environment. For purposes of evaluating
future Employability and impact on “long-term loss of income” within an
administrative proceeding, a broader definition of “Employability”
is called for. Determination of Employability should result in a list or “pool” of occupations that
best represent a workers employment potential. Depending upon the individual,
this employment potential might be best represented by 1-2 jobs (persons with
many years of experience & skill development in a single or well-defined
occupational area e.g. teacher, journeyman welder, police officer, etc.) or a larger
group of occupations with similar demands and potential (administrative assistant,
clerk, manual laborer, etc.).
For these purposes, I propose the following alternative definition of “Employability”:
Employability: “The collective employment strengths & limitations that an individual
has by virtue of their innate abilities, education, work capacities, skills, and knowledge”.
In addition to Employability, the VR
must consider how an individual’s
Employability interacts with realities of the labor market and
workplace. The A.M.A.
Guides calls this consortium of factors the “Place Ability”
of the individual. This
refers to the process of an individual taking their employment potential, their
“ Employability”, and applying it in a real labor market.
For purposes of this analysis “Place Ability” is defined as follows:
Place Ability – the ability of the individual to obtain a job and retain a job, given
the realities of the current and future job market (supply & demand, growth rates,
turnover), the “competitiveness” of the job applicant, i.e. the ranking of an
applicant against their fellow applicants, (more or less experience, skills, etc.), and the
“Employer-Employee Fit”, i.e. how the job applicant matches up with the employer
environment, and the need for and availability of job accommodations”.
Thus, it is proposed that the role of the Vocational Rehabilitationist in the PDRS
should be to help to ”bridge the gap” between impairment and work disability by
providing an individualized analysis of employability, place ability, and earning
capacity over the worker’s remaining worklife.
The SEDEC Method described below focuses on these sequential steps.
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