Return-to-Work Criteria

Often, return-to-work criteria are based on data collected by professionals who have never experienced the level of demand required in fire fighting. Some discharge criteria being used are modified from average work populations. Medical and rehabilitation systems are using tools provided without a complete understanding of the needs of the fire fighting profession. Therefore, it’s important for physicians and rehabilitation specialists to be educated on the demands fire fighters must be prepared for.

Kim Favorite, Occupational Health and Fitness Coordinator for the Seattle Fire Department, is currently seeking grant funding to develop a program called, "Fire Service Clinical Pathways." This program addresses this very issue.

In her work, she sites a Montreal/Quebec study, "Obstacles and factors facilitating return to work of workers with musculoskeletal disorders," which confirms that one of the major obstacles for returning workers to the job is communication between companies and the treating physicians.

More specifically, the study reveals that the highest level of frustration is with the various approaches and criteria used by physicians for injured workers. This is compounded tenfold for the fire service since most doctors, occupational therapists and physical therapists do not have a clear understanding of the true scope of the possible job duties or hazards a fire fighter faces each day.

Favorite agrees that physicians, rehabilitation specialists, trainers, fire departments and insurance agencies all need to be educated to the needs of fire fighters. Video of fire fighters taking the Candidate Physical Ability Test (CPAT) or conducting fire ground operations can help educate physicians and rehabilitation specialists as to the level of rehabilitation fire fighters need.

Fire Fighters Need to Be Involved

Fire fighters also need be part of the process, and fire departments must support these efforts. Some fire Departments have implemented the IAFF/IAFC Joint Labor-Management Wellness/Fitness Initiative, but without a primary physician who understands the unique needs of fire fighters, inconsistent approaches to fire fighter injury care and return to work criteria will remain.

Whether it’s in diagnosing prior dysfunction for a pre-hire exam or evaluating and treating an acute injury, these inconsistencies can have a major impact on the future careers of individuals in the fire service.

Athletic teams at major universities often have four or five specialized sports physicians, three or four certified athletic trainers and numerous student trainers all working with cutting-edge information and technology. Meanwhile, 90 percent of all fire fighters who wear 50 or more pounds of equipment and must be ready to respond day or night to any emergency or hazard -- and who are expected to work for 25-30 years or more -- have little or no specific injury care and return-to-work criteria.

The medical community, insurance providers and disability organizations need to realize that this disconnect is not only putting fire fighters and communities at risk, but also costing millions in re-injuries and disability claims that could be prevented.

Each fire department has a responsibility to build relationships with doctors and rehabilitation specialists who are treating their fire fighters. The medical community wants to provide the best care possible, and fire departments need to educate them regarding fire fighter needs. For example, Portland Local 43 has provided videos of its physical agility test. Other ways include distributing literature or arranging ride-a-longs.

"The fire fighting community must become advocates and informed consumers for our fire fighters," urges Gomez. "Our fire fighters and families deserve it, and our communities demand it."

orlando@adapttraining.com
www.adapttraining.com