A Tennessee workers compensation case has put a spotlight on a longstanding problem claims professionals say has frustrated employers, insurers and injured workers for decades: Treating physicians often make return-to-work decisions without fully understanding what an employee actually does on the job.

The issue came into focus in June in Beckman v. Manheim Tennessee LLC, when a Tennessee workers comp judge awarded temporary disability benefits after concluding that the treating physician initially misunderstood the physical demands of an injured worker’s position and imposed restrictions that failed to account for the job’s essential duties, which were not provided clearly.

For workers compensation experts, the case was less surprising than familiar.

“It’s one of the largest issues we face,” said Steve Dadio, Tradition, Florida-based senior director of vocational recovery services for Paradigm.

“The doctor should have in front of him or her a document that very clearly lays out the physical demands of a job,” he said. “If they don’t have that, they’re going by what the injured worker says or what they assume to be true.”

That disconnect is what turned the Tennessee claim into litigation, said Tammy Bradly, Birmingham, Alabama-based senior director of clinical strategy and market insights at Enlyte.

“This very well could have been prevented,” Ms. Bradly said. Employers often assume a job description provides sufficient information, but it rarely identifies the essential functions of a position or the physical demands associated with each task, she said.

Mr. Dadio has seen the consequences firsthand. He recalled evaluating a certified nursing assistant whose employer refused to allow her to return to work because an outdated job description required lifting 100 pounds. A visit to the facility revealed the employer had long since installed mechanical patient lifts, allowing the employee to safely return the next day.

“The job description had probably been written decades ago,” he said.

Those outdated documents are often among the first warning signs that a return-to-work program may struggle, said Irina Simpson, Philadelphia-based executive vice president of workers compensation for Gallagher Bassett.

“The opportunity to receive all of the job descriptions and make sure they’re as current as possible is critical,” she said.

Technology, automation and ergonomic improvements have changed many jobs over the years, yet employers frequently fail to update the documents physicians rely on when determining work restrictions, Mr. Dadio said.

Employers with mature return-to-work programs increasingly supplement written job descriptions with photographs, videos and detailed physical demands analyses that show physicians exactly what employees do throughout a workday, Ms. Simpson said (see related story below).

Even then, communication can break down, she said. Adjusters may fail to obtain accurate job information, providers may receive incomplete documentation and supervisors may misunderstand medical restrictions when employees return to work.

Adding to the problem, employers frequently confuse job descriptions with job analyses, even though they serve different purposes, said Nesha Courtney, Paris, Kentucky-based national product manager for advocacy, disability and return-to-work services for Broadspire.

“A job description is really generic,” Ms. Courtney said. “A job analysis breaks that job down into its physical components.”

Experts recommend employers maintain detailed job analyses and physical demands analyses for key positions before injuries occur so they can immediately provide accurate information to physicians, adjusters and nurse case managers after a claim is reported.

Without those resources, physicians often respond with equally vague work restrictions.

“If you say light duty, what does that mean?” Ms. Simpson said. “If you say no heavy lifting, is it five pounds? Fifty-five pounds? The definitions can vary.”

Those ambiguities make it more difficult for employers to accommodate injured workers.

Ms. Courtney said she recently reviewed a physician’s note containing only two words describing an employee’s work status: “sedentary work.”

“Sedentary means a lot of different things,” she said.

Employers should also develop task lists for modified-duty assignments, so physicians understand what transitional work is available.

Miscommunication often spills into litigation, said Jeff Adelson, a partner with Irvine, California-based Bober, Peterson & Koby.

“The doctor is only as good as the information the doctor receives,” Mr. Adelson said.

He recalled defending claims involving workers at a California distribution center who described physically demanding warehouse jobs. After attorneys, claims professionals and brokers toured the facility, they discovered the operation had become highly automated, with workers scanning boxes rather than repeatedly lifting and unpacking them.

Physicians are often forced to make decisions without a complete understanding of what a worker’s tasks are, said Tiffany Speers, president of the California Applicants’ Attorneys Association and an attorney with Boxer Law in Oakland, California.

“I don’t think the right hand knows what the left hand is doing when it comes to interactions with doctors,” Ms. Speers said.

Digital tools clarify work demands for doctors

Technology is giving workers compensation professionals new tools to solve one of the industry’s oldest problems: ensuring that treating physicians understand exactly what injured employees do before making return-to-work decisions.

While claims experts stress that technology cannot replace communication, many say digital job analyses, videos and artificial intelligence are making it easier to connect employers, adjusters and medical providers before misunderstandings become litigation.

Employers increasingly supplement traditional job descriptions with photographs, videos and predictive analytics that help clinicians visualize job demands, said Irina Simpson, Philadelphia-based executive vice president of workers compensation for Gallagher Bassett.

Machine learning models can identify claims that may benefit from earlier clinical intervention, while AI tools are beginning to analyze work restrictions and support return-to-work decisions. Future applications may even recommend accommodations to employers based on physician-recommended restrictions, she said.

Technology is also improving information sharing between claims organizations and providers, said Beth Burry Jackson, Richmond, Virginia-based head of managed care for Sedgwick.

“The best outcomes occur when (issues are) addressed early in the process,” she said.

Electronic medical records, digital work-capability summaries and secure information exchanges allow claims professionals to communicate job demands more quickly and consistently, helping physicians make informed decisions before recovery stalls, she said.