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  • Medical Marijuana- A Workplace Safety Hazard?

    The use of prescribed medical marijuana by employees creates questions for Canadian employers. How do you deal with an employee in a safety-sensitive role who has a medical marijuana licence? Are employees with medical marijuana licences exempt from drug testing? If an employee with a licence says they need to use their marijuana at the workplace, how is this addressed?

    What Employers need to know:

    • Employees with a license should be treated like any other employee with prescription medication that could affect their ability to carry out their duties of employment.
    • The regular principles around duty to accommodate apply.
    • Accommodation does not mean allowing an employee to carry out his or her duties while impaired. Under Ontario’s Occupational Health and Safety Act (OHSA), an employer has an obligation to take every precaution reasonable in the circumstances to protect the health and safety of workers. This includes identifying hazards which may result from an employee working while under the influence of medical marijuana.
    • An employer must carry out its health and safety due diligence at the same time it accommodates an employee requiring the use of medical marijuana in the workplace. In the case of a safety-sensitive position, this may mean considering whether the employee can be reassigned to a non-safety-sensitive position.
    • Employers can set limits if the employee says they need to smoke on the job, such as where and when they can smoke.

    Proactive steps for employers

    Employers can get ahead of the changes occurring by re-examining their workplace drug and alcohol policies. Employers should pay special attention to the wording around prescription and non-prescription medication. The companies drug and alcohol policy should:

    • Require an employee to disclose information about any prescription drug that may impair his or her ability to perform work safely.
    • Prohibit an employee in a safety-sensitive position from working while impaired.
    • Set out a process for obtaining additional medical information to facilitate accommodation.
    • Ensure the employee (and union if applicable) participates in the accommodation process.
    • Identify restrictions on the use of medical marijuana in the workplace (e.g., where and when).
    • Identify consequences in the event of a breach of the policy i.e., discipline.
    • Employers should advise employees and candidates that such medical opinions will be required prior to the worker’s taking on safety sensitive work.

    What to Expect From Your Medical Department:

    • Employers should seek out guidance from knowledgeable and experienced physicians to determine how to treat cases involving medical marijuana use, to develop general guidelines around what constitutes safe use versus impairment.
    • As it is difficult to measure individual sensitivities to the drug, a physician knowledgeable about occupational health, who also understands the potential impact of medical marijuana on workplace safety should evaluate the employee to determine if he or she can perform their job safely while taking the drug. The worker’s doctor should also sign off on this evaluation.
    • An Occupational Health physician may act as a liaison between your organization and the employees family doctor to understand the condition marijuana has been prescribed for, the dosage, side effects, etc.
    • Provide expert advice and support in developing a comprehensive and effective drug and alcohol policy and when dealing with complex cases.
    • Help set out a process for obtaining additional medical information to facilitate accommodation

    While making sure organizations understand and effectively implement new legislative and policy changes can sometimes be challenging, with the right support and guidance, the process can be made easier for all parties involved. Dr. Karpilow urges employers to have an open dialogue with their employees regarding any policy changes so everyone is informed and in compliance. To learn more about Workplace Medical Corp.’s Company Doctor program, please click here

    If marijuana is used in the workplace it can affect the health and safety of the person taking it as well as those around them, as well as have an adverse effect on productivity.  Marijuana is known to have the following effects (Wadsworth EJ et al, 2006):

    • Short-term memory problems
    • Impaired thinking
    • Loss of balance and coordination
    • Decreased concentration
    • Changes in sensory perception
    • Impaired ability to perform complex tasks
    • Decreased alertness
    • Decreased reaction time

    See more at http://learnaboutmarijuanawa.org/factsheets/workplace.htm#sthash.GU0nekQn.dpuf

    If marijuana is used in the workplace it can affect the health and safety of the person taking it as well as those around them, as well as have an adverse effect on productivity.  Marijuana is known to have the following effects (Wadsworth EJ et al, 2006):

    • Short-term memory problems
    • Impaired thinking
    • Loss of balance and coordination
    • Decreased concentration
    • Changes in sensory perception
    • Impaired ability to perform complex tasks
    • Decreased alertness
    • Decreased reaction time

    See more at http://learnaboutmarijuanawa.org/factsheets/workplace.htm#sthash.GU0nekQn.dpuf

    How Does Marijuana Affect Work Performance?

    Marijuana affects every user differently and those effects can depend on:

    • The person – their mood, personality, size, and weight;
    • The amount taken and whether it is mixed with anything else;
    • The environment in which the drug is used.

    If marijuana is used in the workplace it can affect the health and safety of the person taking it as well as those around them, as well as have an adverse effect on productivity.  Marijuana is known to have the following effects (Wadsworth EJ et al, 2006):

    • Short-term memory problems
    • Impaired thinking
    • Loss of balance and coordination
    • Decreased concentration
    • Changes in sensory perception
    • Impaired ability to perform complex tasks
    • Decreased alertness
    • Decreased reaction time

    The effects of marijuana can last from two to six hours.  These side effects may make it hazardous to use marijuana at work, particularly if a person is operating heavy machinery or driving a vehicle. There is also a greater risk of an accident occurring due to the poor performance of even simple manual tasks. Regular marijuana users may start to exhibit signs of loss of energy and interest in their tasks, causing their performance to suffer. They may also find it difficult to learn new work skills. 

    Jon Burtenshaw

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  • How to Manage Commercial Truck Driver’s Under “W” Licence Laws Through a Company Doctor Program

    Your organization probably already knows about the new “W” code or class D license change, a result of the US/Canada Medical Reciprocity Agreement for Commercial Drivers. You may be asking yourself, what does this new regulation mean for you, the employer? How can you make sure your drivers are fit to drive in the U.S. and if they are not, what can you do? First, to review the legislation:

    Drivers with any of the following medical conditions are restricted from driving in the U.S:

    • Hearing impairment
    • Monocular vision
    • Insulin-dependent diabetes
    • Epilepsy/seizure history
    • If they have failed to file a cyclical medical report and were downgraded to a class “D” as a result

    An important aspect of this regulation is that it will be the Ministry of Transportation, not the family doctor that will determine if your driver will receive a “W” code on their license. Many organizations have taken the new legislation as an opportunity to evaluate the policies and procedures they have in place to deal with the changes occurring in their industry.

    Policies and procedures that should be reviewed in light of new regulation are:

    • What to do if a driver is determined as not medically fit?
    • How are you informed if your driver is classified as “W”? Are you dependent upon him or her telling you? The Ministry determines this, amends the actual DL and the employee reports to their employer.
    • If your driver is using a family physician, are you getting an objective medical?
    • Who do you turn to for medical advice and support?

    Many organizations see value in turning to an occupational health physician or “company doctor” program to help facilitate the policies and procedures that need to be updated and to help streamline any future changes that are required.

    How your occupational health physician or “Company Doctor” can help:

    • Provide you with the confidence of knowing the medical status of your employee.
    • Help integrate the services of the physician in your policies and procedures so it becomes a well-known standard for your company.
    • Provide updated medical review if your driver is downgraded.
    • Know your industry and work environment.
    • Provide centralized record keeping.
    • Provide objective driver medical exams.
    • Provide medial advice and support to help you, your drivers and their treating physician develop a return to work plan based on early intervention and objective medical information.
    • Support your risk management strategies.
    • Provide you with the peace of mind that your drivers are safe and fit for work.

    Not surprising, one of the biggest risks your driver faces in not being downgraded and refused entry to the U.S. is not the driver medical, but the record keeping process.

    What you need to know about the record keeping process:

    • You, as the employer are responsible to file your driver’s cyclical medical. If you don’t, they will be downgraded to Class G.
    • The driver takes the original medical assessment to the Ministry office, they grant a license (with possible restrictions), and then the driver has to provide a valid license to their employer.
    • Those drivers who failed to file a medical report and were downgraded to D must file a satisfactory medical report to have the “W” code removed.
    • Medical records are required every 3 to 5 years.

    If you would like to know more about how working with Workplace Medical Corporation’s Company Doctor program can save your organization time, money and boost productivity with our occupational health expertise, please contact us.

    Jon Burtenshaw

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  • Ironman Athlete Collects Monthly Workers Compensation Cheque

    The Phoenix Arizona News describes an extreme case of Workers Compensation fraud – woman competes in Ironman while on Workers Compensation. As an experienced case manager, I see workers compensation fraud often – although it is not usually as extreme as collecting Workers Compensation cheques while competing in an Ironman event.

    How does fraud happen and what can you do about it?

    The problem starts when employers and Case Managers accept a Doctor’s Note from a family or general physician. The family physician often gets only one side of the story and claims are approved by “word of one doctor”.

    Be in control. Proactively manage your disability claims.

    As the employer, you will ultimately be paying for this fraud so you need to proactively manage claims and not rely on the worker’s compensation board. Claims Management relies on a complete diagnosis that takes into account the physical demands of the job as well as the physical and mental limits of the employee. Often an employee will advise their doctor that their job demands exceed their limitations, and the doctor will diagnose from there. Employers are not privy to the medical background that went into the diagnosis and thus, cannot know how complete the assessment was. This is when a company needs an Occupational Health Physician.

    What role does a Company Doctor play?

    My recommendation is that the employer should have their own “company doctor” or occupational health physician to review the physical demands of the job and compare that to the capabilities of the employee. If the employee is completely unfit for duty, the Physician would be able to recommend a rehabilitation program. If the employee is somewhat fit for duty, they could potentially go back to work immediately, with modified work duties. The Occupational Health Physician would then reassess the employee to mark any changes or improvements until the time that the employee could return safely to work. Case Managers require the Occupational Health perspective in order to effectively manage claim expenses for the employer and to ensure the employer is in control.

    5 Ways to Avoid Fraudulent Claims

    1. Be involved in Case Management. Ensure Case Managers obtain all of the medical information used to make the diagnosis and do not rely on the interpretation of the information from treating providers. The employee should not drive the diagnosis.
    2. Separate medical from non-medical information in order to determine the cause of an absence.
    3. Work with Case Managers who will validate the initial medical report by using Doctor-to-Doctor Conferencing and Time-Loss Reviews, which are medical assessments performed by an Occupational Health Physician.
    4. Confirm that the diagnosis takes into account the actual requirements of the employee’s job, and note the potential for modified work duties.
    5. Require that Case Managers have ongoing contact with the employee to note their responses to their rehabilitative treatment and reassess their functional abilities over time.

    For more information about Claims Management, Workers Compensation disputes and how to prevent avoidable absences, contact us.

    Strategic Absence Management Inc., a division of Workplace Medical

    Penny Buckner is the Director of Strategic Absence Management Inc. She is also a Registered Nurse with over 15 years of experience in the Group Disability arena in both Canada and the United States. Penny’s experience includes managing Short and Long Term Disability claims at Canada Life and Sun Life, developing and implementing an Early Intervention product used at several national insurers as well as providing case management and auditing services for OTIP (Ontario Teachers Insurance Plan).  Currently, Penny leads our disability management program and our team of nurse case managers.

    Jon Burtenshaw

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