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PREPOST - Handling Pre-existing conditions

PREPOST - Pre-injury adjustments for pre-existing conditions or second injury situations.

SkillTRAN's current PREPOST product has only a few options for adjusting the worker's pre-injury profile. Those options involve selective upward adjustment of a person's work history to "average" levels for Strength (Medium), GED-RML (333), and Aptitudes-GVNSPQKFMEC (33333333333). PREPOST is currently programmed to only enable upward adjustment of any or all of these factors if the worker's history did not require demonstration of performance at some of these levels. OASYS has greater latitude for adjustment of a worker's pre-injury and post-injury worker trait profile.

The conventional recommendation has been to assume that a person was average pre-injury if they graduated high school, earned an equivalency certificate, or were very close to it. In a situation where there is no work history, the classic online PREPOST assumes that all occupational options were open to an individual pre-injury, and no limitations are set in the initial pre-injury profile. All worker characteristics are automatically set to maximum values (i.e. Strength=V; GED-RML = 666; Aptitudes-GVNSPQKFMEC = 11111111111).

The normal processing of a PREPOST case involves:

  1 - Entry of work history

  2a - Optional upward adjustment for unused pre-injury potential

  2b - Adjustment for post-injury residual capacities

  3 - Searches ( 8 simultaneous searches) to examine numbers of occupations that could be performed (pre-injury vs. post-injury).

  4 - Result table calculating loss of access to occupations and a histogram to show the impact of a set of functional worker profile adjustments pre-injury vs. post-injury.

This information is then used by the vocational expert as a building block in formulating an opinion about the impact of a disability on occupational potential. The expert can re-adjust the worker profile and examine the impact of a different constellation of factors (such as a different strength level, etc) by repeating the search to get a fresh calculation of loss result table and graph.

Pre-Existing Conditions / Second Injury Situation

In a situation such as a person with a pre-existing set of conditions that must be filtered out or in a second injury situation, PREPOST is not currently programmed to allow any other pre-injury profile adjustments. However, there is a workaround to this situation. It involves repeat searches and profile adjustments and a little bit of math. The process is as follows:

Step 1 - Enter the work history (or none to set the profile "wide open").

Step 2 - Adjust the worker profile to reflect the PRE-EXISTING, PRE-INJURY worker profile.

Step 3 - Do the analysis. Note the results for each level of transferability (automatically recorded in the report, too).

Step 4 - Get any labor market information you might need.

Step 5 - Re-Adjust the worker profile to reflect the final post-injury worker profile.

Step 6 - Do the analysis again. Note the results for each level of transferability.

Step 7 - Get any labor market information you might need.

The mathematic computations to perform are simple. The results of the first search (in Step 3) above produce raw numbers labeled pre-injury vs. post-injury, and then calculate a loss of occupational access. In this special case, the post-injury numbers of the first search really represent the occupational range of options available to the person pre-injury. Therefore, take these raw post-injury numbers from the first search and compare them to the raw post-injury numbers of the second search (the final range of occupations available to the person post-injury). Manually re-calculate the loss using the raw numbers from the first post-injury results as if they were the pre-injury numbers for the second search. The resulting calculations for each level of transferability reflect the post-injury impact of an injury after accounting for pre-existing condition(s).

The mathematical formula to calculate occupational loss works like this for a given level of transferability:

Occupational Loss = ( 1 - ( N Post-Injury Occupations / N Pre-Injury Occupations) )

As PREPOST and all of the other SkillTRAN Online Services evolve, pre-injury adjustments will become more easily handled. For now, until re-engineering of SOS has occurred, use the methodology above to handle pre-existing and second injury case situations. 

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