COHN Disability and Return-to-Work 5 — Questions and Answers
Question 1: The 'biopsychosocial model' of disability, as applied in return-to-work, recognizes that disability is influenced by:
- Biological factors only, specifically the severity of tissue damage
- Biological, psychological, and social factors interacting together (Correct answer)
- Social factors exclusively, such as employer attitudes
- Psychological factors only, such as motivation and attitude
Correct answer: Biological, psychological, and social factors interacting together
The biopsychosocial model recognizes that disability results from the interaction of biological (injury severity), psychological (fear, depression), and social (workplace relationships, culture) factors.
Question 2: An employee with a documented anxiety disorder requests a quiet workspace as an ADA accommodation. The employer should:
- Deny the request because mental health conditions are not covered under the ADA
- Engage in the interactive process to determine if the accommodation is reasonable (Correct answer)
- Immediately provide any workspace the employee requests without discussion
- Require the employee to provide monthly psychiatric evaluations
Correct answer: Engage in the interactive process to determine if the accommodation is reasonable
The ADA covers mental health conditions, and employers must engage in a good-faith interactive process to determine whether a requested accommodation is reasonable.
Question 3: Which metric BEST measures the effectiveness of a return-to-work program?
- The number of workers' compensation claims filed per year
- Lost workday rate, total disability duration, and percentage of workers successfully returning to their original position (Correct answer)
- The number of ergonomic evaluations completed
- Employee satisfaction scores from annual surveys
Correct answer: Lost workday rate, total disability duration, and percentage of workers successfully returning to their original position
Program effectiveness is best measured by outcome metrics such as lost workday rates, total disability duration, and the rate of successful return to the original position.
Question 4: A COHN is conducting a post-offer employment examination. The primary purpose of this examination is to:
- Screen out applicants with pre-existing disabilities to reduce future claims
- Establish a baseline of physical capabilities and identify any conditions requiring accommodation before job start (Correct answer)
- Determine whether applicants meet the ADA definition of disabled
- Replace the need for a job analysis by assessing the applicant's full physical fitness
Correct answer: Establish a baseline of physical capabilities and identify any conditions requiring accommodation before job start
Post-offer exams establish a baseline of the new hire's physical status and help identify accommodation needs — they must not be used to discriminate against individuals with disabilities.
Question 5: When an employee's work restrictions conflict with the employer's production needs, the COHN's BEST approach is to:
- Side with the employer's production needs to protect the company
- Facilitate a multidisciplinary meeting to problem-solve modified duty options that honor restrictions while meeting operational needs (Correct answer)
- Advise the employee to ignore the production pressure
- Remove the employee from work entirely to avoid conflict
Correct answer: Facilitate a multidisciplinary meeting to problem-solve modified duty options that honor restrictions while meeting operational needs
The COHN facilitates collaborative problem-solving among all stakeholders to find solutions that respect medical restrictions while addressing operational realities.
Question 6: Which of the following situations would require the COHN to override a supervisor's decision to return an injured worker to full duty?
- The worker complains about minor job dissatisfaction
- The treating physician has issued a written restriction that precludes full-duty work (Correct answer)
- The worker has been on modified duty for more than two weeks
- The supervisor believes the worker is exaggerating symptoms
Correct answer: The treating physician has issued a written restriction that precludes full-duty work
Medical restrictions issued by the treating physician are binding; no supervisor has the authority to override written medical work restrictions.
Question 7: The purpose of a 'job demands analysis' (JDA) in occupational health is BEST described as:
- Evaluating employee performance for merit reviews
- Systematically identifying the physical, cognitive, and environmental requirements of a job to match with worker capabilities (Correct answer)
- Calculating overtime pay requirements for physically demanding jobs
- Determining the minimum education required for a specific position
Correct answer: Systematically identifying the physical, cognitive, and environmental requirements of a job to match with worker capabilities
A JDA identifies and quantifies the essential physical, cognitive, and environmental demands of a job to enable proper matching of worker capability to job requirements.
COHN Disability and Return-to-Work 5
The 'biopsychosocial model' of disability, as applied in return-to-work, recognizes that disability is influenced by: