Alan Engelberg
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The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, provides useful definitions of employability, employability determination, and medical determinations related to employability. As the AMA Guides notes, and the term medical determination related to employability has supplanted the use of employability. Clearly, factors unrelated to health status affect both employability and its determination, but the physician's role is limited to providing useful medical information, culminating in a statement of risk to the employer. The physician's purview never includes a determination of employability, nor does it justify an opinion that an individual is or is not employable. Managers in human resources departments can clarify the basic principles of equal employment opportunity and thereby minimize the risk of intentional or inadvertent discriminatory actions. Disability evaluation covers the interplay of the injured employee, the human resources function, and the health care providers. When a worker's health status is a factor, the physician's assistance in helping an employer determine employability is crucial, but physicians must never voluntarily state that a person is or is not employable. Physicians can assist an employer in determining if a medical condition precludes travel to work, being at work for a specified time, and assignment of appropriate tasks with or without reasonable accommodation.

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    Demeter SL, Andersson GBJ, Smith GM, eds. Disability Evaluation. St. Louis: Mosby-Year Book; 1996: chapter 49.

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