This is a question that we have heard over the years from companies that require a Commercial Drivers License (CDL) for employees in certain job titles – whether they are bus/transport vehicle drivers or public works employees. For many positions that involve driving certain classes of vehicles, the state or federal government require a driver to have a CDL. One component of obtaining and maintaining a CDL is undergoing a DOT medical examination with a DOT certified provider.
The main purpose of a DOT medical examination as part of obtaining/maintaining a CDL is to ensure that a driver is medically safe to operate the vehicles within the classification of their license. Priority areas of a DOT medical exam include assessments of vision, hearing, blood pressure, cardiovascular health history, metabolic health history (ex. diabetes), and an overall physical assessment. An assessment of the upper and lower extremities checks for muscle weakness or loss of limbs. While range of motion is addressed in a DOT medical examination, it is to determine whether the examinee has any potential range of motion issues that the DOT examiner may feel are detrimental to their ability to operate trucks and passenger buses. While an employer may be sending a driver for an exam, the examiner is not evaluating based on specific job demands.
The DOT medical examination does not address specific range of motion issues related to ingress/egress for specific types of vehicles (how high is the first step and the grab handles), the range of motion required to operate controls on specific vehicles, or the strength and range of motion related requirements to perform employer specific tasks (loading/unloading products/materials, securing items, operating controls, moving hoses, pulling down ladders, etc.). A job specific post-offer physical pre-employment evaluation (or depending upon the situation, Return To Work FCE or Fit For Duty FCE) can address the examinee’s ability to perform the essential minimum postural and physical demands of the position. Employers should have a customized job description that includes objective measurements of the essential minimum physical and postural demands of the job title. These measurements should be collected using the vehicles, equipment, and other items that are used by the employer and employees when performing their job.
Obtaining a DOT medical certification does not necessarily mean that a driver can meet the essential postural and physical demands of a customized job description. Conversely, meeting the essential postural and physical demands of a customized job description does not mean that a driver will be able to successfully pass a DOT medical examination (a variety of medical conditions are automatic exclusions in DOT medical examinations or require physician approved waivers).
NJ Ergonomics can assist with the documentation of objective measurement of physical and postural demands of job tasks as well as generation of Post-Offer Pre-Employment physical abilities testing protocols that are based on the essential demands of a job title.
There are several things that make the process of going onsite to help tell the stories of how people do their jobs fun. I love to get to talk to people and have them teach me about what they do and I love to find out what brought them to that job. I enjoy looking and digging into the physical and postural demands of the position, measuring them, and being able to convey them back in a way that is useful to physicians, nurses, and physical therapists to rehab an injured employee and help them return to work.
But, one of my hobbies is photography. I love that I can use my hobby at work to help tell the story. Sometimes, words can not convey the environment that a task is performed in or the posture a worker has to adopt to complete the task. They old saw “a picture says a 1,000 words” is definitely true when it comes to photography incorporated into a job description. It can help a clinician better imagine the task as performed in the environment. For a physical therapist, it may help them pick a better exercise to mimic the task or for a physician, it may help them to better understand the needed strength or range of motion for the task.
That being said, worksite photograph can sometimes make matters worse if the photo does not tell an accurate story of the action or environment being depicted. The perspective that a photo is taken from can distort the viewer’s perception of where a task is performed at or can make the height at which a task is performed looked less than or greater than it actually is. If the photograph distorts the task or the environment, it can do an injustice to the worker or the clinicians as the return to work process is engaged.
The photograph at the top of this blog was taken when we were leaving the worksite where laborers were building a new interchange where three highways merge together. The dockworkers who were operating the crane were installing 50 ton pilings that would eventually support the roof of a tunnel. When I took this image, we were in our vehicle and on the actual highway that was still in operation but below the job site. It looks as if the crane is precipitously close to an inclined surface where backing up a little bit could be disastrous.
In reality, there was a significant area of operational surface around the crane. That surface was also pretty muddy as we had several hours of solid rain prior to our visit. That mud is important because it helps remind the treating clinicians that the employees have to be able to “walk in areas of wet and/or uneven terrain” which helps to put the context in place for why the ability to walk and the ability to balance is important within the position. The photograph below looks at the crane from an entirely different perspective and shows how much additional space is around the crane. (For the photographers that may read this, the photograph was shot an effective focal length of 24mm. Even with this wide angle, I had to back up a significant distance to be able to capture the entirety of the crane within the frame.)