What are Medical Restrictions?
A medical restriction is an important communication between the Health Services Department and supervisors (and others) identifying an employee's limitations and capabilities. Medical restrictions do not include any medical diagnosis, but are limited to functional descriptions of what employees can and cannot do (e.g., no lifting over 25 pounds, no reaching above shoulder height). The purpose of medical restrictions is to safeguard employee health and safety. Any employee who may require some restriction in his/her work assignments must come to Health Services for evaluation. Supervisors should not accept work restrictions from outside clinicians, but refer the matter to Health Services.
How Are Medical Restrictions Issued?
Medical restrictions are issued electronically by the Health Services Department and involve an interaction between the employee and HSD's clinician. The clinician will assess the medical issues and any functional limitations and determine if they impact the employee's work assignments, necessitating the need for a work restriction.
The clinician's assessment can involve any or all of the following depending on the specifics of an employee's clinical situation:
- Conversation with the employee.
- A physical assessment (e.g., range of motion exam after a back injury).
- Review of written communications from non-LLNS health care providers.
- Additional communications with non-LLNS health care providers to clarify issues. Communication with supervisors and others to characterize current specific work assignments and other issues (e.g., review position description and Job Demands Worksheet).
Health Services clinicians maintain strict standards of medical confidentiality. The Health Services Department's posted notice of privacy practices describes these procedures in detail. All communications with individuals other than the employee involve no discussion of medical diagnosis, but rather are limited to how the employee's work assignments may be impacted by the medical condition. For example, an employee may share with a Health Services clinician that he underwent a hernia operation, but in any subsequent communications with others at the Laboratory, the clinician would only share functional limitations as a result of the surgery (e.g., no strenuous pushing or pulling, no lifting over 25 pounds).
How Are Medical Restrictions Communicated?
Medical restrictions are an important communication for those with a need to know. A medical restriction represents administratively sensitive information as opposed to medically confidential information, since only work limitations and related topics are discussed in the communication. No medically confidential information is shared in a medical restriction. Medical restrictions are distributed through a variety of means, as detailed below.
Health Services Department clinicians contact supervisors immediately when they issue a new or more severe medical restriction, to ensure timely communication and to address any questions.
An e-mail notification of the restriction is sent immediately to the employee, the individual identified as the employee's payroll supervisor and if applicable matrix supervisor, and to his/her RTW Liaison. This usually occurs within hours of the clinician's assessment.
Paper copies of the electronic notification are sent by Health Services Department personnel only if a recipient does not have an e-mail address. (Recipients with e-mail who would like a paper copy may print a copy of the electronic notification.) A copy of the electronic notification is placed in the employee's medical chart in Health Services.
When is it necessary to come to Health Services?
Employees are required to report to the Health Services Department when returning to work after any of the following:
- Occupational injury or illness involving one or more days of lost work time.
- Non-occupational injury or illness of 5 or more consecutive days.
- Non-occupational injury or illness requiring hospitalization or surgery.
(See ES&H Manual, Document 10.1,"Occupational Medical Program.")
Employees should also come to HSD if they receive a note from their personal clinician that recommends work restrictions.
In addition, employees may be directed to HSD by their payroll/matrix supervisor or management if there is a question regarding their ability to work safely which could result in the issuance of a medical restriction.
Employees should bring relevant information from their personal clinician to aid HSD clinicians in their assessment. Specifically:
- A note with specific work limitations the employee's clinician believes are necessary.
- The dates the work restrictions will need to remain in place.
- Other information as requested by the HSD clinician responsible for the work status assessment.
Absence of these materials may delay your return to work.
Employees should observe all current medical restrictions both at work and away from work, and communicate any problems or concerns to their payroll/matrix supervisor or Health Services in a timely manner.
As a general rule, employees are not required to share detailed medical/diagnosis information from their clinicians with supervisors or other departmental personnel. HSD is sanctioned to manage this information at the Laboratory in order to maximize employee confidentiality and ensure appropriate communication of work status to supervisor(s) and departmental representatives.
If a temporary restriction calls for medical review on the expiration date of the restriction, employees should return to HSD for that review.
If an employee's medical status changes or his/her personal clinician issues different instructions, HSD should be notified immediately. Similarly, if an employee experiences increased pain or symptoms after returning to work with a restriction, they should report this to their payroll/matrix supervisor and HSD immediately.