COHN Disability and Return-to-Work 4 — Questions and Answers
Question 1: Which of the following is an example of an 'undue hardship' that might excuse an employer from providing a requested ADA accommodation?
- The accommodation would cost $50 for a large Fortune 500 company
- The accommodation would require extensive restructuring that fundamentally alters the nature of the business operation (Correct answer)
- The employee's coworkers are inconvenienced by the accommodation
- The accommodation is not specifically listed in the employee's job description
Correct answer: The accommodation would require extensive restructuring that fundamentally alters the nature of the business operation
Undue hardship under the ADA considers significant difficulty or expense relative to the employer's size, resources, and the nature of the business — not mere inconvenience.
Question 2: Early return-to-work programs have been shown to benefit employers primarily by:
- Eliminating all future workers' compensation claims
- Reducing total disability costs, maintaining worker productivity, and preserving employee skills and morale (Correct answer)
- Shifting liability from the employer to the workers' compensation insurer
- Allowing employers to monitor injured workers for claim fraud
Correct answer: Reducing total disability costs, maintaining worker productivity, and preserving employee skills and morale
Early RTW programs reduce total claim costs, maintain productivity, prevent deconditioning, and support employee morale and retention.
Question 3: When reviewing a physician's return-to-work restrictions, a COHN notices the restrictions are vague (e.g., 'light duty'). What is the BEST action?
- Interpret the restrictions based on the nurse's clinical judgment alone
- Contact the treating physician to clarify specific functional limitations in measurable terms (Correct answer)
- Return the employee to full duty since 'light duty' is too vague to enforce
- Send the employee back out on full disability leave until clearer restrictions are provided
Correct answer: Contact the treating physician to clarify specific functional limitations in measurable terms
The COHN should contact the treating physician to obtain specific, measurable restrictions (e.g., maximum pounds lifted, hours standing) to properly match the worker to available duties.
Question 4: A nurse who suspects a supervisor is pressuring an injured worker to return to work before medically appropriate should FIRST:
- File a complaint with OSHA on the worker's behalf
- Document the concern and discuss it with the occupational health medical director or appropriate supervisor (Correct answer)
- Advise the worker to retain an attorney
- Ignore the situation as supervisor-employee relations are outside the nurse's scope
Correct answer: Document the concern and discuss it with the occupational health medical director or appropriate supervisor
The COHN should document concerns and escalate through appropriate channels, such as consulting with the occupational health medical director or raising the issue with HR or management.
Question 5: Under workers' compensation, 'temporary total disability' (TTD) benefits are typically paid when:
- The worker has a permanent impairment rating above 50%
- The worker is completely unable to work while recovering from a work-related injury (Correct answer)
- The worker chooses not to return to modified duty
- The employer has no light-duty positions available
Correct answer: The worker is completely unable to work while recovering from a work-related injury
TTD benefits are paid when an injured worker is temporarily unable to perform any work while healing from a work-related injury or illness.
Question 6: Which of the following BEST describes the role of an 'ergonomic job modification' in a return-to-work program?
- Eliminating the injured worker's position to reduce future injury risk
- Redesigning the workstation or work methods to reduce physical demands and accommodate restrictions (Correct answer)
- Transferring the worker to a different department permanently
- Providing the worker with pain medication to tolerate the original job
Correct answer: Redesigning the workstation or work methods to reduce physical demands and accommodate restrictions
Ergonomic job modifications redesign workstations, tools, or work methods to accommodate a worker's restrictions and reduce physical demands, enabling safe return.
Question 7: A COHN is asked to develop a stay-at-work program. Which element is MOST critical for its success?
- Requiring all injured workers to report injuries immediately under penalty of termination
- Early identification of injured workers, prompt medical intervention, and supervisor involvement (Correct answer)
- Limiting program access to workers with lost-time injuries only
- Outsourcing all case management to third-party vendors
Correct answer: Early identification of injured workers, prompt medical intervention, and supervisor involvement
Successful stay-at-work programs depend on early injury identification, prompt medical care, and active supervisor support to keep workers productively engaged.
COHN Disability and Return-to-Work 4
Which of the following is an example of an 'undue hardship' that might excuse an employer from providing a requested ADA accommodation?