MEDICAL ASSESSMENT SERVICES DIVISION –
The purpose of an IME (Independent Medical Examination) is to provide an objective, third party assessment of an individual’s medical status.Typically, the examining specialist is asked to provide detailed information about diagnosis, subjective and objective signs and symptoms, physical and functional restrictions or limitations, prognosis, commentary on maximum medical recovery, return to work recommendations, treatment advice, additional investigations or diagnostics, environmental and workplace accommodative considerations, and they may be asked to respond to case specific questions.
An Independent Medical Examination is performed by any of the following specialist fields; Orthopedic Surgery, Psychiatry, Rheumatology, Neurology, Internal Medicine, Cardiology, Psychology, Chiropractic, Physical Therapy, and/or Occupational Therapy as examples, or the IME may be performed as a multi-disciplinary effort depending on the medical condition and the needs of the referral source.
An IME may also be performed in conjunction with a Functional Capacity Evaluation (see detailed description below) to determine physical abilities and to allow the IME assessor to provide a more comprehensive interpretation of the claimant’s level of function.
An IME may also be requested as a file review. In this case, the specialist would be provided with a complete medical brief, which is reviewed in detail, and used by the assessor to clarify diagnoses, treatment recommendations and substantiate or clarify restrictions or limitations.
Specialists commonly available: general internal medicine, and specialties including, cardiology, gastroenterology, neurology, neurosurgery, ophthalmology, orthopedic surgery, ENT, physiatry, psychiatry, psychology (neuropsychology, psycho-vocational), rheumatology, and others.
Functional Capacity Evaluations (also called functional ability evaluations) provide information with respect to strength, muscular endurance, overall conditioning, repetitive working tolerances, and sustained activity tolerances. In essence, this type of assessment objectively documents an individual’s current physical ability, tolerances, and limitations, which have direct applications in the workplace. ATF Canada uses advanced and highly flexible functional testing technology (such as the ARCON based Functional Evaluation System) which utilizes Motion-Time Studies (also called Methods-Time-Measurement or MTM), to compare an individual’s testing results to researched industrial standards. Work tolerances are expressed by ability to perform work tasks over the average 8-hour workday, and expressed in terms Occasional, Frequent or Constant levels of work capacity.
ATF Canada also understands that each case is unique and that no assessment tool or health professional can directly measure pain. That being said, the validity and reliability of a participant’s performance is an important component of FCE interpretation and is affected by the presence of real or perceived pain. In order to address this, our assessors utilize clinical experience, objective observation of performance, distraction techniques, and/or statistical analysis of test performance to determine whether the effort was valid, consistent, and ultimately useful for the decision-making process.
Whether you are looking for a claimant’s general level of function or a direct comparison to a pre-injury job, our functional assessments will provide the objective information you require. In order to determine physical capacity, these assessments can be scheduled to occur within the course of 4 hours, or extended to occur over a three to five day period. Most purposes can be addressed through the course of a single day assessment.
A PDA does not typically require the presence of the worker/ employee as it is meant to address employment tasks for a specific category of work. Via an on-site visit, this assessment will clarify the type of work performed in a specific job category (i.e. trades, assembly, packaging, clerical, etc.) and quantifies the job duties that are necessary to perform a given occupation. Areas addressed include: skill level tolerance, physical capacity, cognitive demands, posture, work frequency, duration, pace, loads, forces, special tools required, environmental stressors and others.
The In-Home Functional Assessment involves an in person, home site visit by an appropriately qualified health care professional (typically an occupational therapist, or Registered Nurse), with the goal of establishing a claimant’s level of the functional performance for any activities of daily living as they are associated with self-care abilities and attendant care needs, care giving duties, and housekeeping/ home maintenance roles, as compared with needs, roles, responsibilities, and duties prior to the injury/ disability in question. As a result of the assessment, recommendations may be made regarding the initiation of services, equipment, treatment and/or other investigations that may be appropriate in order to maximize function, enhance quality of life, and expedite advancement of the claim. Short term follow up by the occupational therapist is available to insure safety in the home and community, and to introduce intervention for improving function.
The Job Site Analysis (aka Worksite Analysis) is another on site evaluation but is tailored more to the specific needs, stresses and environment of an employee. Often, it makes use of information gathered from a Physical Demands Analysis (PDA) and a review of pertinent file material and makes recommendations regarding return to work options. This type of assessment may incorporate medical/functional opinions obtained through IME’s, FCE’s or other interventions to formulate recommendations.
The Ergonomic Analysis addresses specific workstation issues including physical forces acting on an employee while performing employment related tasks. Through this assessment, recommendations regarding assistive equipment, body positioning, and layout of the workstation are provided in order to optimize employee performance and decrease risk for musculoskeletal injuries. The integration of ergonomic principles through education on posture and work tasks reduces the risk of re-injury and improves the worker's comfort and productivity.
ATF Canada provides Occupational Therapy home based assessment services accompanied by case management intervention where appropriate. Qualified OT’s, PT’s and other duly qualified professionals perform these evaluations and are available to instruct claimants in the safe and effective use of any recommended assistive devices and/or therapeutic aids, and provide instruction in body mechanics and energy conservation techniques to allow optimal function within the limits of their condition. When necessary, timely follow-up visits are coordinated which closely monitor the claimant's progress and ensure his/her safe return to self-care, childcare, homemaking, and/or work duties as applicable. By observing the claimant at their place of residence, and addressing these issues in situ, the therapist is able to thoroughly address needs specific to the environment in which the claimant functions.
ATF Canada makes use of functional testing to perform employment fitness screening called a Post Offer Employment Test. This type of assessment provides objective information about a prospective employee’s ability to meet and perform the physical demands of a specific occupation or group of occupations. In order for this assessment to be valid and effective, the ATF Canada Medical Assessment Division requires a detailed description of the essential physical demands of each position being screened.The components of this assessment are based on the National Institute of Occupational Health & Safety Standards (NIOSH) for safe lifting practices. We can also assess dynamic material handling, strength and endurance, postural tolerances and repetitive activity tolerances.
Implementing a program of post offer employment screening is a proactive means of assisting with claims cost containment by decreasing the incidence of injuries, damage to property, hiring and training of temporary or replacement staff, and WSIB premiums. In addition, it objectively identifies whether or not individuals can safely meet the job demands, it increases production by ensuring new hires are physically capable of meeting all employment demands, and it reduces down time, schedule shifting and co-workers stress by placing the right individuals into the right positions. Effective post offer employment testing protocols and policy should be included as part of your corporations comprehensive Health and Safety Policy and Procedures Manual. If you do not have one, or if your current policies are outdates and/or requires revision, please contact us as we can assist you with its redevelopment.
MRI’s (Magnetic Resonance Imaging) for soft tissue visualization (can be scheduled within 2 – 5 days of your request), CT Scans, Bone Scans, EMG (Electromyographic) Studies, X-rays, Pulmonary Function Tests (Spirometry), *Others as requested.