To piggyback on this, we do have our occupational medicine team provide fitness for duty evaluations for our own employees, and, as David mentioned, we do not make referrals. We put them on hold and request that they seek care to address
the areas of concerns. There is one exception to this process – we do not do fitness for duty evaluations for physicians/faculty MD’s. Those are managed through a process similar to an IME where we contract to have an external, unaffiliated physician perform
the evaluation and render an opinion. They are generally removed from clinical duties until that can be completed, but we expedite the process to get this done timely. We would, however, perform the necessary drug screen and alcohol testing for any employee.
Laura
Laura L Radke, MD
Adjunct Assistant Professor of Medicine
Senior Medical Director, F&MCW Occupational Health Services
Phone: 262-253-8197 | Fax:
262-253-5152 Cell Phone:
414-530-0723
E-mail:
laura.radke@froedtert.com
Froedtert & the Medical College of Wisconsin Workforce Health / North Hills Health Center
Building B First Floor
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051
From: MCOH-EH <mcoh-eh-bounces@mylist.net>
On Behalf Of David S. Cockrum via MCOH-EH
Sent: Thursday, January 22, 2026 10:50 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: David S. Cockrum <David.S.Cockrum@hitchcock.org>
Subject: Re: [MCOH-EH] Question about Fitness for Duty Procedure
|
Tim- If a FFD case on one of our own employees is referred to Occ Med, a provider will conduct the evaluation,
with drug and alcohol testing by our nurses if indicated. We don’t make a formal referral to specialists. This is a real gray legal area. For our own employees, when |
|
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|
Tim-
If a FFD case on one of our own employees is referred to Occ Med, a provider will conduct the evaluation, with drug and alcohol testing by our nurses if indicated.
We don’t make a formal referral to specialists. This is a real gray legal area. For our own employees, when we see the FFD eval, we are not a treating provider and there is
no physician-patient relationship. We are performing a service specifically for the employer. If we were to refer to a specialist, this could obligate the employer to then pay directly for all care related to the condition, since it was an employer rep (Occ
Med) that referred.
Instead, we provide a “Dear Doctor” letter to the employee with some mostly standardized questions about medical status, need for accommodations, etc. It then becomes the employee’s
responsibility to seek medical eval and treatment (using their own health insurance a payor). The employee will typically be placed on paid admin leave by HR and given a reasonable timeline to bring the letter back with accommodation recommendations (or for
drug/EtOH impairment, completion of a treatment program). If the employee needs more time to get through the medical wickets to figure out what is going on, they are directed to apply for STD.
I know not every institution will approach it in this way. This is how our employment legal expert has guided us to ensure we maintain the difference between treating and performing
the employer function.
David
From: MCOH-EH <mcoh-eh-bounces@mylist.net>
On Behalf Of Tim Crump via MCOH-EH
Sent: Wednesday, January 21, 2026 8:22 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Tim Crump <crumpt@ohsu.edu>
Subject: [MCOH-EH] Question about Fitness for Duty Procedure **EXTERNAL**
Hello everyone, I wanted to see how others are managing fitness for duty concerns with employee. Specifically, for those who are involved in the fitness for duty
process, who leads the Occupational/Employee Health participation, a nurse, a provider
Hello everyone, I wanted to see how others are managing fitness for duty concerns with employee. Specifically, for those who are involved in the fitness for duty process, who leads the Occupational/Employee
Health participation, a nurse, a provider or someone else?
When you have to refer an employee to see a specialist, do you have a set list of specialists who have agreed in advance to play this role, or do you connect with a specialist for referral as the need arises?
Thank you as always for any input. Warmly, Tim
Tim Crump, MSN, FNP
Tim Crump, MSN, FNP
He/Him/They/Them
Family Nurse Practitioner
Multnomah Pavilion (Second Floor, SW Wing), 3161 SW Pavilion Loop
Occupational Health
Healthcare Human Resources
+
ASIST Trained Caregiver [ohsu.edu]
Oregon Health & Science University
Occupational Health
3181 SW Sam Jackson Park Rd,
Mail code: UHN 89
Portland, OR 97239-3098
Department Phone: 503-494-5271
Office Phone: 503-494-5184
Fax: 503-494-4457
Email: crumpt@ohsu.edu
Wed-Fri, 7:30-6:00
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