Disability Management: Strategies for Effective Workplace Accommodation, Exams of Nursing

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CDMS VOC EXAM QUESTIONS CDMS VOC EXAM QUESTIONS WITH GUARANTEED ACCURATE ANSWERS |VERIFIED CDMS focus - ACCURATE ANSWERS✔✔ Prevent and mitigate the human and economic impact of injury/illness and disability for employees and employees to optimize quality of care, productivity, organizational health and regulatory compliance. Maintain a balance between providing Services and interventions that protect jobs for worker with liabilities while controlling the financial safety and other risks that confront employers. Disability Management - ACCURATE ANSWERS✔✔ A workplace prevention and remediation strategy that seeks to prevent disability from occurring, or lacking that, to intervene early following the onset of liability, using coordinated, cost-conscious, quality rehabilitation services that reflect an organizational commitment to continued employment of those experiencing functional work limitations. The remediation goal of disability management is successful job maintenance or optimum timing for returning to work.

Keys to Disability Management - ACCURATE ANSWERS✔✔ Prevention, Early Intervention, Coordination, communication, cost conscious, continued employment, optimum timing for RTW. Variety of Hats in Disability Management - ACCURATE ANSWERS✔✔ Ensuring equal opportunities in the workplace. Improving employment prospects for person with disabilities by facilitating recruitment, RTW , job retention and opportunities for advancement Promoting a safe, accessible and healthy workplace Assuring that employer costs associated with disability among employees are minimized including health care and insurance payment in some instances. Maximizing the contributions which workers disabilities can make to the enterprise. Focus Key of Disability Management - ACCURATE ANSWERS✔✔ Balance people and business needs Benefits of Disability Management - ACCURATE ANSWERS✔✔ Preventing workplace disability (all kinds)

Encourage RTW minimizes lost time and cost to the business. Greater employee retention, loyalty, and morale Higher profitability, increased productivity Compliance with ADA and other legislation Principles of Disability Management - ACCURATE ANSWERS✔✔ Partner with physicians, employers, and employees Focus on core competencies and retain competent workers. prevention Early Intervention Specialized claim handling Special Investigation Units

Intervention Protocols - ACCURATE ANSWERS✔✔ Providing education and early intervention services to prevent or minimize the effects of disability in the workplace. Facilitating early identification, referral and treatment for disability and/ or injuries at work Assisting employees with disabilities in overcoming disability- related restrictions or limitations. Implementing policy and/or contract provisions regarding rtw, reasonable accommodation, and medical separation, Consulting with management, human resources, and other staff regarding workplace disability issues. Support for disability management must be from the top down. Disability Managment Protocols - ACCURATE ANSWERS✔✔ Coordination Communication Accommodation Modification Early Identification Appropriate Referrals

Top-Down Support Other factors to consider in disability management - ACCURATE ANSWERS✔✔ Who is eligible, and for what benefits? Who is responsible to do what, and when? How long will an employee's job be held? Develop a list of needed accommodations (Worker info, job tasks, or by type of disability) Establish a data collection system to document progress and problems (documentation, reports) Cost containment techniques - ACCURATE ANSWERS✔✔ negotiation price, contracts, alternative care costs Alternative care-most cost-effective w/ good care Home care vs. Hospital Care Review of Treatment Plan

Review of Billing Aggressive case management-actions stake place when needed. CDMS name history - ACCURATE ANSWERS✔✔ CRC 1974 Insurance Rehab 1970s CIRS 1984 Name changed to CDMS 1996 Cost benefit analysis - ACCURATE ANSWERS✔✔ financial report Cost=Savings Cost effectiveness of case mgmt., tx, program, etc. Separate from client reports Relies on human judgment. justifies use of case manager Cost benefit analysis report contain - ACCURATE ANSWERS✔✔ identifying info Overview of interventions summary of interventions case mgmt fees

savings-how achieved. actual costs gross savings (potential- actual) Net savings (gross savings- case management fees) status of case Utilization Management (UR) - ACCURATE ANSWERS✔✔ Evaluates necessity, appropriateness, efficiency of Servies Pre-admission concurrent retrospective provides cost containment based on diability Case management - ACCURATE ANSWERS✔✔ a process that focuses on high risk or high-cost patients/clients managed care - ACCURATE ANSWERS✔✔ a system of cost- containment programs used to control, direct and approved access to the health care delivery system. Case load management - ACCURATE ANSWERS✔✔ Public=case finding Obligated to find appropriate clients.

Private=marketing Seek client authorization/consent for service. Evaluation through fact finding. Communication with all parties Case finding - ACCURATE ANSWERS✔✔ obligation to identify and serve targeted population. results in outreach efforts beneficence - ACCURATE ANSWERS✔✔ The course of action that is likely to promote the greatest good for the client. Nonmaleficence - ACCURATE ANSWERS✔✔ The course of action that is least likely to result in harm or injury to the client. Autonomy - ACCURATE ANSWERS✔✔ Identifying what promotes the greatest independence. Justice - ACCURATE ANSWERS✔✔ what is fair and proper to do under the circumstances Fidelity - ACCURATE ANSWERS✔✔ Keeping promises and commitments that you have made to a client

CDMS- Primary Obligation - ACCURATE ANSWERS✔✔ Exercise independent judgment in offering appropriate recommendations that consider the client needs and the parameters of the applicable disability management systems. CDMS Ethics Principle 1 - ACCURATE ANSWERS✔✔ Certificants shall endeavor to place the public interest above their own at all times. CDMS Ethics Principle 2 - ACCURATE ANSWERS✔✔ certificants shall respect the integrity and protect the welfare of those person or groups with whom they are working. CDMS Ethics Principle 3 - ACCURATE ANSWERS✔✔ Certificants shall always maintain objectivity in their relationships with clients. CDMS Ethics Principle 4 - ACCURATE ANSWERS✔✔ Certificants shall act with integrity in dealing with other professionals so as to facilitate their contribution with respect to achieving maximum benefits for the client CDMS Ethics Principle 5 - ACCURATE ANSWERS✔✔ Certificants shall keep their technical competency at a level which ensure their clients will receive the benefit of the highest quality of service the profession can offer.

CDMS Ethics Principle 6 - ACCURATE ANSWERS✔✔ Certificants shall honor the integrity and respect the limitations placed on the use of the CDMS designation. CDMS Ethics Principle 7 - ACCURATE ANSWERS✔✔ Certificants shall obey all laws and regulations, avoiding any conduct or activity that could harm others. CDMS Ethics Principle 8 - ACCURATE ANSWERS✔✔ Certificants shall help maintain the integrity of the Code of Professional Conduct. Keys: CDMS Ethic Principles - ACCURATE ANSWERS✔✔ · Public interest · Independent judgement · Respect · Protect · Objective · Integrity · Maximum benefit · Maintain technical competence · Stay area of expertise · Lawful · No harm to others Observation and report to preserve credential.

Informed Consent - ACCURATE ANSWERS✔✔ Client has right to consent or withdraw from services. Client must be Informed enough to make wise decision. Aware of side effects, benefits, negative consequences, Alternatives Know risks of following through/not following through What is being offered/type of services? Client has capacity to give consent. -competent decision-making ability -Comprehension of information -Voluntariness Confidentiality - ACCURATE ANSWERS✔✔ Privileged-Attorney, doctor, clergy. Non-privileged-counselor, case manager Privileged is legal concept belonging to the client. Client can waive privilege Notify that must share with 3rd party payors Can break confidentiality when: - ACCURATE ANSWERS✔✔ · Danger to self or others (warn other and call police) · Needs professional services (i.e. emergency room) · Refer for non-payment after reasonable attempts · Professional consultation to move case · 3rd party payor

Legal Issues in Disability Management - ACCURATE ANSWERS✔✔ Managers can be held liable when something bad happens Must act within scope of their expertise. If contradictory information, seek the truth. Do not comply with unreasonable 3rd party payor limits without written protest. Courts demand that the patients' interests come first. Negligence - ACCURATE ANSWERS✔✔ Conduct which falls below a standard of care. Can be an act or an omission. Deposition - ACCURATE ANSWERS✔✔ The taking and recording of witness testimony under oath before a court reporter away from the courthouse and before trial. Interrogatories - ACCURATE ANSWERS✔✔ Questions and answers written under oath Discovery - ACCURATE ANSWERS✔✔ Entire effort to obtain information before trial through demands for documents, depositions, witnesses, interrogatories, admissions of fact, examination of the scene, and the petitions and motions to enforce discovery. ADA - ACCURATE ANSWERS✔✔ 1990 American with Disabilities Act

IDEA - ACCURATE ANSWERS✔✔ Individuals with Disabilities Education Act FHA - ACCURATE ANSWERS✔✔ Fair Housing Act ABA - ACCURATE ANSWERS✔✔ Architectural Barriers Act ACAA - ACCURATE ANSWERS✔✔ Air Carriers Access Act Rehabilitation Act of 1973 - ACCURATE ANSWERS✔✔ · Focus on Federal · Grandfather of ADA-expanded to public employers · Involved consumers in rehab process · Affirmative action in federal hiring · Architectural and Transportation Barriers Compliance-Federal Buildings · Affirmative action by Federal Contract recipients ($2500) · Equal opportunity for Disabled Steps in Employability Planning (1973 Rehab Act) - ACCURATE ANSWERS✔✔ 1. Clarify physical, mental, emotional strengths and limitations including prevocational deficits.

2. Identify vocational interests, aptitudes, and existing vocational (transferable) skills.
3. Relate this to different job possibilities.
4. Develop or write the IWRP of rehab plan with the consumer.
5. Emphasis is not imposed but developed with. IWRP - ACCURATE ANSWERS✔✔ Individual Written Rehabilitation Plan Principles of IWRP (1973 rehab act) - ACCURATE ANSWERS✔✔ · Developed with consumer not for consumer · Consumers fully involved and active in all aspects · Must contain: -Vocational objective (goal) -Outline of all anticipated services -Party responsibilities each service -Anticipated program completion date 1973 Rehab Act relevant Sections: - ACCURATE ANSWERS✔✔ Section 501-Federal Agencies Section 503-Contractors and subcontractors ($10,000) Section 504-Federal funding for programs/activities Section 508-Electronics and Info

(present in more than one sense) Section 501 (1973 Rehab Act) - ACCURATE ANSWERS✔✔ Requires affirmative action and nondiscrimination in employment by federal agencies of the executive branch. Section 503 (1973 Rehab Act) - ACCURATE ANSWERS✔✔ Requires affirmative action and prohibits employment discrimination by Federal government contractors and subcontractors with contracts of more than $10,000. Section 504 (1973 Rehab Act) - ACCURATE ANSWERS✔✔ Prohibits discrimination on the basis of disability in programs and activities, public and private that receive federal financial assistance or under any program or activity conducted by any Executive agency or by the United States Postal Services. Section 508 (1973 Rehab Act) - ACCURATE ANSWERS✔✔ Establishes requirements for electronic and information technology developed, maintained, procured or used by the Federal government. Requires Federal electronic and information technology to be accessible to people with disabilities. This often means ensuring that information systems do not rely on a single sense to convey information.

ERISA - ACCURATE ANSWERS✔✔ · 1974

· Employee Retirement Income Security Act · Governs self-funded health benefit plans · Intended to create a federal system for regulating self-funded employee benefit plans, including retirement and health insurance. Pregnancy Discrimination Act - ACCURATE ANSWERS✔✔ >= 15 Employees Treat pregnant woman same as other employees on medical leave Does not mandate leave. Cobra (1985) - ACCURATE ANSWERS✔✔ · Consolidated Ominbus Budget Reconciliation Act · Requires mandatory continuation of health benefits coverage for employees and dependents who would lose benefits after terminating employment.

· Benefits are time limited- 18 months and in some cases 36 months · · >=20 employees FMLA - ACCURATE ANSWERS✔✔ · Family and Medical Leave Act · 12 weeks in 12 months consecutive or interspersed · >=50 employees in 75 mile radius · Same or = position upon return · Unpaid (can substitute accrued paid leave) · Benefits protected and continue · Employer can require medical documentation and/or med release to RTW · FMLA records must be kept separate and confidential FMLA Qualifying Events - ACCURATE ANSWERS✔✔ · Employee own serious health condition · Immediate family member serious health condition · To care for newborn child or adopted child or foster care (aka bonding leave) ADA

(1990) - ACCURATE ANSWERS✔✔ · Federal, State and Employers

=15 employees · Obtain medical records/info pertaining to specific disability only · Separate and confidential file · Require medical exam only to determine -able to do essential job functions -part of reasonable accommodation -job related and consistent with business necessity ADA Door Width Ramp Slopes - ACCURATE ANSWERS✔✔ 32" door with 18" clearance 1 inch for every 12 inches (1 to 12) ADA Definition of Disability - ACCURATE ANSWERS✔✔ A physical or mental impairnment that substantially limits one or more of the major life activities (i.e. sleep, work, walk, talk etc.) A record of such impairment

Being regarded as having such an impairment (Believed to be impaired) To Be Legally Entitled to ADA protection - ACCURATE ANSWERS✔✔ Must be legally disabled by definition Disability must be known to the employer Must be qualified to perform the essential functions of the job once reasonable accommodation is provided. Requires employers to make reasonable accommodations to the known physical or mental limitations of an individual with a disability unless the accommodation would impose an undue hardship on the employer. Employer escape clause = undue hardship EEOC - ACCURATE ANSWERS✔✔ Equal Employment Opportunity Commission Established by Title VII of the Civil Rights Act of 1964 EEOC Enforces the following federal statutes: - ACCURATE ANSWERS✔✔ · Title VII of the Civil Rights Act of 1964 as amended, prohibiting employment discrimination on the basis of race, color religion, sex or national origin. · Age Discrimination in Employment Act (ADEA) of 1967, as amended, prohibiting employment discrimination against individuals 40 years of age and older. · Equal Pay Act (EPA) of 1963 prohibiting discrimination on the basis of gender in compensation for substantially similar work under similar conditions.

· ADA Title 1 and Title V: Prohibiting employment discrimination on the basis of disability in the private sector and state and local government; · 1973 Rehab Act-Section 501 & 505: prohibiting employment discrimination against federal employees with disabilities; and · Civil Rights Act of 1991: providing monetary damages in cases of intentional discrimination and clarifying provisions regarding disparate impact actions. Title VII - ACCURATE ANSWERS✔✔ 1964 Civil Rights Act Discrimination-race, color, religion, sex, origin ADEA - ACCURATE ANSWERS✔✔ 1967 Age Discrimination in Employment Act EPA - ACCURATE ANSWERS✔✔ 1963 Equal Pay Act Gender and pay discrimination Definition of Essential Functions (EEOC) - ACCURATE ANSWERS✔✔ · The position exists to perform the function · There are limited number of other employees available to perform the function or among whom the function can be distributed.

· The function is highly specialized and the person in the position is hired for special expertise or ability to perform it. EEOC Employer Guidelines - ACCURATE ANSWERS✔✔ · An employer may not compel a disabled individual to accept an accommodation, but if the accommodation is refused and therefore the individual is unable to meet performance standards, the individual is not entitled to protection under the ADA. · Employer are not required to provide personal items (glasses, wheelchair, etc) as an accommodation. OSHA (1970) - ACCURATE ANSWERS✔✔ Occupational Safety and Health Administration Primary Federal Regulator Occupational Safety and Health Administration Primary Federal Regulator WISHA - ACCURATE ANSWERS✔✔ Washington Industrial Safety and Health Act Washington State counterpart to OSHA

OSHA Employee Responsibilities - ACCURATE ANSWERS✔✔ OSHA does not cite employees for violations. · Comply with all applicable OSHA Standards. · Follow all lawful employer safety and health rules and regulations, and wear or use prescribed protective equipment while working. · Report hazardous conditions to the supervisor. · Report any job-related injury or illness to the employer, and seek treatment properly. · Cooperate with the OSHA compliance officer conducting an inspection if he or she inquiries about safety and health conditions in the workplace. · Exercise rights under the Act in a responsible manner. National Labor Relations Act - ACCURATE ANSWERS✔✔ · Guarantees employees the right to organize. · Prohibits employers from dominating or assisting labor organizations. Fair Labor Standards Act (1938) - ACCURATE ANSWERS✔✔ · Federal Law · Established federal minimum wage (adjusted yearly) · Guaranteed time and half for overtime in certain jobs · Prohibited most employment of minors in "oppressive child labor" · Employers w/gross sales-volume >=$500,000

Disability Manager's Tips - ACCURATE ANSWERS✔✔ Determine which laws apply Examine types of medical exams & certifications are allowed under legislation. Determine what reinstatement rights an employee has (i.e. same, new, modified, etc.). Determine what benefits must be provided during an employee's leave. Know when light duty is appropriate. Definition-Disability Prevention & Workplace Intervention - ACCURATE ANSWERS✔✔ Involves joint labor and management collaboration in the identification of workplace safety and risk factors. It also covers the recommendation and implementation of prevention, health and wellness, intervention practices and strategies, such as ergonomics, job analyses, and return to work programs. Health and wellness - ACCURATE ANSWERS✔✔ · Prevention- encourages healthy practices · Covers all health problems not just workplace illness/injury (i.e. smoking, drinking, stress, fitness, illness, etc) Benefits Transitional & Early RTW - ACCURATE ANSWERS✔✔ 1. Increases workforce productivity

2. Reduces cost of lost work days

3. Reduces claims and litigation costs
4. Increases employee relations & motivation
5. Quicker physical & emotional recovery
6. Minimizes employee wage & benefit loss
7. Decrease need to replace workers
8. Decrease incidence of long term disability Ergonomics - ACCURATE ANSWERS✔✔ · All work activities should permit the worker to adopt several different, but equally healthy and safe postures. (Alternate postures) · Where muscular force has to be exterted it should be done by the Largest appropriate muscle groups available. · Work activities should be performed with the joints at about mid-point of their range of movement. This applies particularly to the head, trunk and upper limbs. (Cortlett, 1983) Transitional and Early RTW Key Components - ACCURATE ANSWERS✔✔ 1. Open communication among all parties
9. Different RTW options
10. Flexibility in schedule and/or pace

4. Support from supervisors/coworkers
5. Use of essential functions to target accommodations
6. Incentives for employees and managers Reserves - ACCURATE ANSWERS✔✔ An amount representing actual or potential liabilities that is kept by an insurer to cover debts to policyholders. Loss Reserve - ACCURATE ANSWERS✔✔ The dollar amount designated as the estimated cost of an accident at the time the first notice is received. Estimated initial cost Case Reserve - ACCURATE ANSWERS✔✔ The dollar amount stated in a claims file that represents an estimate of the amount still unpaid. Estimate cost adjusted as information becomes available. Ongoing adjustments Medicaid - ACCURATE ANSWERS✔✔ 1965 Title XIX (19) of Social Security Act