Orange County NC Website
Browse       Search
DocuSign Envelope ID: EAE3745D -23C6- 4352- A3D7- 9903DCB5D084 <br />■ Even if the employee has fully "recovered" from injury or illness and no longer considers him or <br />herself "injured", for documentation purposes the test should be identified as a "post- injury" fit for <br />duty, or an injured worker, because that was the trigger for the test. <br />• When testing an employee post-injury or illness the provider will: <br />o Use the WorkSTEPS Fit for Duty Physical Capacity Consent Form <br />o Use the WorkSTEPS Post injury Fit for Duty Medical History Interview <br />o Not perform "routine" medical measures, including heart rate and blood pressure, that are <br />not related to the injury or condition for which the employee is being seen, or that are not <br />contributing to a job related fumctional deficit. <br />o Not perform the standard "baseline" tests such as step test, Sorenson's or grip if they are <br />not related to the injured area. <br />o Perform only the dynamic lift postures that are considered qualifying criteria. <br />o Perform any and all standard job specific tasks for the position, and expand to include <br />any additional essential function tasks that could be impacted by their injury or condition. <br />16,0 <br />ltiln t!. KALY�,t.t� <br />0379946755E477... <br />L.ullipauy RuplG,mut lum JL dle <br />DocuSignnefa edby: <br />� � L�; 5.4kr <br />382693097218498... <br />►v vrko l nro rcepresentative /Title <br />6/29/2018 <br />Date <br />6/25/2018 <br />Date <br />