How Extreme Ergonomics Can Help You Manage Employee Comorbidities

Underlying medical conditions are usually the defining feature of an extreme ergonomics accommodation case.
By: | October 28, 2020

The all-virtual National Ergonomics Conference continues on Nov. 4 with a presentation by Tim Pottorff, principal and owner of QP3 ErgoSystems LLC. Portoff’s session is focused on extreme ergonomic accommodations, their frequency and how employers can better utilize the services of a third party to overcome common roadblocks in complex ergonomic assessment cases.

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According to Pottorff, extreme accommodations can be almost anything, so he’ll explore the topic through case studies.

“Usually with ergonomics, there are some really simple things you can do, whether it’s from a postural standpoint or maybe work method,” Pottorff explained.

“The reason I’m calling this ‘extreme’ ergonomics accommodations is because many of the situations that I’ll be discussing not only  have an ergonomics issue, but there are also underlying medical issues that played a role. One case had probably a dozen other medical conditions that played a massive role in the challenges for making the right accommodations.”

Learning the Full Story

Pottorff said  that underlying medical conditions are usually the defining feature of an extreme ergonomics accommodation case and that concerns about privacy are a secondary consideration for ergonomists and any consultants that may serve the employee to achieve a safe and comfortable working environment.

“Sometimes folks are just embarrassed or unwilling to discuss conditions that affect them, and that in turn makes it difficult for the practitioner to make an effective recommendation, because we don’t know the whole story,” he said.

Frequently described as co-morbidities, multiple underlying medical conditions can compound the effect of a chronic illness and that chronic illness’s effect on work performance. Even further, co-morbidities are exceedingly common in the American population.

Tim Pottorff, principal and owner, QP3 ErgoSystems LLC

A 2018 statistical study published in the American Journal of Preventive Medicine regarding a population of patients with hypertension discovered alarming rates of co-morbid conditions (using a common standard called the Elixhauser Comorbidity Index).

“In all, 14.0 percent of U.S hypertensive adults did not have any comorbidity, whereas 23.0 percent had one; 24.4 percent had two; and 38.7 percent had three or more,” Park et al wrote.

Given that, it’s hardly a leap to think extreme accommodations growing out of comorbidity prevalence could occur, and for Pottorff, that is primarily driven by increasing recognition of the fact.

“I think [comorbidities and multiple underlying medical conditions] have always been there, we’re more aware of them now,” he said.

“You do see more morbid obesity and that can affect a person’s ability to access keyboard and mouse, and I’ve been dealing with that since I started in the profession. For example, in health care, as the average person gets bigger, patient handling is a primary risk factor for back injuries. We do have to look at the individual and the caregiver as the employee, so it’s always been here, and in certain industries it’s more of an issue than others.”

A Duty to Care

Beyond the employer’s desire to create an inclusive and productive work environment for everyone, businesses have significant obligations under the Americans with Disabilities Act and the OSHA General Duty Clause to provide accommodations, even if they are extreme.

OSHA’s Ergonomics Standards and Enforcement FAQs page states: “Even if there are no guidelines specific to your industry, as an employer you still an obligation under the General Duty Clause, Section 5(a)(1) to keep your workplace free from recognized serious hazards, including ergonomic hazards. OSHA will cite for ergonomic hazards under the General Duty Clause or issue ergonomic hazard alert letters, where appropriate, as part of its overall enforcement program.”

What Then Constitutes an Extreme Accommodation?

According to Pottorff, types of extreme accommodations vary greatly and include “changing the office location and type of office from cubicle to private office,” very specific interventions such as padding corners for an employee suffering from epileptic seizures with multiple causes, and “looking at restroom facilities and what’s available in that regard. Looking at the whole picture and major medical considerations.”

Pottorff further explained that the process of implementing extreme accommodations like changing the office set-up landscape is also altered.

“Usually extreme accommodations do take longer, because they’re not your standard sit/stand desk or different chair,” he said.

“In these cases, just a different chair would mean a very specific different chair. It depends on the organization. It can be beneficial to bring in a third party consultant, because people are often unwilling to open up to people in their own organizations.”

Impacts from Our WFH Environment 

As with all things work-related in the COVID age, extreme accommodations also play a role in the work-from-home environment.

Noting that COVID’s effect on traditional work environments is also a likely force behind a “bubbling up” of issues like increased domestic violence and alcohol and drug abuse, it may also be an ergonomic risk.

“The risk factors don’t change whether you go from working in a regular office to a work from home office, and actually people tend to be more at risk, because they may have a substandard workstation at home that is okay for a day a week, but is not necessarily set up for five days a week,” Pottorff explained.

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Ergonomic Excellence, Everywhere

Pottorff hopes that attendees of his session and the organizations they represent learn to appreciate the science of ergonomics beyond the regulatory burden.

“People need to have a robust workstation arrangement wherever they’re working, and I think a lot of companies still don’t understand or realize that injuries that result from working from home are work related.”

His key takeaway? “It’s okay to ask for help, not know all the answers and bring in a third party.”

Registration for the virtual National Ergonomics Conference is available here&

Nina Luckman is a business journalist based in New Orleans, focusing primarily on the workers' compensation industry. Over the last several years, Nina has served as Editor of Louisiana Comp Blog, a news site she started in 2014 under the auspices of a group self-insurance fund. She can be reached at [email protected]

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