Category Archives: Uncategorized

OSHA New Rule “Nudges” Employers

Pre-Read Comments (Terry Lawson, PT, CAE)

Preemptive injury prevention and management programs will not only mitigate injuries and “reportables” but show evidence of safety process and procedure essentially satisfying requirements that employers maintain safe working conditions.

If you are already using these programs, you should not have to worry about deeper inquiry suggested in these new rules.  However, for those not utilizing current best practices, this is strong “writing on thew all” that you are going to be under increased scrutiny.  Consider implementing injury prevention and management programs today.

Trade News Release Banner Image

May 11, 2016

OSHA’s final rule to ‘nudge’ employers to prevent workplace injuries, illnesses
New federal requirements take effect August 10, 2016

WASHINGTON – The U.S. Department of Labor’s Occupational Safety and Health Administration today issued a final rule to modernize injury data collection to better inform workers, employers, the public and OSHA about workplace hazards. With this new rule, OSHA is applying the insights of behavioral economics to improve workplace safety and prevent injuries and illnesses.

OSHA requires many employers to keep a record* of injuries and illnesses to help these employers and their employees identify hazards, fix problems and prevent additional injuries and illnesses. The Bureau of Labor Statistics reports more than three million workers suffer a workplace injury or illness every year. Currently, little or no information about worker injuries and illnesses at individual employers is made public or available to OSHA. Under the new rule, employers in high-hazard industries will send OSHA injury and illness data that the employers are already required to collect, for posting on the agency’s website.

Just as public disclosure of their kitchens’ sanitary conditions encourages restaurant owners to improve food safety, OSHA expects that public disclosure of work injury data will encourage employers to increase their efforts to prevent work-related injuries and illnesses.

“Since high injury rates are a sign of poor management, no employer wants to be seen publicly as operating a dangerous workplace,” said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. “Our new reporting requirements will ‘nudge’ employers to prevent worker injuries and illnesses to demonstrate to investors, job seekers, customers and the public that they operate safe and well-managed facilities. Access to injury data will also help OSHA better target our compliance assistance and enforcement resources at establishments where workers are at greatest risk, and enable ‘big data’ researchers to apply their skills to making workplaces safer.”

The availability of these data will enable prospective employees to identify workplaces where their risk of injury is lowest; as a result, employers competing to hire the best workers will make injury prevention a higher priority. Access to these data will also enable employers to benchmark their safety and health performance against industry leaders, to improve their own safety programs.

To ensure that the injury data on OSHA logs are accurate and complete, the final rule also promotes an employee’s right to report injuries and illnesses without fear of retaliation, and clarifies that an employer must have a reasonable procedure for reporting work-related injuries that does not discourage employees from reporting. This aspect of the rule targets employer programs and policies that, while nominally promoting safety, have the effect of discouraging workers from reporting injuries and, in turn leading to incomplete or inaccurate records of workplace hazards.

Using data collected under the new rule, OSHA will create the largest publicly available data set on work injuries and illnesses, enabling researchers to better study injury causation, identify new workplace safety hazards before they become widespread and evaluate the effectiveness of injury and illness prevention activities. OSHA will remove all personally identifiable information associated with the data before it is publicly accessible.

Under the new rule, all establishments with 250 or more employees in industries covered by the recordkeeping regulation must electronically submit to OSHA injury and illness information from OSHA Forms 300, 300A, and 301. Establishments with 20-249 employees in certain industries* must electronically submit information from OSHA Form 300A only.

The new requirements take effect Aug. 10, 2016, with phased in data submissions beginning in 2017. These requirements do not add to or change an employer’s obligation to complete and retain injury and illness records under the Recording and Reporting Occupational Injuries and Illnesses regulation.

The final rule is available on Federal Register at:*

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit

# # #

Media Contacts:

Mandy McClure, 202-693-4672,

Release Number: 16-970-NAT

U.S. Department of Labor news materials are accessible at The department’s Reasonable Accommodation Resource Center converts departmental information and documents into alternative formats, which include Braille and large print. For alternative format requests, please contact the department at (202) 693-7828 (voice) or (800) 877-8339 (federal relay).

* Accessibility Assistance Contact OSHA’s Office of Communications at 202-693-1999 for assistance accessing PDF materials.

TRUE Capacity Evaluation© Founder to Join Forces with National Firm

March 1, 2014

Terry Lawson, PT, CAE, CEO of Integrated Injury Management Services Inc. and founder of TRUE Capacity Evaluation© has joined forces with Physiotherapy Associates, the second largest outpatient rehabilitation service company in the U.S.

Physiotherapy Associates serves thousands of patients in 575 locations across 34 states. As an industry leader, they continue to explore and develop new techniques, products and treatments for their patients across the country.

Mr. Lawson will join Physiotherapy Associates as Industrial Rehabilitation Director, Research and Development.  His emphasis will be in developing Functional Employment Testing, Work-Related Physical Therapy, and associated services in 100+ locations in the western states with particular focus on 70+ locations in California.  He will also continue to serve his existing clients as Integrated Injury Management Services, Inc.

For more information, please contact Mr. Lawson at TRUE Capacity Evaluation contact or 800.515.4552



I saw this via Linked In the other day.  Wow!  So great to finally see general recognition of what we’ve known for almost 20 years now.  Of course I don’t agree with all that’s said.  There are some comments from some individuals who represent the negatives in the field.  Some quoted or their represented technology are part of the problem.

But overall, thanks to Robert Cisneros and Risk and, its good to see it brought to the forefront, again.

Helping Local High School

Roberts Hawaii Helps Themselves While Helping Local High School

Roberts Hawaii, the premier tour and transportation company in Hawaii has cooperated with a local high school to produce an in-house safety video for their drivers to learn better safety techniques in loading/off-loading baggage on their buses and vans.

Safety Manager, Jennifer Hill says, “The last picture is of me handing Waianae High School’s Searider Productions’ director our donation check for their help in the video’s production.  All the kids you see in the pictures are going to Florida next month for a national video production competition.  100% of our donation will be used for their trip.”

The video production titled, “Think Before You Lift” where company employees wrote and acted a script with various safety tips in handling baggage for their specific buses and vehicles.

Roberts Hawaii’s safety program includes a wide range of programs including injury prevention and management program implemented through Integrated Injury Management Service Inc.  Terry Lawson, PT, CAE, CEO of Integrated Injury Management is a kama’aina (long-time Hawaii resident), currently residing in California, has been working with Roberts Hawaii for over three years in developing this program. It is the first to be implemented state-wide, through local physical therapy clinics providing pre-employment/post-offer functional testing, fit-for-duty testing and Functional Capacity Evaluation (True Capacity Evaluations). All functional testing in the program is to determine the ability of workers to safely perform job tasks.

The local clinics participating are:

Concentra Medical Center/Physical Therapy-Honolulu, Oahu

Elite Physical Therapy and Sports Medicine-Wailuku, Maui

Club Rehab-Kona, Hawaii

“Think Before You LIft” is one in a series of cooperative video productions Roberts Hawaii has sponsored primarily for safety applications.  These productions by Roberts employees are very helpful to not only get the safety word out, but to get employees working together on projects to help themselves and their communities.  And it’s not hard to tell by the faces of the employees and student that they had a great time doing it.

All the best to the Waianae High School’s ‘Searider Productions’ as they take off to Florida for their national video production competition!

IS7A0721 IS7A0723 IS7A0596-1

Carpal Tunnel

Carpal Tunnel: Work or Not Work-Related? What’s Really Important…

I’ve read recent Linked In Work Comp Analysis Group comments regarding  Daniel Miller’s posting, “Carpal Tunnel Syndrome Often Misdiagnosed; Not Work-Related” with interest.  Obviously there is conflicting data and many opinions.

As an ergonomist-job analysis specialist and a 30-yr work-injury treating physical therapist with reasonable knowledge of the science and physiology as well as experience regarding mechanism of injuries typically called “carpal tunnel”, there is no question that repetitive motion to the extent called for in many job “causes” increased soft tissue friction, fatigue, inflammation, swelling and associated “mechanical-overcrowding” of structures, pain of whatever tissue or area involved.  In addition, surrounding body areas will experience supporting muscle fatigue, reactive postures compounding the problem.

These multiple variables cause diagnostic problems that most treaters attempt to oversimplify.  For example the common assumption of “carpal tunnel” with typical ineffective rehab treatment, surgery, and questionable outcomes, while ignoring other potential causes such as the other areas of the “triple-crush” chain (elbow, thoracic-outlet, cervical) for fear of “expanding the injury” an losing credibility or favor with referrers or payers.  An alternative would be to courageously address and educate on the underlying poor cervical posture will often eliminate the complaints of finger numbness and tingling and encourage better habits that will minimize future problems.

There is no doubt that “life-style” is a significant risk factor including not just additional personal time on the computer, smartphone, or tablet, but other common health risks such as diabetes, obesity, hypertension, lack of exercise, diet, etc…  These are also specific risk factors for musculoskeletal injury and conditions.

What is so sad is that despite the monstrous costs, incredible confusion and frustration including the mentioned scientific evidence that “carpal tunnel” is NOT work-related (although I obviously disagree in that generalization); despite all this:  Employers and their representatives continue to ignore the simple and common sense approaches to PREVENTING this conundrum.   Here are two that come to mind:

1. Legally and appropriately SCREEN-OUT new hire candidates with signs and symptoms of existing (pre-existing) repetitive motion conditions.  Yes, it is entirely legal and defensible when performed according to ADAAA/EEOC and state guidelines and RECOMMENDATIONS.  Studies have shown that:

  • 1/3 of CT cases occur in the first year of employment
  • 15% occur in the first 3 months of employment
  • Resulting in the new employer  paying for the previous employer’s problem (or the employee’s personal pre-existing non- work-related condition)

2. Implement early discomfort detection and treatment programs in line with OSHA guidelines and RECOMMENDATIONS. Treat employees as well as their ergonomic concerns and opportunities to interact and intervene BEFORE the inevitable “claim” and resulting antagonistic and costly sequelae.

Notice I didn’t say, “Go out and buy expensive ergonomic workstations for everybody in the company.”  Obviously very costly and it doesn’t help.  But don’t continue to hide your head in the sand or wring your hands and complain about these problems when there are simple and effective solutions.


  1. Don’t hire your next claim. Legally SCREEN-OUT those with pre-existing conditions that make them at risk or impending and significant harm to themselves or others.  Don’t buy trouble.
  2. Get expert advice on reasonably mitigating common injury mechanisms including such simple alternatives as: lifting with 2 people instead of one, job rotation-(switch to the other side of the assembly line 4 times per day, schedule switches between different machines, tasks, etc…), pre-shirt and in-shirt stretching and general fitness-type exercise to get the blood and lymph moving from problem areas
  3. Implement early detection and OSHA “first-aid” treatment programs.


Hundreds of the most well-known companies are using these simple methods with positive and documentable results.  With the high costs of each injury, preventing or mitigating just one will easily pay for all the above-mentioned programs with plenty left over.  Feel free to contact me for documentation or further information.


Terry Lawson, PT, CAE




FCE Status Quo

Hello All!  I thought I would debut this blog by calling to your attention a provocative article written not too long ago by a colleague.

It seems that the status quo over the last 20 years in the FCE world has not been as “scientific” as many would have you believe.  This particular area of the physical therapy we consider our part of “Evidence-based Medicine.”  However, unfortunately the evidence points to a continued use of Invalid Validity testing leading to questionable credibility of the FCE process.  This information has been known since at least 1998, but most of the suspect methodologies discussed are still in widespread use in FCEs today!

See Detecting Sincerity of Effort; A Summary of Methods and Approaches. Lechner, Bradbury, Bradley, PHYSICAL THERAPY, Vol 78 No 8 Aug 1998 ( and

Simons, G. (2006). “Credibility Crisis in FCEs.” PT Products ONLINE (Oct): 24-26 (

It’s against human nature to admit failures and mistakes; certainly as individuals, but apparently much more so for a professional community.  In my opinion, it’s about time that we confront this issue directly and attend to it carefully until we find answers that will satisfy our referring physicians, payer-clients and their claimants.

My research suggests there are answers.  There are, available now, valid methods of measuring the “illusive” sincerity of effort.  Here’s an article that perhaps can open the conversation, further exposing the issue with some recommendations.  I will be featuring more articles and other evidence currently available that indicates valid methods of determining sincerity of effort are available now.

Think about this… ”What’s the point of FCE, if you don’t know whether the claimant was providing sincere effort?“

Take a look at

“Three Functional Capacity Evaluation Myths That Have Cost Your Company A Lot of Money”

Darrell Schapmire and let me know what you think.