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7 <br /> <br />“Attachment A” <br />Description of Services <br /> <br /> <br />Post Offer Testing to Include: <br /> <br />Medical History – The candidate is taken through a comprehensive medical history interview to obtain <br />information on previous injuries, surgeries, treatments, as well as current medical conditions. Candidate’s <br />also sign a “falsification of the information” clause which states that falsifying information on the medical <br />history, could result in the withdrawal of the conditional job offer of employment. <br /> <br />Musculoskeletal Examination – A WorkSTEPS certified licensed clinician completes a comprehensive <br />musculoskeletal evaluation with over 100 baseline measures. <br /> <br />Static Grip - This portion of the tests measures grip strength and gathers baseline strength readings on the <br />employee. <br /> <br />Dynamic Lifting - This portion of the test utilizes NIOSH’s 4-standard lifting postures to gather baseline <br />material handling data, as well as to qualify individuals to attempt job simulation tasks. Candidate’s are <br />instructed on proper lifting techniques for each lifting posture. <br /> <br />Job Specific Tasks - This portion tests the candidate’s ability to perform the essential functions for the <br />position being offered in a controlled clinical setting. The essential functions are created from a job analysis <br />which captures accrual weights and measures for that position begin tested. <br /> <br /> <br />Fit for Duty Testing as Part of A Return To Work (“RTW”) Program To Include: <br /> <br />WorkSTEPS will be conducting Fit-for-Duty (Post-Injury RTW) Tests on existing employees to include the <br />following: <br /> <br /> Any reported injury, illness, or condition that gives the employer re asonable belief that the <br />employee’s ability to perform essential job functions will be impaired or create a direct threat to <br />health and safety. <br /> <br /> This category may also include testing at the request of the employer because, although there has <br />been no formal injury or medical condition reported, the employer has observed current <br />performance problems or has received reliable reports of performance problems indicating that the <br />employee may not be able to perform essential job functions or may pose a direct threat to the <br />health and safety of the employee or others. <br /> <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 /> <br /> When testing an employee post-injury or illness the provider will: <br /> <br />o Use the WorkSTEPS Fit for Duty Physical Capacity Consent Form <br /> <br />o Use the WorkSTEPS Post Injury Fit for Duty Medical History Interview <br /> <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 functional deficit. <br /> <br />DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE