FREQUENTLY ASKED QUESTIONS BY INDUSTRY ABOUT INRTEK

1. What does the name "INRTEK" mean?

INRTEK is an acronym for Injury Reduction Technology. The name suggests our basic premise of reducing injuries in the workplace by scientifically matching the physical capabilities of the worker to the physical demands of the job.

2. How does this test meet the requirements of Federal disability and Equal Employment laws (ADA & EEOC)? Why do you feel you can perform this test pre-job offer?

* The INRTEK evaluation accesses the major muscle groups involved in performing physically demanding jobs for a statistically significant correlation to job function which demonstrates job relatedness as outlined in the ADA.
* An isokinetic evaluation provides a more objective measurement of function in comparison to any other assessment tool.
* The evaluation is not a medical evaluation as defined by ADA.
* The evaluation is non-discriminatory relative to age and gender.
The ADA specifically addresses agility and strength/fitness tests as not being prohibited under the act.

3. How do you ensure the standardization of your testing?

INRTEK performs all technical training for the provider network. This technology utilizes standard protocols, equipment, training, and data analysis. INRTEK interprets all data at a central location. The results are monitored and examined via numerous evaluative protocols at this central location and suspect tests are investigated and re-administered if necessary. This greatly enhances quality control, standardization, and defensibility.

4. How do I know your test is going to work?

INRTEK provides storage, compilation, and monitoring of results on a continuous basis. Although, no test can guarantee a specific decrease of injuries, substantial differences have been documented between the matched worker and unmatched worker in numerous case studies. An analysis of the INRTEK database by the University of Massachusetts concluded 95% of the evaluated workforce identified as physically capable of performing physically demanding jobs worked injury free. In comparison, 75% of the evaluated workforce identified as incapable were injured. It was concluded an accurately evaluated and matched worker is 14 times less likely to be injured than an unmatched worker. There are over 800 independent research articles documenting the accuracy, validity, and reliability of isokinetic testing. Numerous INRTEK client case studies have consistently verified substantial cost savings from the technology.

5. What do the reports mean? How do I read them?

This requires examining the specific INRTEK report, pre-placement or Return to Work. But in general, a standard index score (SIS) is provided and compared to an established standard for a specific job. The SIS score is developed by use of a regression analysis from various scores and ratios for all joints tested (knee, shoulder, back). A descriptive analysis summarizing the raw scores and SIS is provided with each evaluation.

6. How do you determine the standards for specific jobs? Can we have our own database?

INRTEK compares your job descriptions to the existing database of tens of thousands of healthy industrial workers. INRTEK can establish and recommend a minimum physical capability standard in three ways:
1. Conduct a pilot study of the healthy incumbent workforce.
2. Match to like job descriptions already in the database.
3. Match to the Dept. of Labor, Definition of Strength Levels.
A database can be established on a client's specific incumbent workforce.

7. How many tests will it take of my own people before I have a statistically sound and defensible database of my own?

Minimum requirement is 50. Any number greater than 50 would serve to enhance the defensibility of the database.

8. How long before I get results back?

Pre-placement evals are completed within 24-48 hours of INRTEK receiving the results from the provider site. Return to Work/ Physical Capability Evaluations may be returned within 5-7 working days from receipt of results at INRTEK.

9. Can a job candidate refuse to take your test, and what can I do legally?

If the evaluation is part of the new hire process, and if the new hire candidate refuses to take the evaluation, the candidate may be disqualified. If the evaluation is for a return-to-work evaluation, it depends on the various laws of each state as to the legal recourse available to the employer if the employee refuses to take the test. It should be noted, that the treating physician must refer the employee for a return-to-work evaluation. The employer's claims administrator can advise of appropriate action that may be taken under the respective state workers' compensation statute.

10. How do I justify the cost?

What were your comp costs last year? Take your top 1 or 2 claims. What did they cost your company? How many new hires are you projecting? Look at the reduction of injuries in the matched groups in the database. Compare the cost of testing each new hire to your comp costs last year, or even the highest claims. Employers who have utilized the INRTEK technology have realized at least a 7 to 1 return on investment for every $1 invested in the technology. Some employers have actually reported a 30 to 1 return on investment.

11. Can you do nationwide testing? I have other locations.

INRTEK has a nationwide provider network. When gaps in service exist, INRTEK will research the clinics in a specific area to establish a new provider site.

12. What is a normative database and what does it mean to me? How do I match my jobs to your database? What jobs are in the database?

The INRTEK normative database of tens of thousands of evaluations of healthy industrial workers is the basis for establishing the standards for specific job descriptions. This database provides the comparison for each evaluation. This represents the largest isokinetic database in the world. The key to its utilization is the fact it consists of only healthy uninjured workers. All data on injured workers is maintained in a separate database.

13. Does this test stand up in court? What is your litigation track record?

The ADA regulations are clear relative to physical strength/agility testing. The law combined with 30 years of isokinetic technology, 800 + research articles, INRTEK's normative database, standardized procedures and protocols, and numerous successful client case studies, have likely kept away litigation from claimant's and their attorneys. As of June 1998, INRTEK has not been challenged for age, gender, or ADA discrimination. We have completed tens of thousands of evaluations; 70% of which involved new hire evaluations.

14. How do I handle the concerns of the unions?

We have found most unions are supportive of the technology. It must be sold as a win-win situation for their members. The unions like the "sports medicine" concept for their members. The technology becomes an added "benefit" if sold correctly.

15. What happens if someone gets hurt doing the test? Who's responsible?

The Equal Employment Opportunity Commission, on October 10, 1995, stated, "An employer may ask an applicant to assume responsibility and release the employer of liability for injuries incurred in performing a physical agility or fitness test." Additionally, we have chosen an evaluation that utilizes isokinetic testing which is the safest way to load the musculoskeletal system.
It is also performed with the person stabilized, controlled, and under the supervision of a trained technician at the provider site. Although the isokinetic evaluation is not risk free, there is little chance of serious injury in this type of environment. The best feature of this evaluation is failure to meet the standard will not put the applicant at risk.
The equipment can only produce forces to meet the output of the applicant. The risk is much higher when the test load in a lift test surpasses the capability of the applicant. Failure of a lift test could injure the applicant. INRTEK has been involved in tens of thousands of isokinetic evaluations without any injuries to any applicant or employee. Can this be said for all the isometric and isotonic evaluations that have been performed?

16. Will this catch someone faking an injury? How do you know they are giving a full effort?

When testing isokinetically maximal effort is highly reproducible. The isokinetic test is a dynamic test (requires movement). Force curves are plotted along a range of motion scale. Maximal effort will produce similar curves with respect to amplitude and shape. Someone faking an injury, (a symptom magnifier) will produce inconsistent curve shapes and this is clearly noted in the Return-to-Work report.

17. How is this test different from other FCE's?

Refer to "Functional Capacity Evaluations (FCE�s) vs. Isokinetic Evaluations �. This document outlines the basic qualities of the INRTEK System that separates INRTEK from any other type of physical evaluation.

18. When do we ask for the return to work test in the claim management continuum?

Ideally, following INRTEK's recommended sports medicine conditioning model to return an injured employee to work in the shortest time possible. A baseline assessment should be administered within 4-6 days post-injury followed by 4-6 weeks of progressive physical therapy, concluded with a return-to-work readiness evaluation.

19. What jobs should I test?

Any physically demanding job, and especially those jobs where injuries continue to occur. Most of the jobs in our database fall into the medium, heavy, and very heavy categories. An employer is not obligated to test all employee job classifications within the company.
20. How do I get started? Do I have to sign a contract?
INRTEK does not require an industrial client to sign a contract or commit to a specific number of evaluations. The program may be started and stopped at anytime. We must however remind you, to conform to the ADA and EEOC guidelines, when administering this test to prospective hires, all similarly situated applicants must be tested. A company may not pick and choose applicants to be tested. If started for a specific job description, all candidates must be tested while the INRTEK evaluation is being utilized.

21. How many tests can you accommodate? Can you handle my volume?

This is a question each provider facility must answer. When you develop your marketing plan you must also consider the amount of time, personnel, and resources you are able to commit to your industrial evaluation program. Many employers operate multiple shifts and may require testing outside of normal business hours. Providers are encouraged to utilize certified athletic trainers on a contract basis to accommodate variable volumes and after hours testing.

22. What industrial clients use this testing now and what are their results? Can I contact any of them?

INRTEK's clients represent some of the nation's largest employers and government agencies. The company currently supports hundreds of clients, not including the many client customers developed by the INRTEK Provider Network. As a courtesy to our industrial clients, and to maintain confidentiality, INRTEK does not publish contact information for their clients.

23. Do you track the results of your tests? Do you have case studies that are documented with your results? I am going to be asked that by my boss?

Tracking is a key component of the INRTEK System. Section 3 documents specific findings and return on investments experienced by a few of INRTEK customers. INRTEK will also analyze the employer's injury occurrences to determine the program effectiveness. Also quarterly reports are available on the number and type of evaluations that have been conducted with a breakdown of recommendation rates on new hire evaluations.

24. Do your tests take into account 6-8 hours days? How does your test measure endurance?

The key to measuring endurance is the comparison to a healthy population database. No test, based on the test alone, can predict the endurance necessary to work 8 hour days, five days a week, over months and years. What makes INRTEK unique is the ability to provide a cost effective test, administered in a reasonable amount of time, that compares directly to a database of workers demonstrating the endurance necessary to perform physically demanding jobs over long periods of time.

25. Can we test incumbent workers? Legally, what can I do with this data?

Incumbent workers can be tested, on a volunteer basis, and this data can be used to establish standards and baseline data. You may not terminate an existing employee or place them into a lower paying job based on this data. However, after an employer has established job standards, employees requesting job transfer to another job may be tested as long as all candidates are similarly tested. And you can move a person into a less physically demanding job as long as there is not a loss in pay or seniority.

26. What about re-testing? If they pass when they're hired, what about four, five, six years later. How often can I re-test?

After establishing consistent company policy, an employer may offer voluntary re-testing to identify employees needing reconditioning. Concurrently, these employees should be offered, at no expense, the opportunity to participate in an on or off-site conditioning program.

27. In a return to work test, what if we discover a joint other than the injured joint is also deficient, now what do I do?

This scenario shows the value of the INRTEK evaluation. Because we focus on the relationship of knee, shoulder, and trunk functioning together, any deficiency could indicate the employee is a candidate for re-injury. It is also probable an uninjured joint deficiency caused the injury. Many back injuries occur when upper body strength is deficient and the back is injured because of frequent compensation for this weakness. This is also why tests that look only at the back are not valid indicators of injury probability. If the INRTEK evaluation shows deficiency in a joint other than the injured joint, that employee needs additional therapy and conditioning until the deficiency is corrected. Otherwise, they are likely to be re-injured.

28. Is this test safe?

Isokinetics provide the safest form of muscle loading. It accommodates to musculoskeletal leverage changes and fatigue. It applies resistance directly proportional to the force output of the individual. The test is also performed with the body in a stabilized environment to eliminate substitution body movements. INRTEK has been involved in tens of thousands of isokinetic evaluations without any injuries to applicants or employees. Can this be said for all isometric and isotonic evaluations that have been performed?

29. Can I customize the format of the report you give me?

Within limitations the format of the INRTEK report can be customized. Specific requests should be discussed directly with INRTEK.

30. Why do you say your tests are objective, standardized, and defensible? Explain these points to me and what do they mean to me?

Objective: Utilizes proven physical performance technology that ensures accuracy, reliability, and validity. Isokinetic equipment has field calibration procedures traceable to the National Bureau of Standards. This procedure replaces human subjective evaluation with research proven technology.
Standardized: High degree of reproducibility. This encompasses all procedures:
protocol, equipment, training, data analysis, etc. The evaluation is administered and evaluated in a consistent manner for all applicants.
Defensible: The degree to which we are successful at objectivity and standardization, the higher the defensibility of the results. The reason INRTEK is so particular about the procedures of the evaluation is the fact that each evaluation has the potential to be litigated.

31. For a return to work test, who can order the test? Claims adjuster, case manager, or attending physician?

A claims adjuster or employer representative can suggest a Physical Capability Evaluation be conducted. Only the treating physician can order the test. It's not always easy for an employer to get the physician to agree to a test, especially if the employee is a symptom magnifier or hostile claimant.

32. Your tests do not seem to replicate job function movement patterns? My employees do not move in the patterns you are testing.

The test is not a functional simulation test, and that is by design. The procedure INRTEK uses has shown a high correlation to function, and that has been documented in hundreds of independent research studies. By evaluating the muscle groups associated with the movement of the knee, shoulder, and trunk we are assessing the major muscle groups used in physically demanding jobs.
Our procedure also allows for isolation of left and right sides during the evaluation. During functional simulation the body has a great ability to compensate for weakness in one joint with the strength in another. Although the stabilized isolation of joints in our evaluation may not replicate job function, it provides a more complete analysis of capability.

33. Do your tests give an indication of any carpal tunnel related problems?

Although the INRTEK evaluation is not a direct test for carpal tunnel syndrome, there does seem to be a connection between shoulder weakness and increased susceptibility for carpal tunnel problems.

34. How can we derive impairment ratings from a PCE?

Only a physician can make an impairment rating based on specific AMA guidelines.
The INRTEK program can be an effective tool to objectively quantify an individual's physical capability relative to the performance of specific muscle groups and physical work.
The results of the INRTEK standardized isokinetic evaluation of the knee, shoulder, and back flexion and extension movements include bilateral and antagonistic muscle group deficits as well as combined scores and work level recommendations for each of these muscle groups. These scores are then compared to a normative database of tens of thousands of workers performing and/or applying for various types of industrial jobs.
Using this information, along with the medical history and the physician�s own medical evaluation, a physician can more effectively determine the extent of impairment of the knee, shoulder, and/or back muscle groups and/or overall physical capability of an individual in order to make a more objective recommendation regarding an individual's specific limitations or degree of disability.
In summary, the INRTEK evaluation results can be used as part of an impairment evaluation by a physician, to help determine degree of impairment or disability rating, but cannot (and is not meant to) be used in and of itself for this purpose.