2014-573-E HR - Job Ready Services, LLC for the WorkSTEPS Testing Program for Workplace Fitness For Duty and Functional Capacity Testing for Certain Work Groups $15,000

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DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255 "Attachment A" Description of Services Post Offer Testing to Include: Medical History — The job candidate is asked to complete a comprehensive medical history administered by an occupational healthcare professional that has been trained and certified in the WorkSTEPS Program. This history includes information gathering on previous injuries and/or surgeries, previous physical therapy /chiropractor visits, etc. The employee also signs a statement that falsification of the information he /she has provided could result in the withdrawal of the conditional job offer. Musculoskeletal Examination — A WorkSTEPS certified clinician completes this portion of the exam. The exam looks at all major joints and muscle groups. Thirty (30) baseline measurements are documented. The muscle groups are checked for strength as well as any atrophy. The shoulders, elbows, wrists, back, ankles, knees and hips are checked for signs of crepitus as well as ligament stability. In addition, the lumbar and the cervical spine is also checked. Flexion, extension, side bending and twisting are all measured. Visual inspection of the spine for signs of surgery is performed. Deep tendon reflexes of the biceps, triceps, patellar tendon and Achilles tendon are performed to further check for spinal cord problems. Shoulder range of motion is checked and measured as well for movement in the internal and external rational planes. The rotator cuff is also thoroughly checked. Static Grip - This portion of the tests measures grip strength and gathers baseline strength readings on the employee. Dynamic Lifting - This portion of the test gathers baseline, full motion, and strength readings. The employee is asked to lift a NIOSH box from 4 different positions. These 4 positions are lifting the box from floor to knuckle height, 12 inches off the floor to knuckle height, knuckle height to shoulder and shoulder to overhead. With each of these lifts, the employee is asked to lift the box. After the lift, they are asked if they can safely handle more weight. The employee is asked at the beginning to try and lift their maximum safe lift. The employee is shown and instructed on the proper lifting techniques for each of these lifting positions. Job Specific Tasks - This portion tests assesses the job candidate's ability to perform the essential functions of the job he /she is applying for. The essential functions for a job description are created through job analysis that is performed by a qualified vendor of the employer's choosing (this can be the WorkSTEPS Provider who will be providing testing service but is not required). The employer is obligated to participate in the job analysis process by approving and verifying that the essential functions have been properly identified and are accurate. Upper Quadrant/Carpal Tunnel Test - A series of baseline upper extremity tests utilized to identify carpal tunnel syndrome ( "CTS "). This test consists of a brief musculoskeletal examination focusing primarily on the upper extremities, grip, pinch, and forearm strength and endurance tests, an optional nerve conduction test, and essential functions tests if applicable. The results are compared to recognized norms and an employment recommendation is given to the employer. The Upper Quadrant/Carpal Tunnel Test is NOT used to diagnose CTS. It is performed only as a baseline test to identify abnormalities that have resulted in strength, motion, or sensory loss that correlates to pain or other symptoms consistent with common upper extremity problems and cumulative traumas like CTS. When symptoms or loss of function are identified during the testing process, a "Refer for "Additional Medical Clearance"