Evaluating patients for return to work.

The family physician is often instrumental in the process of returning a patient to the workplace after injury or illness. Initially, the physician must gain an understanding of the job's demands through detailed discussions with the patient, the patient's work supervisor or the occupational medicine staff at the patient's place of employment. Other helpful sources of information include job demand analysis evaluations and the Dictionary of Occupational Titles. With an adequate knowledge of job requirements and patient limitations, the physician should document specific workplace restrictions, ensuring a safe and progressive reentry to work. Occupational rehabilitation programs such as work hardening may be prescribed, if necessary. If the physician is unsure of the patient's status, a functional capacity evaluation should be considered. The family physician should also be familiar with the Americans with Disabilities Act as it applies to the patient's "fitness" to perform the "essential tasks" of the patient's job.