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11-30-1992^i::.?1.' .?.. ','r"iir'• ,F ?'y ?t• Its ??'Tr'"F'?•,: r..-; ?:.?i ? .. °7:.' ,- 'i ... . . ?'i;", ', is .'.j, ?).?[ iC 'r•' , •1• - r. ??. • ;?',a ??, ,ti atr ?: 5.'Y' •.F. :,. .i. is ? if a:.;•{:1: : {I t ,,lV 'r'?k,`%SW1, J.;•r' `?i "°,r. ;.?3:t-`1 ?? .17. ? :i.?:? - 1iY' ,'??;'3 :if :1,'r.;,i e•,?,1', J! .Y k ,i', ' ?y?a?;` , kt 1' ?? 77'{s`,,!% ^1z ,-?•G?r.;q4 ! •s; r ?,.i4 pa'b:,i ii.l' F+ r ;' .'f? '.NC Om." .rM f',"={??'Xj .:,?, ,c , -!sy sfl'"y,tL;.e! ?; •a. 'y?,'•c?rt?:7..? :^a?,°;.'?•.CSi13" :r?,: .'?, .,.''' ?. -i, ?', ,r i ?."L .f. -iti N.7 •?t-. )rF S.I J°^S yra y. i?'.?,1 ?'yC??r.: •, 3.jt{,!'j ??il E.t j?:2L,s,'; l.5,.?,.?j,y fI'r-.r°:,n-:'?r.Y? 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' . ?3's 'l:' ' , . . ! ; ,f ; . ,; ? • , • I f r , .s F'.k? ?' 9. a F r .. t• .. -c f: 1.: '! ,E . ? , .. ? y . I. J. ' • ' , • ? [ X1,. {4i' }lJ. .i ..'.i??f ?.1 'k rr ??'?"'S° : :'! .1 ? ? r ?.{ y ' . .?yl. D._ ? 4. YA g,+ ?.? V tJ r. it 'f .f -?'.. f. 2,. 'r". ?•Y. `I {'fE: ../:• wYlTi.f'SS5 ?. 1' 'r; 1.. .l. { j.?. .49?? ?.F'-.'a1Sf.?.•.; ,??i(.x.. :Ft "•.Sq, ?: i>s, ??i c»..1??`?•t9'r?•s?.:.? i 4'kl -: ? .: 'N.. ?TT i ??r3 ' i ; 4 ?'1 CW i h r ? ?T ` $• ` ; ^ ? , ? : 1 ?ti' ' 4.:, F. ij' °4. rl..a.l f S J1 '7 w s, . . . ?, . . t rr. ....!kr'... . ... t 7 , da < . r:JNf.IVY f1a ,Z?.C.e•..., [ 4: -r ,. E .r -9i - , .. ? ?7 - , ; _ .. ? ... • is ? 2. ;Approval of Minutes . of 11/2/92 r 3.. Request far acceptance into membership: a) Norma,Skinner ' b) George Savatovic ; c) Timothy.C. Geary d) Jacqualyn DeGroy e) Ruben J: Hernandez f) William F. Keller, Jr.. 4. Pension(s) to lie granted: .,Regular ' Michael A. Bruscell 5. Pension(s) to be granted: Widow's Sharon McAteley; widow of'Gerard J. McAuley 6. Pension(s) to be granted: Non-Job-Connected Disability Ray Brock 7. (Cant. from 11/2/92) Temporary Amendment to the PAC Policies & Procedures Manual to allow a quorum of the PAC to vote on . disability pensions 8. (Cont. from -11/2/92) Medical Standards for Pension Physical Examinations 9. Other Business: . 10. Adjournment: 1. r (.'• ? ?1f. .•Slli .rl }.I ,?i"?r?•.i '.I?.f .r il';`. 1';1 ,.I1: .1l.; .',.„. r4./ ,I .r 1. •1?' ,sE 3 • .. i ' t6aalw..Wrrr...w-u. r.n_.nr..r •r.rr I.?r... ?.rr n.. r r».. ?+r .-w.n-?r.nrr_..ar..--.r•..,..M...r .wu...r ?. r .inn...... ......n-_. CLEARWATER CITY COMMISSION Agenda Cover Memorandum Item n ' . 11730192 Meeting Date: Trustees of the Employees Pension Fund Subject: Membership' in Employees' Pension Plan Recommendation/Motion: Employee(s) listed below be accepted into the Employees' Pension Plan as rec ommended by the Pension Advisory:. Committee. ' ? and that the appropriate officials be authorized to execute same. BACKGROUND: Date Seniority Pension ' Name Bnd _Igh Class Di L?i0? ) ffectivc Norma Skinner, Staff Asst. II Police 1/2/90 10/5192 . George Savatovic, Sanitation, Worker Pub. Wks./Solid Waste 6/1/92 10/26/92 Timothy C. Geary, Recreation Leader Marine I2/I6/91 10/5/92 Jacqualyn DcGroy, Staff Asst. 'III PIO/Econ, Dev, 10115190 10/22/92 Ruben J. Hernandez, Firefighter Fire 1 1 /2/92 11/2/92 William F, Keller, Jr., Firefighter Fire 11/2/92 1 1 /2/92 Reviewed by: Legal_ l)A- J A- Originating Dep Human Res Budget 1 Purchasing Na" User Dept.: Risk Mgmt. N,4' DIS NA- - ? ACM Advertised:' Other Date: Submitted by: Paper: 19 Not required Affected parties ? Notified City Manager Not required costs: Il_9- Commission Action: Total Approved . ? Approved w/conditions Current FY CJ Denied ? Continued lo: _ Funding Source: ? Capt..Imp. ? Operating ? Other Appropriation Code; Attachments: • Letter(s) ? None Ld- CITY OF CLEARWATER EMPLOYEES'.' PENSION PLAN PENSION ADVISORY COMMITTEE Tpt Pension Trustees FROM- „ P,,wlon Advisory Committee SUBJECT: Recommendation for Acceptance into Pension Plan DATE November 4, 1992 As Trustees of the City of Clearwater Employees' Pension Fund, you are hereby" notified that the employees 'listed,- below have been. duly examined by a local physician and each has been designated as a "first class risk". These employees are eligible for pension membership as noted in the Pension Eligibility Date column below, and it is the recommendation of the Pension Advisory Committee that they be accepted into membership. Nam% JQ Class _& Deppl,/Div. Norma Skinner, Staff Assistant 11, Birth- Qate 4/18/37 Police Department *Employee hired from permanent part-time to full-time permanent status. Hire date reflects date hired as permanent part-time. George Savatovic, Sanitation Worker, 09/20/59 PublicWorks/Utilities/Solid Waste *Employee hired from temporary to permanent status, Hire date reflects date hired as temporary. Timothy C. Geary, Recreation Leader, 12/24/57 Marine Department *Employee hired from permanent part-time to full-time permanent status. Hire date reflects date hired as permanent part-time. JacquaIyn DeGroy, Staff Assistant lil, 05/14/42 Public Information Office/Economic Development *Employee was originally denied pension participation. Re-examined and approved for pension on '10/22/92. Ruben' J. Hernandez, Firefighter 07/30/62 Fire Department William F. Keller, Jr., 06/13/63 Pension Elig. Him Data D= 01/02/90 10/5/92* 06/01/92 . 10/26/92* 12/16191 10/05/92* 10/15/90 10/22/92* 11/02/92 11/02/92 1 1 /02/92 1)/02/92 Firefighter/Paramedic Fire Department CLEARWATER CITY COMMISSION Agenda Cover Memorandum arta'r? 't'rustees of the Employee' Pension Fund Item N At 11/30/92 Meeting Date: Subject: Pension(s) To Be Granted Recommendation/Motion: Employee(s) listed below be granted a regular pension under Section(s) 26.34 and/or 26.37 of the Employees' Pension Plan as recommended by the Pension Advisory Committee. ? and that the appropriate officials be authorized to execute same. BACKGROUND:' ----- --- ---- - Namc Michael A. Bruscell, Police Lieutenant, Police Department, was employed by the City on October 2, 1972, , and began participating in the Pension Plan on that date. His- retirement will be effective on June 18, 1993, at the end of the day. Revlewed by: Originnting Dept Costs: Total Commission Action: Log HIV Human Res c Approved Budget C4 Approved w/conditions Purchasing All! ' User Dept.: ------ Currant FY IJ Denied Risk M mt. ? ., _ 9 Continued lo: DIS AJA- Funding Sourco; ACM Advertised: I.1 Capt. imp. Other Onto: I l Operating Attachments: Letter(s) Submitted by: Papor, Other_ Request Form Lid. Not ruquirad Allocled partios Approprlallon Codo,. City Manager D Nollllod LK1 Not rue}uirud Ll f`!one lit ?..-•C?iTC.?4'i['1i=Mme........ , C I T Y' O,F C'L E A.'R W A T E R POST OFFICE BOX 4748 CLEARWATER. FLORIDA 34618.4748 Personnel Department 462.6870 M. Honorable Mayor and Members -of the - City Commission as Trustees of the . Employees' Pension Plan FROM: Pension Advisory Committee COPIES: Michael A. Brusccli; Dan Deignan, Assistant Director of Administrative Service/ Finance Director, Employee's File SUBJECT: Regular Pension---Michael A. Bruscell DATE: November 4, 1992 The Pension Advisory Committee received an application for regular pension from Michael A. Bruscell • on November 3, 1992. Mr., Bruscell was employed by the City on October 2, 1972, and has been a participant in the Pension Plan since October 7, 1972. The amount of Mr. Bruscell's pension will be computed by the Finance Department at such time as his last five years of service and salary can be calculated. By motion made and duly carried at its meeting of November 4, 1992, the Pension Advisory Committee ' approved/recommended a regular pension based on years of service for Michael A. Bruscell in accordance with Section 26.34 of the City Code. This pension will be effective on a date to be determined. I hereby certify that the Pension Advisory Committee has approved the granting of a regular retirement pension for Micahel A. Brusccil and the above dates are correct. '144.-4 I ? =Chi it an, Pension Advisory Committee "Equal Employment and Affirmative Action Employer" r I PENSION REQUEST FORM I, Michael A. Bruacell do hereby apply. for retirement from the City. of Clearwater 'General Employees' Pension Plan. MY benefits date is October 2, 19.72 (Entry date into pension plan) My date of hire is October 2, 1972 My birthday, is November' 3, 1946 My job classification is Police Lieutenant and I work in the Po1ice De:parttnent. Services Division. My resignation date is_ November 13, 1992 The type of pension for which I am applying is (check only one): x Regular Pension based an years of service Job-connected Disability Pension Non-job-connected Disability Pension Pity spouse's name is: _ Kathleen ..__.., , Dependent children under the age of 18 and residing In my household are; (Print Child's Full Name) (Child's Date of Birth) I hereby certify all of the above to be true and correct: (Sign vinbez) 3, 1992 + NOTARY P BLIC. STATE OF FLORIOA. MY COMMISSION EXPIRES: JULY 11, 1994, (Date) •OND[O TNRU NOTARY PUPL,IC UHtJZAWRIT;A[G (Notary Public) .Y 1. ! r r r' 3 t 141 I?-•. • , ,• r ' • .• ' . CITY OF CLEARWATER f ; GENERAL EMPLOYEES' PENSION PLA:a OPTIONS - POLICE OFFICERS. ' OPTION #1: Employees can receive a lump sum payment for vacation and holiday pay and 112 of accrued sick leave at the. time- of separation from the City. There will be no ' 8% deduction for pension from 'this -lump sutra payment` nor will "this amount count as earnings in the calculation- of the. pension. The last . day of work will. be the termination date and pension benefits will begin the following day. OPTION #2: Employee can extend termination date by the time due for (Only available to vacation, holiday pay, and 1/2 of- accrued sick leave. einployees 'aired Termination date will be the final day of extended time. , prior to 10/1/90) Pension benefits will begin the following day. OPTION #3: Employees can split their accumulated sick time at '• (Only available to one-quarter pay and one-quarter early retirement time. That employees, hired portion received as one-quarter pay will not have 89'0 prior to 1011190) deducted for pension nor will it count as earnings in the calculation of the pension, The - portion applied toward early retirement time will be subject to the 8% pension deduction and will count- as earnings for pension calculations. Termination date will be the final day of extended time; pension benefits will begin the following day. I, Michael A. Bruscell an employee of the City of Clearwater, hereby apply for pension benefits under the General Employees' Pension Plan. I hereby certify that I fully understand the three options offered to me. I choose to retire using Option # 2 and wish ' my benefits to be calculated under this option. I understand that once this form is signed, my decision is irrevocable. EMPLOYEE'S SIGNATURE:,, &.. A_,.,_Q 110--36-9773 SOCIAL SECURITY #: _ W1T Ew ADDRESS: _ 1679 Spottswood Circle ??- Palm Harbor, FL 34683 DATE:„ November 3, 1992 000i . 1 ?`C ?u..r.?rr.Lr.....?.? -+.-?n_r....e...?.r.n.....w?tiar..?.+..__.?er.?........ ?..???.._. t CLEARWATER CITY COMMISSION Agenda Cover Memorandum item # I 1/3U/92 Trustees of the Employees' Pension Fund Meeting Dale: ' Subject: j .. Pension(s) To Be Granted I Recommendation/Motion: Individual(s) listed below be granted a widow's pension under Section(s) 26.36 and/or 26.37 of the Employees' Pension Plan as recommended by the Pension Advisory Committee. ? and that the appropriate officials be authorized to execute same. Mw? BACKGROUND: Name Sharon McAuley, widow of Gerard J. McAuley, Police Sergeant, Police Department, to be effective on October 26, 1992. Sgt. McAuley was employed by the City of Clearwater on April 9, -1973, and began participating in the Pension Plan on that date. He passed away on October 25, 1992. Benefits payable to Mrs. McAuley are based on the formula for a non-job-connected disability pension for Gerard McAuley (i.e. years of service tines 2 1/2% times the average salary for the last five years), Sgt. McAuley had 19 1/2 years of service. This pension is payable to Mrs. McAuley in the approximate amount of $22,902.51 per year for the first five years- (100%8) and in the amount of $11,451.26 per year (50%) thereafter, provided she does not remarry. Reviewed by: Originating Dept. Costs: Commission Action: Legal Human Reso cc Total ? Approved ' Pit- Sudget 0 Approved wlconditions Purchasing NA- User Dept.: - Denied Risk Mgmt...?. ??. Current FY U Continued to: DIS Nh" Source: Fundin _ - g ACM Advertised: Capt. Imp. A h Other Al ? Operating ttac ments: Date: Paper: 0 Other Letters Submitted by: [A• Not required Affected parties Appropriation Code: ? Notified lJ None City Manager 91 Not required , , ' • [ I BFI I , I , , ' • [ ' } } i C I T Y OF L E A R W A 'I' E R i POST OFFICE BOX 4748 CLEARWATER, FLORIDA 34618.4748 Personnel Departrn nl 462.8970 'ID Honorable Mayor and Members of the City Commission as Trustees of the . ` Employees' Pension Plan FROM: Pension Advisory Committee COPIES: Michael Laursen; Members, Pension Advisory Committee; Dan Deignan SUSJrECr: Pension for Sharon McAuley - Widow of Gerard McAuley DATE: November 4, 1992 The Pension Advisory Committee (PAC) received an application from Sharon E. McAuley, widow of Gerard J. McAuley, Police Sergeant, for a widow's pension. Sharon McAuley has been determined by the Pension Advisory Committee to meet the requirements of the Pension Plan for a widow's pension based on the following:' Gerard J. McAuley was (1) employed by the City on April 9, 1973; (2) began participating in the pension plan on April 9, 1973; and (3) passed away on October 25, 1992. By motion made and duly carried at its meeting of November 4, 1992, the Pension Advisory Committee approved the widow's pension for Mrs. McAuley in accordance with provisions of Section 26.36 of the City Code. This pension is to be effective October 26, 1992. The amount of Mrs. McAuley's pension will be calculated by the Finance Department according to the formula in the Pension Plan. I hereby certify that the Pension Advisory Committee has approved the granting of a widow's pension to Sharon E. McAuley, widow of Gerard J. McAuley and the above dates are correct. Chaff n, Pension Advisory Committee ''Equal Employment and Affirmative Action Employer" Clearwater, Fl. 34616 ' RE: Gerard McAuley, deceased To Wham It May Concern: The purpose of this letter is, to formally request pension benefits entitled to my family. I have attached a copy of my marriage license and a copy of the death certificate wi11 be sent to'you as soon as I receive it. My Social Security number is. 112-38-2454. I appreciate your expeditious processing of this matter. Sincerely, A. A as Aft- a on E. McAuley 29702 66th Way N. Clearwater, Fl, 34621 SEkt0% 0 CLEARWATER CITY COMMISSION Agenda Cover Memorandum item N' 11/30/92 -0?AFEA`???? Trustees of the Employees' Pension Fund MUeting pats: Subject- Pension(s) To Be Granted Recommendation/Motion: Ray Brock, Maintenance Worker I, Public Service Division, Public Works Department, be granted a non-jab-connected disability pension under Section(s) 26.84 of the Employees' Pension Plan as recommended by the Pension Advisory Committee. ? and that the appropriate officials be authorized to execute same. BACKGROUND: Ray Brock, Maintenance Worker I, Public Service Division, Public Works Department, was employed by the City on June 3, 1975, and began participating in the Pension Plan on December 4, 1975. He has a herniated disc which resulted In his application for a non-Job-connected disability pension. Mr. Brock submitted a letter from Dr. Douglas J. Welland (dated September 25, 1992) and Dr. Victor Bilotta (dated November 9, 1992) in support of his request for a non-Job-connected disability pension. Although Mr. Brock has applied for a non-job-connected disability, there is the possibility that his current spine problem Is related to an on-the-job injury he incurred several years ago. In view of this fact, Mr. Brock also submitted copies of the medical documentation contained in his City of Clearwater Worker's Compensation file. There is a Worker's Compensation claim pending for his current injury, but a final decision will not be rendered until after a hearing-to be held In January. If the ruling is in Mr. Brock's favor, he Is expected to request this pension be changed to a job-connected disability pension. Based on an average salary of approximately $18,046 over the past five years and u6sing the formula for computing a non-Job-connected disability pension, Mr. Brock's pension will approximate $7,218 annually. Charts from Finance which take into consideration mortality rates and age reflect the "present value cost of financing" this pension will be approximately $57,020.69. Reviewed by: Legal 4Z& Budget .. ^AJ14' Purchasing All;- Risk Mgmt. &Z& DIS NFL ACM ?Ksk ') - Other __ ALL Submitted by: City Manager Ori ineting Dept.vu' ' Costs: Human Resources User Dept.: Advertised: Date. Paper: V-Nol required Affected parties ? Notified Not required Total Current FY Funding Source: ? Capt. Imp. ? Operating ? Other Appropriation Code. Commission Action: ? Approved ? Approved wlconditions i? Denied ? Continued to: _ Attachments: ? None Letter(s) Request Form • 1. • VICTOR J. BILOTTA• M.o., P.A. BOMB & JOINT SURGERY' 1? } 2961 • 1sT AVE. NO. NOV f 9 ST. PETERSOURG. FLOR{CMA 33713 1 PHOnt 327.2727 . November 9 ..1992 .. < Mr. Mike•Larson City .of Clearwater- Human Resources P.O. Box 4748 Clearwater, Florida 346118-4748 RE: Ray Brock Dear Mr. Larson: .. Mr. Brock is a 59 year old male seen today complaining about sharp pain in his neck. He states that he injured his neck when he was lifting some heavy concrete above his head onto a truck. At that time,, he was working for the City of Clearwater. He does-not clearly remember the exact date of the injury., He continued to work after he did it, but was noting that his fingers and arms were numb and tingling. He thinks it was about four or five days later that he. sought medical attention. He noticed that his arm wa weak and he had to use his left arm to assist himself to move his right arm. He eventually did undergo a surgical procedure on the cervical epine and this procedure relieved the paresthesias in his right upper extremity. He says that he still has pain when he turns his head and some pain when he raises his right arm, but the severe pain that was constant and the numbness and tangling are not there any more. He also complains of some pain in the low back and left thigh area and he says that this came on following the surgery that he had on his neck. He says that his back is stiff he cannot lift or bend very well and he cannot stand for long periods of time because it makes his back hurt. He has, harl surgery on his right shoulder three to four years ago for recurrent dislocation of his shoulder. Apparently this was done by Dr. Schwab and he was working for the City of Clearwater at that time as a post hole digger when he injured his shoulder. The only medication he is taking right now is Extra Strength Tylenol for headaches that he gets at night. He says he is allergic to an antibiotic, but he cannot remember the name'of the medicine. He states at this time he rests about half the day because of pain in the neck and head and pain in the lower back. He-has received a restriction of no lifting above his head and is not allowed to lift more than 20-25' pounds and this 'restriction comes from Dr. Weiland who did his neck surgery. Social history reveals he smokes a pack of cigarettes a day, he drinks six beers a day and has two to three caps of coffee a day. Mr. Mike Larson City of Clearwater Human Resources RE : . Ray Brock November 9; 1992 Page 2 . His work history reveals that he worked as a heavy equipment operator for 18 years for the City of Clearwater and did concrete work for about six to seven months, prior to his injury. He has not returned to work since four or five days post injury. He denies any other significant injuries. Family history reveals that he'is married and has been married for 26 years. He has five children. He says they are all in good health. He has one diabetic sister. He has four deceased brothers from heart disease,.cerebral vascular accident, war wounds and one from cirrhosis with alcoholism. He knows of no family history of significant neck or back problems. The only, other records that he has is a letter from Dr. Weiland assigning him a 15% permanent impairment of the whole body and this was following his cervical fusion. We did not have any of the office notes or surgical records available to us at this time. There is no history or dates on his accident or treatment prior to his referral to the Florida Spine Institute. There are no notes regarding his rehabilitation. In addition, it is noted that Mr. Brock is a rather poor historian. Physical examination reveals a 511011, 165 pound, right handed male who was in no acute distress. He is able to walk about the office today without a limp. Be does get on and off the exam table slowly, complaining of pain in his low back when he does so. There is limited motion in the cervical spine. He rotates 30 degrees to the right, about 25 degrees to the left. He dorsiflexes 30 degrees. He can forward flex and put his chin on his chest. Left and right lateral bending are limited to 15 degrees left and 30 degrees right. Left rotation and left lateral bending seem to give him the most pain. He has a negative 5purling's test today. He also has a healed surgical scar to the left of the midline anteriorly in the neck. Examination of his shoulders reveals that he has marked limitation of motion in the right shoulder. He has 100 degrees of abduction, about 30 degrees of external rotation and 40 degrees of internal rotation. There is a healed surgical scar over the anterior aspect of the shoulder joint. He also has some pain associated with shoulder motion. Examination of the lower back reveals marked limitation of motion. Forward flexion is only about 20 degrees. Dorsiflexion is about 20 degrees. Left and right lateral bending are 30 degrees in both directions. He complains, of pain with all of these motions. Flexion of the left hip is limited. It is 0-80 degrees. He has some pain with flexion and pain with internal rotation which is to about 15 degrees. External rotation is to about 30 degrees with some complaints of mild pain and he does indicate the hip joint region when these motions are carried out. He also has bilateral hamstring tightness on straight leg raising, but no radicular pain Mr. Mike Larson City of Clearwater, Human Resources RE: Ray Brock November 9, 1992 Page 3 or back pain when this maneuver is carried out: He has 1+ biceps and 2+ triceps reflexes bilaterally. At the present time there is no forearm or hand weakness on the right as compared to the left. Sensory testing reveals hypesthesia in C-5,6 distribution on the right as compared to the left. He has no motor weakness that I can detect in the lower extremities and there are no sensory deficits present in his lower extremities at this time. Patellar and Achilles reflexes are 1+ and equal. He does have a healed surgical scar over the left iliac crest which served as a donor site for the bone for' his cervical fusion. This scar is not tender at the present time. He has no tenderness or swelling about the other joints. 'His peripheral pulses are intact and equal. He does have x-rays and he does have'an MRI. study available. The x-rays that we have are from July 16th and July 30th. These are cervical spine x- rays and he has an MRI from February 14th. The MRI'does show some disc bulging and stenosis at C-3,4, C-4,5 and C-5,6. C-3,4 and C- 4,5 appear to be the most severely involved and the pathology is best seen on T--2 images. There is disc bulging as well as some facet hypertrophy present on these films. There does not appear to be a great deal of compression of the spinal canal. On the standard x-rays, which I assume are postoperative, they are quite dank but it looks like there was a fusion done at C-3,4 and C-4,5. Again, on the standard x-rays cervical spondylosis is noted, particularly at the three levels where the changes were observed on the MRI. IMPRESSION: At this time Mr. Brock is post cervical laminectomy with what appears to be a two level fusion. He has residual signs and symptoms following this surgery. He also has limited motion in the cervical spine. His previously operated shoulder is not related to this specific injury and it is my opinion that the lower back and possible hip problems that he has are not related to this particular operation. At the present time he has had multiple levels operated with residual pain and rigidity present. It would be my opinion that at the present time, according to the Revised Third Edition of AMA Guidelines, he has a 13% permanent partial physical impairment of the body as a whole based on his cervical surgery and based on the injury that occurred that caused these particular symptoms and signs. Sincere , Victor J. Bilo a, M.D. VJB/plm 77te Sp1ne Cave Experts Ortbopeedic Spine Surgery Douglas A Weiland, M.D,, P.A. Elizabeth C. Sirna, M.D., P.A. Paul J. Zak, M.D. Physical Medicine & Rehabilitation Robert Q Gruber, DA, Constantine G Souchias, M.D. Neurology Sandra H. Roth, M.D. Neuroradlology C.P. Shah, M.D. Psychology Richard N. Frank, Ph. D. Spare Care Services Imaging Mill CT Scan Myelogram Spine Surgery Spinal Reconstructions Laser Discectomy Percutancous Fusions Scoliosis Spinal 5teno5is Herniated Discs Etectrodiagnostic Medicine VAG Nerve Conduction Study SSEP Neurological Assessment Spinal Disorders Headaches & Seizures Rehabilitation Services Physical Therapy Physical Reconditioning Aquatic Therapy Back School Arthritis Relief Psychological Services Evaluation & Treatment Pain Management Biofeedback Solt Tissue Injury Manipulation Physical Therapy Epidural Steroid Injections Trigger Point Injections Florida Spine Institute Florjdas Largest Center Devoted Entirely to Medical and Surgical Care of the Neck and Back September 15, 1992 TO WHOM IT MAY CONCERN Re: Ray Brock x`4402 Mr. Ray Brock is a patient of mine who had a - two-level herniated disc with increasing radiculopathy. This was markedly debilitating and, because of this, he was taken to surgery where he had a cervical fusion. The operation was very successful, and overall his pain has been markedly decreased. The cervical fusion looks very solid. However, I do not think he will ever return to full manual labor with heavy lifting. He will essentially be on a permanent light--duty disability, which I would define as lifting less than twenty-five (25) pounds on a moderate level, and he will not be able to do continued overhead work with his hands. I do believe that this disability is permanent. If one looks at the disability in regard to the Minnesota Medical. Guideline Tables we would rate this disability as approximately fifteen percent (15%) whole body. I, do believe the patient would benefit from another round of physical therapy over the next three to six weeks. But, other than this, I believe he has reached maximum medical improvement. Please contact me if T,.Ttiay be of any urther assistance. Sincerely, } .? L Douglas J. Weiland, M. ` DJW/rab cc: Attorney Workmen's Co"ensation 2250 Drew Street, Clearwater, Florida 34625 (613)79-SPINE • (813) 797.7463 • Fax (813) 726-1580 w i 1 sl?irlrSlR? Pvroonnd flRpu nwt 442.8870 CITY' OF C L E A R W A T E R POST OFFICE 'BOX 4746 CLEARWATER. FLORIOA 34618.4748 1 TQ Honorable Mayor and Members, of the City Commission ?as Trustees of the Employees' Pension Plan kROK, Pension Advisory Committee COPIES: Ray H. Brock; Risk Management; Dan De'ignan, Assistant Director of Administrative. Services/Finance Director; Employee's File SUBJECT:, Pension for Ray H. Brock-Non-job-connected Disability Pension DATE: October 7, 1992 The Pension Advisory Committee (PAC) received an application for disability pension from Ray H. Brock. on September 21, 1992. Mr. Brock has been determined by the Pension Advisory Committee to meet the requirements of the Pension Plan for a non-job-connected disability pension. He was employed by the City on June 3, 1975, and began participating in the pension plan on December 4, 1975 Further, he has submitted medical documentation, copies of which are attached, relative to his disability which has been reviewed and approved by the PAC. By motion made and duly carried at its meeting of October 7, 1992, the Pension Advisory Committee approved/recommended the granting of a non-job-connected disability pension to Mr. Brock in accordance with provisions of Section 26.34 of the City Code. This pension is to be effective on a date to be determined. The amount of Mr. Brock's pension will be calculated by the Finance Deparunent according to the formula in the Pension Plan for non-job-connnectcd disability pension at such time as his last five years of service and salary can be computed. I hereby certify that the Pension Advisory Committee has approved the granting of a non-job-connected disability pension for Ray H. Brock and that the above dates are correct. hairman, Pension Advisory Committee s ?q "Equal Employment and Affirmative Action Employer" PENSION REQUEST FORM d I. Ray H. Brock do hereby apply for retirement from the City of Clearwater General Employees' Pension Plan, My benefits date is December 4, 1975 ' (Entry date into pension plan) My -date of hire is June 3, 1975 My birthday is September 1, 1933 My job classification is Maintenance Worker I and I work in the Public Works Department. Public Service Division. M y resignation date is to be .determined The type of pension for which I am applying is (check only one): Regular Pension based on years of service Job-connected Disability Pension Non-job-connected Disability Pension My spouse's name is: Donna Jean Brock Dependent children under the age of 1S and residing in my household are. (Print Child's Full Name) (Child's Date of Birth) I hereby certify all of the above to be true and correct: ROLM Signature) eptember 21, 1992 (Date) (Notary P lic) 1407nRY P#JBLiC, 'SrX7t OF MIDRI()& MY, COMI%i1GSlON EXPIRES: JULY 11, 1!)94, ¦Ox DED TxhW marARr owuawc u uAcRwRIrCNf. ' CITY OF CLEARWATER GENERAL EMPLOYEES' PENSION PLAN OPTIONS - GENERAL EMPLOYEES OPTION #1: Employees can receive a lump sum payment for vacation and holiday pay and 1/2 of -accrued sick leave at the time of separation from the City. There will be no 9% deduction for pension from this lump sum payment nor will this, amount count as earnings in the calculation of the pension. The last day of work will be. the termination date and pension benefits will begin the following day. OPTION #2:• Employee can extend termination date by the time due (Only available to for vacation, holiday pay, and, 1/2 of accrued sick leave. Y employees hired Termination date will be the final day of extended time. prior to 10/1/90) Pension benefits will begin the following 'day. - IRay H. Brock an employee of the City of Clearwater, hereby apply for pension benefits under the General Employees' Pension Plan. I hereby certify that I fully understand the two options offered to me. I choose to retire using, Option # 1 and wish my benefits to be calculated under this option. I understand that once this form is signed, my, decision is irrevocable. EMPLOYEE'S SIGNATURE:- &4 SOCIAL SECURITY #: 263-44-3889 WITNESSES: ADDRESS: _ 1400 1/2 North Garden Avenue Clearwater, FL 34615-2430 00, V U`?l?C DATE: _ September 21, 1992 SEAt?? CLEARWATER CITY COMMISSION Agenda Cover Memorandum Item # y?Y?r`oa Trustees of the Employees' Pension Fund Meeting [?ate: t t/?o Subject: Amendment to Pension Advisory Committee Policies & Procedures Manual Recommendation/Motion: Approve a temporary amendment to the Pension Advisory Committee (PAC) Policies & Procedures Manual to allow a quorum of the PAC to vote on disability pensions until January 27, 1992. ? and that the appropriate officials be authorized to execute same. BACKGROUND: The Pension Advisory Committee (PAC) consists of three employees who are elected by a majority of the City employees covered by City pension. The Pension Advisory Committee Polices & Procedures Manual contains a provision in the policy for "Processing Disability Pension Requests" (No 9, page 8 of the Manual) which states that all three members of the Committee must be present when the Committee votes on disability pension requests. The PAC Policies & Procedures Manual was approved by the PAC and the Trustees. The pension ordinance itself does not contain any language relating to a requirement that all PAC members be present when , they vote on a disability pension request. Due to the illness of the Chairman of the PAC, this policy was temporarily amended for 90 days earlier this year to allow a quorum (two members) to vote on disability pension requests. Subsequently, an extension of this amendment was requested by the PAC and approved by the Trustees. At its meeting of October 7, 1992, the Committee voted to amend this policy again for an indefinite period of time due to the fact that Mr. Nicholson was expected to resign- shortly due to a permanent disability. Mr. Nicholson did resign effective October 21, 1992. The City Attorney's Office has advised that the action of the PAC in proposing an amendment to the policy is reasonable and appropriate. A vote by the PAC under these conditions will require a unanimous vote of the remaining members (two members represent a quorum and a split vote would not carry an approval action). Two votes represent the number of votes that would be required by the PAC to approve a disability pension even with all three members present. The City Cleric has scheduled an election for the employees in the Pension Plan to elect a replacement for Mr. Nicholson. The PAC requests approval by the Trustees of this policy amendment. Staff recommends the temporary amendment to be extended until the PAC election is held. (Election is scheduled for January 26, 1993.) h Reviewed by: Originating Dept.: P1 Commission Action: Legal ?,..? N/? uman Resour Total L-7 Approved .v Budget 0 Approved wlconditlons F'urchasin ??- g User Dept.: Denied C Risk Mgmt. &4' __ __ Current FY - ? Continued to: DIS & Funding Source: - ACM 1Z Advertised: l i Capt. Imp, Other A)A- Date: C Operating Attachments: Paper: C=? Other_ Submitted by: R Not required Affected parties Appropriation Code: ? Notified City Manager Not required L.1 None CLEARWATER CITY COMMISSION -? Agenda Cover Memorandum Item # 41 -raw rE9t?`?? Trustees of the Employees' Pension Fund Meeting Date: 1 1130 Subject: Medical Standards for Pension Physical Examinations Recommendation/Motion: Approve City of Clearwater Medical Standards r-1 and that the appropriate officials be authorized to execute same. BACKGROUND: The City of Clearwater Employees' Pension Plan provides that permanent employees of the City zball participate In the Pension Plan. The Plan also provides that those "...who have failed to pass a comprehensive physical exam and by reason of such fact have not been recommended for acceptance into the plan by the pension advisory committee..." shall be excepted from plan participation. In an effort to enhance the process of Identifying and administering a comprehensive physical exam while ensuring compliance with appropriate laws, such as the Americans with Disabilities Act (ADA), City staff has worked with medical and legal representatives over the past several years to establish a written manual for the City of Clearwater Medical Standards. As noted in the proposed manual, the ADA makes it unlawful for a covered employer to use standards, criteria, or methods of admission which are not job-related and consistent with business necessity and have the effect of discriminating on the basis of disability. The ADA also requires that "reasonable accommodation" be made for the known physical or mental limitation of an otherwise qualified Individual who is a fob applicant (unless the employer can demonstrate that the accommodation would impose an undue hardship). The medical standards are intended to provide general guidelines to be utilized by examining physicians to assist them In making recommendations as to placement in City of Clearwater employment. Medical standards for hire and for pension will be the same; thus, each applicant approved for hire In a full-time permanent position will be approved for pension. The City now Is implementing a process where factors of physical ability, working conditions, and other relevant job facts on an individual position basis are Identified and made available to the medical examiners. The combination of this Individual position assessment and the use of medical standards will enable the examining physicians to assess post-hire candidates to determine If they can perform essential job functions of the position with or without reasonable accommodation. The Pension Adviso.ry Committee approved the proposed medical standards at its meeting of September 2, 1992, and recommended adoption by the Pension Trustees. Reviewed by: Legal /}. Budget __&4 - Purchasing N/-` Risk Mgmt.!?- DIS ACM ' Other h-? Originating Dept.: Human Resource User Dept.: Advertised: Date: Pa: p: 9 Not required Affected parties 0 Notified &Not required Costs: &Lq= Total Current FY Funding Source: (-1 Capt. Imp, Operating i? Other..- Submitted by: City Manager Appropriation Code; Commission Action: Approved i7 Approved w/conditions iJ Denied Continued to: Attachments: i] None ,o . r • ,••_; '}. ' ? ' .f'r ? V .'. ,'-i il, j1 1= ',?I . i' ; 1 S .3 } ? . - . • • ' r r ? S ? ' , fi . 1. • r Y!. i fit,. •Sl i? ?. pi 1• . , .. ?Y . 1 ti - 1 • } ' • I J 1. r ? ?? t' ' .. , v ? t i' ? • ... . ' ' ' ' A; r,: e, s. Yl v ..?'"ah 272{{?et„FFJA'?:14;'F'°'rk:lA•y.r. r... ..„ `. rr.,.f.vwr..M`Kirf ?, r.+w.}$f>r^?r.!f i~.rr>9 1 ?r.?.r :«?. Y..L`rl r.. : .15-wpb i ?'i • '; f ` .- .,, n1?• i .. r. .... AUG 71992 ; CITY 'AF CUMNATER MEDICAL STANDARDS PREPARED FOR THE. CITY OF " • CEARi%TER BY PHYSICTim 10S PROFESSIONAL ' ' SERVICES IN CONJC3HCTION WITH THOHPSONF SIZEMORE & GONZALEZr P.A. CITY OF CLEARWATSE MRICAL STANDARDS IIML PAGE lblTRODUCTION.wso •.r.•.,..r.,...it w.•.•as so ..••.w....ww.r•..•.w•w•1 - 3 JOB GROUP DEFINITIONS ..... 0wr•••r•'••••r••wrswrrw.••assess •r••r w3 4 NOTE TO MEDICAL EXA4INBRS..r..•.......ww..•w.....rrw.......:...4 - 5 1. GENERAL APPEARANCE /HEIGHT AND WRIGHT••••..r•r•••r••.•.•.•5--6 -WEIGHT 2. EMS MW VISIUM•.••.•...•••.w••ww.w••r•.••.aaaaa •••••.•.••..6 " 11 ACUTE CONJUNCTIVITIS . BLINDNESS OR MONOCULAR VISION CHRONIC CONJUNCTIVITXS CORNEAL SCARS,, OFACITIESr OR CORNEAL ULCERS DIABETIC RETINOPATHY GLAucom ' IMPAIRED COLOR VISION IMPAIRED DEPTH PERCEPTION- IMPAIRED EYELID FUNCTION IMPAIRED FIELD OF VISION PROGRESSIVE) INCURABLE, OR INOPERABLE EYE MALIGNANCIES PTERYGIUM STRABISMUS VISUAL ACUITY XANTHELASMA 3• EARS AND H ARTZZG.••rwr•wrr•r••r•••....r ..............r.•.11 - 15 ACOUSTIC NEUROMA ACUTE AND CHRONIC INFEC'T'IONS OR SWELLING OF TSE EXTERNAL Ott INTERNAL EAR ACUTE MASTOIDITIS' CEREBELLAR DISORDERS EARDRUM RETRACTION,, PERFORATIONi OR BULGING EUSTACHIAN TUBE FUNCTION ABNORMALITIES SEARING DEFICIENCIES ..PROGRESSIVE,, INCURABLE;'OR INOPERABLE EAR MALIGNANCIES VERTIGO r I. ' r I i i I. ' 4 • • i i r i ' NOSEr MOUTH, A N D r . L H R O A i • .. • .. r .. w • • • • r . r 66064 **go • • • • Deals - 18 ACTINOHYCOSIO ALLERGIC RHINITIS ARTERITIS ARTIFICIAL LARYNX OR ESOPHAGEAL SPEECH ' BREATAxNV IMPAIRMENT AT NASAL LEVEL EPISTAXIS , MALIGNANT GROWTHS OF 'FACE, THROAT, OR MOUTH SPEECH * DEFECTS 5. SKIN ................«...................................1B - 21 BASAL CELL EPITHELxOHA CHRONIC ACTINIC DAMAGE CHRONIC FURUNCULOSIS' CHRONIC HAND ECSEMA HERPES ZOSTER IMPE'T'IGO LYMPHoHA MYCOSIS FUNGOIDES MALIGNANT MELANOMA OR OTHER SKIN MALIGNANCIES RAYNAUD'S DISEASE SEVERE NUMMuLAR ECZEMA SYSTEHIC LUPUS ERYTHEMATOSUS 6. RESPIRATORY SYSTEM ....................................... 21•- 26 BRONCHIAL ASTHMA BRONCHOGENIC CARCINOMA CHRONIC OBSTRUCTIVE PULMONARY DISEASE CYSTIC FIBROSIS, GOODPASTURE'S SYNDROME, AND FARMER ' S LUNG MALIGNANT MESOTHELIOMAA PULMONARY EMPHYSEMA PULMONARY TUBERCULOSIS TUBERCULOSIS TEST POSI'T'IVE REACTIONS 7. HEART AND PERIPHERAL VASCULAR SYSTEM............ ,........26 - 39 ANEURISM OF THE AORTA, THORACIC, OR ABDOMINAL ANEURISM BACTERIAL ENDOCARDITIS CARDIAC FAILURE CARDIAC PACEMAKER CIRCULATORY FAILURE COARCTATION OF THE AORTA CORONARY HEART DISEASE, FUNCTIONAL CLASS I, II, AND III CORONARY HEART DISEASE, FUNCTIONAL CLASS IV . COR PULMONALE CORONARY THROMBOSIS, INFARCTION, OR HEART BLOCK HEART MuRmuns • L. a,. » c r' r , i r t . ', s' . n . 1., r t ... r. , .. - . ..... _ 4 c ... .. ? i - 1 .. ... . . HEART VALVULAR OR'VESSEL DISEASE HYPERTESION MIT= STENOJIS MITRAL VALVE PROLAPSE OCCLUSIVE PERIPHERAL VASCULAR DISEASE RAPID PULSE RATE RECURRENT PAROXYSM)1L ATRIAL FIBRILLATION "SICK-SINUS SYNDROME SLOW PULSE RATE SUPRAVENTRICULAR DYSRYTHMIAS VARICOSE VEINS AND/OR ULCERATIONS VENTRICULAR ARRYTSMIAS 8. GASTROINTSSTnM SYSTEM ..................... ............39 -46 ACHALAsIs' ANAL FISTULAS AND HEMORRHOIDS CARCINOMA OF THE ESOPHAGUS OR PANCREASE CHRONIC PANCREATITIS CIRRHOSIS DIVERTICULITIS DYsPHAGIA ESOPHAGEAL SPASM ESOPHAGEAL VARICES HEPATITIS HERNIAS OF THE UMBILICUS INGUINALg, OR FEMORAL AREA ILEOSTOMYICOLOSTOMY LIVER ENZYl9E ELEVATION MALIGNANT DISEASE OF THE LIVER, GALLBLADDER, STOMACHl, INT£STINESj, RECTUM OR ANUS. PANCREATXTISr-ACUTE PEPTIC ULCER DISEASE AND DUODENAL ULCER DISEASE RECURRENT PANCREATITIS ULCERATIVE COLITIS AND CRONIC ENTERITIS (CROHNIs DISEASE) 9. GENITOURINARY SYSTEM rrr ..............•••rrr•••••••.••.••46 50 CHRONIC NEPHRITIS EPXDIDYMITIS HYDROCELE MALIGNANT DISEASE OF THE GENITOURINARY S USTEM ? PREGNANCY ' PROSTATIC HYPERTROPHY RECURRENT PYELITIS RENAL CALCULUS RENAL DIALYSIS RENAL FAILURE RENAL TRANSPLANT SINGLE KIDNEY r 111 ' 10. MUSCULOSKSLETALSY5TEM¦.•.•.•r.7•••••w.•.w•••••.•••••.¦.wS0-68 AMPUTATIONS" CHRONIC AND RECURREN'T' BACK DISORDERS CONTRACTURES,, PARALYSIS (INCLUDING KLIPPER"FEIL)i SPASTICITY,, OR ATROPEY 'COSTOTRANSVERSECTOMY DERANGL+MENT OIL' UPPER OR 'LoWER EXTREMITY FLAT FLOoT DEFORMITY FRACTURES JOINT FIXATION MALIGNANT DISEASE OF THE BONE OSTEOARTHRITIS OGTEOCHONDROSIS OSTEOKYLITIS RSEMATOID ARTHRITIS SCOLOSISp KYPSOSIS (WITH/WITHOUT GIBBUS) I VERTEBRAL DERANGEMENTS SEXILUNAR DISLOCATION SHOULDERF TPWRISTr OR ELBOW FUSION SPINAL FRACTURES INCLUDING COMPRESSION FRACTURES SPINE FUSION SPINAL STENOSIS WITH OR WITHOUT DECOMPRESSION SPONDYLOLISTHLSIS SURGICAL PROCEDURE OF BACK (DISCECTOMY, CYMOPAPAINj, FACET RHIZOTOMY) TUBERCULOSIS 11. NERVOUS SYSTEM ............ •••••.....,• .................068--76 CENTRAL NERVOUS SYS'T'EM INFECTIONS CEREBRAL PALSY CEREBRAL VASCULAR ACCIDENT CoNWLsIVE DISORDERS DEGENERATIVE DISORDERS AND EXTRAPYRAMIDAL DISORDERS (PARKINSONISXf PARALYSIS AGITANS f MULTIPLE SCLEROSIS OR MUSCULAR ATROPHIES) MALIGNANT DISEASE WITH OR WITHOUT METASTASIS OF THE BRAIN AND SPINAL CORD MINOR PARALYSIS MAJOR PARALYSIS (HEMIPLEGIAr PARAPLEGIA QUADRIPLEGIA) NERVE TRAUMA 12. ENDOCRINE, METABOLIC AND NUTRITIONAL SYSTEM .............76 -? 80 DIABETES DWARFISM HYPERCALCEMIA OR HYPOCALCEMIA OBESITY PANCREATIC CARCINOMA THYROID CARCINOMA iv l,Y?ti'',i.'',il'.f :; i.:. :'r` , .. „ - ?i, 'i!r `. •. - ;i. •7 . J. k .,,..oabvl`kt$?!?'e`,?',°,4C's.; t?;!}Y';'???.`a Ftn••,?..'s,. ,-.. ..._......n.<rHa.r>as..trf,,.,..-. .... .. .s ,r,.; •.. i ... ,r - .. .. ., .`,.. ... .{•',: s•i.r.'.? .. .? f. '' THYROID DISEASE '( HYPOT,SYROIDISHt' HYPERTHYROIDISH ? .. .. TEYROIDITIS .' ' 13. EaDUMPOXETIC A N D LYMpBATIC SYSTEMS ........... 09000 e v e 080 S 00 , A'.I.D.S. ANEHIA AcOTE LtuxLrmxA .' '. CHRoxtc GRmmOCYTlc LEuKEHIA CHRONIC LYMPHOCYTxc Lmmum A CLOTTING DISoRDERS AND HEHOPHILIA H.I.V. POSITIVE I' HODGKIN'S DISEASE NOi4-HODGKIN') s LYMPHOMA METASTIC DISEASE POLYCYTHEHIA SICKLE CELL DISEASE SICKLE' CELL TRAIT PSYCHO-SOCIAL w7 i. *7?.'• . • • • • • • • • • • w w . • • • . • ? • .. w • w w w w • . • .86 ? 87 ANxIETY DISORDERS DEPRESSION ' ORGANIC BRAIN SYNDROME, . ALZEIMER 'S DISEASE, OR r. DEMENTIA SCHIZOPHRENIA F s t • CITY OF CLEARWATER MEDICAL STANDARDS INTRODUCTION This Introduction ' Contains The Following Important Notation Which Muet-Be Read By A11 Physicians Prior To. Evaluating An Applicant For Employment. On July 26, 1992, the Americans with Disabilities Act (ADA)- went'into effect which provides as a general rule that no employer shall discriminate against a "qualified individual with a 'disability" because of the disability with regard to . . . hiring it is unlawful for the City of Clearwater to use standards, criteria or methods of admission which are not job related and .consistent with business necessity and that have the effect of discriminating on the basis of disability or that perpetuate the discrimination of others who.are subject to common administrative control. For public employers, this prohibition went into effect on January 26, 1992. it is unlawful for a the City of Clearwater not to make "reasonable accommodation" for the known physical or mental limitation of an otherwise "qualified" individual who is an applicant, unless the covered entity can demonstrate that the accommodation would impose a "undue hardship." , Qualified Individual-with a Disability: A "qualified individual with.a disability" means an individual with a disability who with or without reasonable accommodation can 1 perform the essential functions of the employment position that such individual desires. Essential Functions: The "essential functions" means the fundamental job duties of the employment position the individual holds or desires.. The essential job functions will be listed in the job.,description which will accompany each application. The I term "essential job functions" does not include "marginal functions of the position." It is necessary for the City of Clearwater to, initiate an informal interactive process with a qualified individual with a disability in order to determine what, if any, reasonable accommodation is necessary. Such a process should identify the precise limitations resulting from the disability and the potential reasonable accommodation that would overcome those limitations. The City of Clearwater is not required to accept an accommodation suggested by an employee with a disability which is not otherwise "reasonable," or if effectuated, would impose an undue hardship. Undue Hardship: An undue hardship is defined as an accommodation which cannot be made without significant difficulty or expense being incurred by the City of Clearwater. Undue hardship is measured in large part by the resources available to make accommodation. Physician's Role: The physician's role will be to provide the City with the information of what accommodation will be required, if any, to perform the desired position. The physician will also 2 r. e.. .. ti •1','1. 1 ifl.:. lr •. M.. •... ... .. t. ! r ., r ! t • a giver the City his/her opinion as whether accommodation is reasonable. The'City of Clearwater will also require the applicant after reasonable accommodation not-pose a direct threat to the health or safety of himself/herself, or other persons in the workplace. City of Clearwater Job'Grou Definitions: Applicants should be assessed to determine, if they can perform essential job- functions of the position desired with or without reasonable accommodation. Essential job functions are listed on job descriptions. in addition, the positions will also be classified into job groups'A, B. C or D. Those definitions are as follows: GROUP A: Jobs with tasks that require very limited physical exertion in a controlled environmental setting. Examples include some City of Clearwater office, supervisory, administrative, and managerial -positions. GROUP B: Jobs with tasks that require a limited amount of physical exertion and/or involve occasional work in confined spaces or in exposed areas. Applicants may come in contact with environmental factors such as sun, wind, high temperatures, and humidity. Many employees in this job group operate city vehicles. Examples include'City of Clearwater building maintenance crew leaders or supervisors, service attendants, standards inspectors, mechanical inspectors, or plumbing inspectors. 0 1 3 A • S MOUP C i .. i Jobs with tasks that.require a considerable amount of physical labor and/or involve prolonged exposure to potentially hazardous work conditions (e.g. working on ladders, scaffolds or in confined spaces). These job tasks additionally may involve exposure to environmental factors such as sun, wind, high temperatures, low temperatures, humidity, fumes, and dust. Examples include City of Clearwater sanitation workers, mechanical technicians, waste-water treatment plant workers,, tree trimmers or parks workers. GROUP D: Public Safety positions with tasks whose standards are regulated by a Florida Regulatory agency. These standards are addressed in a separate publication. Examples include City of Clearwater police officers and firefighters. Important Note: The City of Clearwater Medical Standards presented here are not all inclusive. An attempt was made to address those medical conditions which-occur most commonly. These standards a.re to be used only as general guidelines to assist the Medical Examiner in making a recommendation to place or not to place an applicant for City of Clearwater employment, post-hiring preplacement. Each applicant will be evaluated on an individual basis after an offer of employment has bee conditionally extended by the City. An- applicant with a combination of conditions which individually do not disqualify him/her for the applied position may still be disqualified if in the opinion of the medical examiner, 4 L ' the combination of conditioiig 'will ' interfere. with the applicant- *a ability to safely perform the'job. Some conditions may require a specialist's evaluation before a recommendation can 'be made and this should be stated on the, medical evaluation report. if additional medical history data is, required in order to make a recommendation concerning whether to place the applicant,. this too should be stated on the medical report. To provide additional medical history data, applicants may be required to submit medical evidence from their personal physician. Additional. diagnostic tests or medical' evaluations which may be necessary to evaluate the medical condition of the applicant and which are not included in the City of Clearwater's physical shall be done at the City of Clearwater's expense. The City of Clearwater reserves the right, at any time, to request that a City chosen specialist also evaluate the applicant prior to placement. Exclusionary criteria used as part of the additional examination will be job related and consistent with business necessity. This evaluation will be done at the City of Clearwater's expense. These standards were written to reflect the intent of the Americans with Disabilities Act of 1990 (AD.A). 1. Hei ht and Wei ht Assessment:' Applicant's height and weight shall be measured with a standardized measurement device.. 5 Standards:, Weight For job groups As, B, & C, gross obesity (greater than 50 pounds over ideal body weight for height/age) which is a result 'of a medical condition, as opposed to a voluntary condition, must not interfere with.the applicant's ability to perform the essential functions of the job desired with or without reasonable. accommodation. in addition, after reasonable accommodation, an applicant who is grossly obese as a result of a medical condition must not pose a direct threat to the health or safety of the individuals or others in the workplace. '(Voluntary gross obesity,is not a disability runless it is associated with an accompanying disability like hypertension, sleep apnea, etc.) 2.-Eves and vision Assessment: A medical history and physical 'examination of the eye shall be performed. Distance vision and near vision shall be evaluated under standard conditions of illumination with a standardized vision measurement instrument. Individuals who normally wear corrective lenses shall be tested with and without these corrective devices. Color vision, peripheral vision and depth perception shall be tested using a standardized vision measurement device. Interoceular pressures shall be tested using a standard measurement device when the history or physical examination suggests tonometry is indicated. I- . 1 Standards: Acute Conjunctiviitis Acute conjunctivitis is.acaeptable for job groups A, B and C, unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. Blindness or Monocular Vision Blindness in one or both eyes is acceptable unless, a certain degree of visual acuities is an essential function of the position desired which cannot be reasonably accommodated. For jobs which require visual standards mandated by DOT or other government agencies, such governmental standards shall be used to determine qualification. Chronic Conjunctivitis Chronic conjunctivitis is acceptable for job groups A, B and C, unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. Corneal Scars, Opacities, or Corneal Ulcers Corneal scars, opacities, or corneal, ulcers are acceptable for job groups A, B and C, unless, despite reasonable accommodation, the-condition interferes with the applicant's 7 ability to perform the essential functions of the job desired or the individual poses a direct threat to the health or safety of the individual or others in the workplace. Diabetic Retinopathy Diabetic retinopathy is acceptable for job groups A, B and Cl unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the individual poses a direct threat to the health or safety of the individual or others in the workplace. Glaucoma Glaucoma is acceptable for job groups A, B and C, unless, despite reasonable accommodation, this condition interferes with 'the applicant's ability to' perform the essential functions of the job desired or the individual would pose a direct threat to the health or safety of the individual or others in the workplace. Impaired Color Vision Impaired color vision is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of himself or others in the workplace. For jobs which require visual standards, mandated by the DOT or other federal governmental agencies, 8 r : such federal governmental standards shall be used to determine qualification. Impaired Depth Perception (and Monocular Vision) Impaired depth perception is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job or the applicant would pose a direct threat to the health or safety of the individual or others in the workplace. For jobs which require visual standards mandated by DOT or other federal government agencies, such federal government standards shall be used to determine qualifications. See: monocular vision. Impaired Eyelid Function Impaired eyelid function is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the individual or others in the workplace. Safety glasses use is recommended for individuals whose job functions may involve eye hazards. Impa'-:ed Field of Vision (and Monocular Vision) Impaired field of vision is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would I pose a direct threat to the health or safety of the applicant 9 or 'others in the workplace. For jobs which require visual standards' mandated by DOT or other federal governmental agency, such federal government standards shall be used to determine qualifications. See: monocular vision. Progressive, Incurable, or Inoperable Eye Malignancies Progressive, incurable' or inoperable eye malignancies are. unacceptable for groups At B and C if at the time of application, despite reasonable accommodation, the condition interferes with' the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the individual or others in the workplace. Pterygium Pterygium is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the individual or others in the workplace. Strabismus Strabismus is acceptable for job groups A, B and C unless, diplopia is present and would, despite reasonable accommodation, interfere with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety .of .the applicant or others in the workplace. 10 Visual Acuity Visual acuity less than 20/50 corrected, in one or both eyes is 3 acceptable in job groups A. B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. For jobs which require reasonable standards mandated by DOT or other federal governmental, agencies,,- such federal government standards shall be used to determine qualifications. See: monocular vision. Xanthelasma Xanthelasma is acceptable for job groups A. B and C'unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses a direct threat to the health or safety of the individual or others in the workplace. 3. Ears and Hearing i Assessment: Examination of the ear canal and eardrum shall be performed using a standard otoscope. A complete medical history shall be taken to include questions regarding noise exposure, previous medical ear problems, ear pain, etc. Eardrum movement examination with an air bulb or valsalva maneuver and eustachian tube examination shall be performed when findings 11 5 on the - history or physical indicate this is necessary., Applicants with job.tasks which include moderate or greater exposures to extreme noise conditions shall , have an audiometric evaluation. Audiometry, when mandated by OSHA, shall be done using a standardized, sound proof booth which is OSHA approved and which is capable of testing.pure air tones ,in the 500 to 8000-Hz frequencies. Audiometry not regulated by OSHA may be done using a reliable audiometric device. Standards:, Acoustic Neuroma Acoustic neuroma is unacceptable for job groups A, B and Cr if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the position of the job desired or the applicant poses a direct threat -to the health or safety of the applicant or others in the workplace. Acute or Chronic Infections or Swelling of the External or Internal Ear Acute or chronic infection or swelling of the external or internal ear canal is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant pose's a direct threat to the health or safety of the individual or others in the workplace. An essential job function should not entail head immersion in water (e.g. Beach Guard, Pool Guard) Unless this impairment can be reasonably accommodated. 12 r .- - Acute Mastoiditis Acute mastoiditis is acceptable for job groups A, B and C unless, despite reasonable accommodation, the applicant is unable to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or .safety of the applicant or others in the workplace. Cerebellar Disorders Cerebellar disorders may be acceptable for job groups A'. This condition may be unacceptable for job groups B and C depending upon'the severity of the individual symptoms and depending on the essential job functions. Normally jobs which require work at heights, driving or heavy equipment use are unacceptable for individuals with this condition. In any case, the individual's ability to perform the essential functions of the job with or without accommodation must be evaluated. If after reasonable accommodation, the individual is unable to perform the essential job functions or poses a direct threat to the health or safety of himself or others in the workplace, the employment offer will be withdrawn. Eardrum Retraction, Perforation, or Bulging Eardrum retraction, perforation, or bulging is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. 13 Eustachian Tube Function Abnormalities Eustachian tube function abnormalities are acceptable for job groups .P Band C except in jobs whose essential job functions require exposure to extreme changes in barometric pressure unless this condition can be reasonably accommodated and the individual would not .pose a direct threat to the health or safety to himself or others in the workplace. Hearing Deficiency Hearing deficiency with or without hearing aids may be acceptable depending on the essential functions of the job and reasonable accommodation available and communication abilities of the applicant. 'Hearing deficiencies may be acceptable for job groups A, B and C unless, despite reasonable. accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the individual would pose a direct threat to the health or safety of himself or others in the workplace. Progressive, Incurable or Inoperable Ear Malignancies Progressive, incurable or inoperable ear malignancies are not acceptable for job groups A, B or C if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's, ability to perform the essential functions of the job desired or-the applicant poses a direct threat to the health or safety. of, the applicant or others in the workplace. 14 Vertigo Vertigo, or dizziness may be acceptable for job groups A, B and C depending on the severity of the dizziness vertigo will be acceptable for groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to,the health or safety of the individual or others in the workplace. Nose. Mouth and Throat Assessments: A medical history and physical examination shall be performed to include questions regarding previous medical ear, mouth, or nose problems. The physical examination shall include an examination of the nose, throat, and mouth as well as an examination of the sinuses and palpation of the sides of the neck to check for masses or enlarged lymph nodes. Standards: Actinomycosis Actinomycosis is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. 15 f Allergic'Rhinitis. Allergic Rhinitis, seasonal or perennial, is acceptable for job groups A, B and C' unless the job functions involves exposure to allergens which would render the applicant unable to perform the essential functions of the job with or without reasonable accommodation. Allergies requiring. medication which sedate the applicant shall be evaluated with particular concern if' the position desired involves the operation of motor vehicles or machinery. If after reasonable accommodation, the applicant would pose a direct threat to the health or safety of himself or others, the employment offer will be withdrawn. Arteritis Arteritis is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform . the essential functions of the job desired or the applicant would pose a direct threat to the applicant or others in the workplace. Artificial Larynx or Esophageal Speech Artificial larynx, esophageal speech and surgical extension of maxillofacial or orofacial malignant growth is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential function of the job desired. Further, applicants will be denied employment if the position desired involves exposure to toxic conditions, infections or 16 k. 0 chemical irritants which, after reasonable accommodation, still pose a direct threat to the health or safety. of the applicant or others in the workplace, Breathing Impairment at Nasal Level (e.g. Cleft Palate Deformity) Breathing impairment at the nasal level is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's essential functions of the job desired. (Essential functions. like use of respirators.) If after reasonable accommodation, the applicant would pose a direct threat to the health or.safety of the applicant or others in 'the workplace, further employment would be denied. Epistaxis Epistaxis is acceptable for jobs At B and C provided the condition does not interfere-with the applicant's ability to perform the essential functions of the job. Further, after reasonable accommodation the applicant. should not pose a direct threat to the health or safety of the applicant or others in the workplace. Progressive,. Incurable, Inoperable Malignancies of the Face, Threat, Mouth or Nose Malignancies of the face, throat, mouth or nose if progressive, incurable, or inoperable are unacceptable for job groups A, B and C if at the time of the application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the 17 dwk+ job desired or the applicant poses a direct threat to 'the health. or safety of the individual or others -in the workplace. Speech Defects Speech defects are acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses a direct threat to the health or safety of the applicant or others in the, workplace. 5. Skin Assessment: Examination of the skin shall be conducted in good light. While the applicant does not have to be totally disrobed,- if history suggests a skin disease the entire skin shall be examined. The examination shall be systematic and descriptions shall be given of distribution and location of eruptions. Description shall also be given of other findings such as skin color, scaling, infections, or induration. Standards: Basal Cell Epithelioma Basal cell epithel.ioma is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses a direct threat to the applicant or others in the workplace. 18 6EL' Chronic Actinic Damage Chronic actinic damage is unacceptable for positions with high sun exposure if the applicant poses a direct, threat to the health or, safety of the applicant or others in the workplace after'reasonable accommodation. Chronic Furunculosis Chronic furunculosis is acceptable for job groups A. B and C. unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Herpes Zoster Herpes zoster is acceptable for groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Impetigo Impetigo is acceptable for job groups A, B and C if the condition is treated and controlled and does not interfere with the applicant's ability to perform the essential ,functions of the job.. 19 i r, . Mycosis Fungoides. Mycosis fungoides is unacceptable for job groups A, B and C if at the time of application, despite reasonable accommodation,. the condition interferes with the applicant's ability to perform. the essential functions of the Job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Progressive, Incurable, or Inoperable Skin Malignancies Skin malignancies are unacceptable for job groups At B and C if at. the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety. of the applicant or others in the workplace. Raynaud's Disease Raynaud's disease is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. An essential function of the job should not be exposure to cold temperatures unless, the essential job function can be reasonably accommodated. The disease must be nongangrenous. 20 Severe Nummular Eczema Severe nummular eczema is acceptable for job.groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform,, the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. The essential functions of the job should not entail aggravating exposure, unless this exposure can be reasonably accommodated. The applicant may be required to wear protective clothing. Systemic Lupus Erythematosus Systemic lupus erythematosus is acceptable for job groups A, B and C unless, despite reasonable accommodation, the symptoms interfere with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or. safety of the applicant or others in the workplace. 6. Res irato S stems Assessment: The examination of the lungs and check shall include a history of present and past respiratory and/or chest diseases. Exam shall include percussion and auscultation. The spinal column and chest wall shall be inspected. Pulmonary function testing shall be performed, when applicable, on all applications for job groups B and C. 21 t Standards: Bronchial Asthma Bronchial asthma, medically controlled, is acceptable for job groups A and B unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Exposure 'to extreme cold air should not be. an essential job function unless, reasonable accommodation can be made. When reasonable accommodation is made, the condition should not interfere with the applicant's ability to 'perform the essential functions of the job. Further, the applicant must not pose a direct to the health or safety of the applicant or others in the workplace. Bronchial asthma is acceptable for job groups B unless FEV I is less than'sixty percent of normal lung functioning for applicant's height and age and the symptoms interfere with the applicant's ability to perform the essential functions of the job desired, despite reasonable accommodation. Job group C positions generally require at least a moderate amount of strength, stamina and endurance for job group C. For job group C the condition is acceptable unless the FEV is less than seventy- five-percent of normal lung capacity for height and age and the symptoms interfere with the applicant's ability to perform essential functions of the job despite reasonable accommodation. Individuals with this condition who are 22 .". cigarette smokers shall be evaluated for job groups A. B and C with special attention given to the specific ability of the applicant to perform the essential functions of the job with or without reasonable accommodation. The medical' exarainer shall take into consideration the aggravating component of cigarette smoking on this condition and the possibility of greater functional impairment under these circumstances. Bronchogenic Carcinoma Bronchogenic carcinoma with or without metastasis is unacceptable for job groups A. B and C (except in cases with small peripheral lesions without metastasis have been surgically treated) if at the time of the application, despite reasonable accommodation the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. i Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease is acceptable for job group A. For job group B this condition is acceptable unless FEV 1 is less than sixty percent of normal lung function for the applicant's height or age and despite reasonable accommodation the condition interferes with the applicant's ability to perform the essential functions of the'job. Job group C positions generally require at least a moderate amount of strength, stamina and endurance. For job group C this condition is acceptable, unless FEW 2 is less than seventy-- 23 !S five percent of normal lung functioning for, height and age an the symptoms interfere with the applicant's ability to perform the essential functions of the job, despite reasonable accommodation. Applicants will also be excluded if they would pose a direct threat to the health or safety of the applicant or others in the workplace, despite reasonable accommodation. An essential job function for all groups must not include exposure to very cold air unless this requirement can be reasonably accommodated. Individuals with this condition-who are cigarette smokers shall be evaluated for job groups A, B and C with special attention given to the specific ability of the applicant to perform the essential functions of the job with or without reasonable accommodation. The medical examiner shall take into consideration the aggravating component of cigarette smoking on this condition and the possibility of greater functional impairment under these circumstances. Cystic Fibrosis, Goodpasture's Syndrome, and Farmer's Lung Cystic fibrosis, Goodpasture's syndrome and Farmer's lung are acceptable for job groups A, B. and C unless, despite reasonable accommodation, any of these conditions interfere with the applicant's ability to perform the essential function of the job or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. 24 E ? Malignant Mesothelioma Malignant mesothelioma is unacceptable for job groups A, B and C if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Pulmonary:Emphysema See bronchial asthma standard. Pulmonary Emphysema is acceptable for job groups A, B and C if standards meet the pulmonary function criteria and the bronchial asthma standard. This condition must not interfere with the applicant's ability to perform the essential function.of the job desired, with or without reasonable accommodation. individuals with this condition who are cigarette smokers shall be evaluated for job groups A, B and C with special attention given to the specific ability of the applicant to perform the essential functions of the job with or without reasonable accommodation. The medical examiner shall take into consideration the aggravating components of the cigarette smoking on those conditions. Pulmonary Tuberculosis Pulmonary tuberculosis is acceptable for job groups A, B and. C if tuberculosis is non-cavitary, inactive and at least three weeks of chemotherapy has been given to previously active tuberculosis patients. Applicants with active tuberculosis 25 Li who have not been treated for three weeks are unacceptable as they pose a direct threat to others in the workplace. Tuberculosis Test Positive Reactions Applicants with positive T.B. tests will be required. to be medically treated and cleared by the Pinellas County Health Unit or by a Florida licensed physician prior to placement. See standard for pulmonary Tuberculosis. Not all applicants with. positive tuberculin skin tests have tuberculosis. Applicants with positive T.B. skin tests who do not have chest x-ray-findings consistent with tuberculosis or positive skin cultures shall not be assumed to have pulmonary tuberculosis. 7. Heart and Peri hera1 Vascular S stem Assessment: The examination of the heart and peripheral vascular system shall include a past medical history as well as a history of current heart and peripheral vascular conditions. The physical examination shall include a blood pressure reading, heart auscultation, and palpation when applicable. The functional classification of each applicant is of utmost importance and shall be matched to the applicant's job requirements before a hiring decision is made. An EKG shall be performed on all applicants for job group C. Standards: Aneurism of the Aorta, Thoracic, or Abdominal Aneurism Aneurism are acceptable for job groups A. B and C, if surgically corrected or if at the time of application, despite 26 L. ' ' reasonable accommodation, the condition does not interfere with the applicant's ability' to perform the essential functions of the job desired and the applicant does not pose m direct threat, to the health or safety of the applicant or others in the workplace,' Bacterial Endocarditis Bacterial Endocarditis is acceptable for job groups A. B and C if, inactive and the individual has been medically cleared by a licensed physician. Cardiac Failure Cardiac failure is acceptable for job' groups, A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. A consultation with the applicant's physician may be necessary to determine the applicant's specific essential job functions capacity, what reasonable accommodation is needed, if any, and whether the applicant after reasonable accommodation poses a direct threat to the health or safety of the applicant or others in the workplace. Such a direct threat shall exclude the applicant from further employment. Cardiac Pacemaker Cardiac pacemaker is acceptable for job.groups A, B and C if the pacemaker is checked by a licensed physician every three 27 ;" months- and symptoms co not interxere witn the app.icant-s Ability to perform the essential functions of the job with or . without reasonable accommodation. A consultation with the applicant's physician may be necessary to determine the specific' essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. in addition, the City of Clearwater may request that a'City selected cardiologist also evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodations are needed, if any. After reasonable accommodation, performance of essential job functions which may pose a direct threat to the health or safety of 'the applicant or -others in the workplace shall be carefully. considered. Such a direct threat shall exclude the applicant from further employment. There are two (2) types of cardiac pacemakers. One type is unipolar, and the other type is 'bipolar. The unipolar pacemakers are unacceptable for job groups which involve work with microwaves or work in high electromagnetic fields such as welders. See coronary disease standards. Circulatory Failure Circulatory failure with shortness of breath, pain or exertion, or enlarged pulsating neck veins is unacceptable for all job groups-if the symptoms rendered the applicant unable to perform the essential'funetions of the job with or without reasonable accommodation. Additionally, the applicant must '28 F t` ? not pose a. health risk or direct threat to the health or safety of himself or others in the workplace. Coarctation of the Aorta Coarctation of the aorta is acceptable for, job groups A. H and C providing the applicant can perform the essential functions of the job with or without reasonable accommodation. Further,, after reasonable accommodation, the applicant should not pose a direct threat to the health or safety of the applicant or others in the workplace. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected cardiologist also evaluate the applicant to assess the specific job functions capacity and what reasonable accommodations are needed, if any. After reasonable accommodation, performance of essential job functions which might pose a direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered when assessing the applicant's ability to perform the essential functions of the job. Such a direct threat shall exclude the applicant from further employment. Coronary Heart Disease, Functional Class 1, 11, and III Coronary heart disease, functional class I. II, and III may be acceptable for job group A if the applicant is capable of performing the essential functions of the job desired with or without reasonable accommodation. Functional Class I and II 29 F E W . is . •,array be acceptable for job'group B. However, each applicant shall be evaluated to determine -the individual essential job functions capacity with or without reasonable accommodation. Further, after reasonable accommodation, the applicant may not pose a direct threat to the health or safety 'of himself or others in the workplace. Functional Class III is unacceptable for job groups B or C if at the time of the application, ' despite reasonable accommodation, the condition interferes with.the applicant's ability to perform the essential functions.of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Applicants shall be assessed individually considering their ability to safely perform essential job functions and what reasonable accommodation is needed, if any. `A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. After reasonable accommodation, performance of essential job functions which may pose a direct threat to the health or safety of the' applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further employment. Coronary Heart Disease, Functional Class IV (e.g. severe angina) Functional Class IV coronary heart disease is unacceptable for all job groups if, despite reasonable accommodation the 30 condition renders the applicant unable to perform the 0 ' essential functions of the job desired or, poses a direct. threat to the health or safety of the applicant'or others in the workplace. Cor Pulmonale Functional Class IV, cot pulmonale heart disease is unacceptable for all job groups if, despite reasonable accommodation, the condition renders the applicant unable to perform the essential-functions of the job or the. applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Coronary Thrombosis, Infarction, or Heart Block History of coronary thrombosis, infarction, or heart block may be acceptable for job, groups A, B and C if a complete cardiology evaluation is performed by a licensed cardiologist who certifies that the condition will not interfere with-the applicant's ability to perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation, the applicant may not pose a direct threat to the health or safety of himself or others in the workplace. A consultation with the applicant's physician may be necessary to determine the specific functional capacities of the applicant and'what reasonable accommodation is needed, if any, N 31 % Heart Murmurs Heart murmurs are acceptable for job groups A. B- &C if symptoms do not interfere with the applicant's ability to perform the essential function of the job which he/she desires, with or without reasonable accommodation. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In'addition, the City of Clearwater may request that a City selected cardiologist also evaluate the applicant to assess specific essential job functions capacity and what reasonable accommodation is needed, if any. After reasonable accommodation, whether the applicant may, pore a direct threat of the health and safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further employment. Heart Valvular or Vessel Disease Heart valvular or vessel disease (with or without murmur) is acceptable for job groups A' and B, if symptoms do not interfere with the applicant's ability to perform the essential functions of the job desired, with or without reasonable accommodation. Applicant's with this condition may not qualify for job group C. The standards for pulmonary heart disease functional class I, II and III apply for valvular and vessel disease as well. Please refer to those standards for further. guidance. The applicant's licensed 32 l.J f? cardiologist must deem the patient capable of,performing the r essential functions of the job with or without reasonable accommodation and without being a direct threat to, the health. or safety oi,the applicant or others in the workplace. Class IV valvular disease is unacceptable unless the applicant can perform the essential functions of the job desired with''or without reasonable accommodation. Further after reasonable accommodation the applicant must-not pose a direct-threat to .the applicant or others in the workplace. A consultation with the applicant's physician may be necessary to determine the essential job functions capacity of the applicant and what accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected cardiologist also evaluate the applicant to assess specific essential job functions capacity and what reasonable accommodation is needed, if any. After reasonable accommodation, whether the applicant poses a direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further consideration. Hypertension (Blood Pressure Persistently > 140/90): Hypertension is acceptable for job groups A, B s C if the condition does not interfere with the applicant's ability to safely perform the essential functions. of the job desired, with or without reasonable accommodation. A consultation with the applicant's 33 physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the city of Clearwater may request that a City selected cardiologist also evaluate the applicant and assess the specific essential job functions capacity and what reasonable accommodation is needed, if any. After reasonable accommodation whether the ,applicant may pose a direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further employment. Mitral Stenosis Mitral Stenosis is acceptable for Job groups A, B, and C providing the symptoms of the condition do not interfere with the applicant's ability to safety perform the essential functions of the job with or without reasonable accommodation. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected cardiologist also evaluate the applicant to assess specific essential job functions capacity and what, reasonable accommodation is needed, if any. After reasonable accommodation, whether the applicant will pose a direct threat to the health or safety of the .applicant or others in the 34 .i workplace shall be carefully considered., Such a direct threat M . shall exclude the applicant from further employment. Occlusive Peripheral Vascular'Disease with/without Bruit Occlusive peripheral vascular disease or claudication is, 'unacceptable for job groups A, B. and C if gangrenous or if symptoms interfere with applicant's ability to safely perform the essential functions of the job desired with or without .reasonable accommodation of the job. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. in addition, the City of Clearwater may request that a' City selected cardiologist also evaluate the applicant to assess specific essential job functions capacity and reasonable accommodation needed, if any. After reasonable accommodation, whether the applicant poses a direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further consideration. Rapid Pulse Rate (Pulse persistently > 100) Rapid pulse rate is acceptable for Job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. . 35 Recurrent Paroxysmal Atrial Fibrillation Recurrent paroxysmal atrial fibrillation may be acceptable for job groups A, B & C so long as the applicant can perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation, the applicant must not pose a.'direct threat to the health 'or safety of the applicant or others in the workplace. The applicant shall provide the examiner with a specialist report which certifies the applicant's ability to safely perform the essential functions of the job desired and what reasonable accommodation is needed, if any. A consultation of the applicant's physician may be necessary to determine the .specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition the City of Clearwater. may request that a City selected cardiologist also evaluate the applicant to assess his/her specific job functions capacity and what reasonable accommodation is needed, if any. After reasonable accommodation, whether the applicant poses a. direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered.' Such a direct threat shall exclude the applicant from further employment. "Sick Sinus Syndrome" "Sick sinus syndrome" associated with syncope, long pauses between heart beats and/or dizzy spells or fainting is unacceptable for job groups A, B and C, unless the applicant 36 f can perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation the applicant must not pose a direct threat to the health or safety of the individual or others in the workplace. Such a direct threat shall exclude the applicant from further employment. Slow Pulse Rate (<64 bmp) Slow pulse rate is acceptable for job groups Al B & C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential, functions of the job desired or the applicant would pose a direct threat to the health or safety of the. applicant or others in the workplace. Supraventricular Dysrythmias (including PAT) Supraventricular dysrythmias are acceptable for job groups A. B and C if the applicant's licensed cardiologist certifies that the condition will not interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodation and what reasonable accommodation, if any, is needed. Furthermore, the applicant's cardiologist must certify that, after reasonable accommodation, performance of essential job function will not pose a direct threat to the health or safety of the applicant or others in the workplace. Such a direct threat shall . exclude the applicant from further employment. 37 ` Varicose Veins and/or Ulcerations Varicose veins and/or ulcerations are acceptable for job groups A, B and C. if conditions do not interfere with the applicant's ability to perform.the essential functions of the job desired with or without reasonable accommodation. A letter from a licensed physician must be presented, which deems the applicant capable of performing the essential. job functions of the job desired with or without reasonable accommodation. in addition, the applicant's physician must certify that with or without reasonable accommodation, the applicant will not pose a direct threat to the health or safety of the applicant or others in the workplace. Applicants applying for positions involving prolonged standing should be evaluated carefully to determine specific essential job functions capacity and a means to reasonably accommodate these essential job functions. Ventricular Arrhythmias Ventricular arrhythmias (other than rare, infrequent PVC's) are acceptable for job groups A, B, and C if a licensed j cardiologist after thorough exam reports that the condition will not interfere with the applicant's ability to perform the essential functions of the job desired and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine, the i specific job functions capacity of the applicant. In addition,. the City of Clearwater may request that a City 38 &a 4` selected cardiologist also evaluate the applicant to assess the specific essential job functions capacity and what i reasonable accommodation is needed, if any. After reasonable' accommodation, whether the applicant poses a direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat .shall exclude the applicant from further consideration.- s. Gastrointestinal System Assessment: A history and physical examination of the abdomen shall be performed. Questions regarding past and present medical gastrointestinal conditions are important. Inspection, auscultation, percussion and palpation of the abdomen shall be performed. A rectal examination shall be done on all males and females when indicated by the medical history or physical examination, on all applicants age 39 and over, or when specified in the medical report form. Standards : Achalasia Achalasia is acceptable for job groups A. B, and C, if the applicant's licensed physician after thorough evaluation reports that after reasonable accommodation, if any, the j condition will not interfere with the applicant's ability to i perform the essential functions of the job desired' and the applicant will not pose a direct threat to the health and safety to the applicant or others in the workplace. In 39 addition, the physician will report what reasonable accommodation is needed, if any. Anal Fistulas and Hemorrhoids Anal fistulas and hemorrhoids are acceptable for job groups A, BO. and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Carcinoma of the Esophagus or Pancreas Carcinoma of the esophagus or pancreas with or without metastasis is unacceptable for all job groups if at the time of .the application despite, reasonable accommodation, the condition interferes with the applicant's ability to perform i the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the individual or others in the workplace. Chronic Pancreatitis Chronic pancreatitis is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. Consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and the reasonable 40 .&1. 1 . F accommodation needed, if any. in addition, the City of Clearwater may request that a City .selected physician. also evaluate the applicant to assess the specific' essential job functions capacity and what reasonable accommodation is needed, if-any. After reasonable accommodation, whether the' applicant may, pose a direct threat to the health. or safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further employment. Cirrhosis Cirrhosis is acceptable for job groups A, B, and 'C if the condition does not interfere with the applicant's ability to perform the essential functions -of the,job which he/she desires with or without reasonable accommodation.' A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the'City of Clearwater may request that a City selected physician evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodation is needed, if any. After reasonable. accommodation, whether the applicant may pose a direct threat to the health or safety of the applicant or others in the workplace shall be carefully considered. Such a direct threat shall exclude the applicant from further employment. 41 Diverticuloeis Diverticulosis is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability -to, perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Dysphagia' Dysphagia is acceptable for job groups A, B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job or the applicant poses "a direct threat to the health or safety of the applicant or others in the workplace. Esophageal Spasm Esophageal spasm is acceptable in job groups A, B, and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the individual or others in the workplace. Esophageal Varices Esophageal'varices are acceptable.for job groups A, B, and C unless acute and uncontrolled such that the condition interferes with the applicant's ability to perform, the essential functions of the job desired with or without 42 } reasonable- accommodation. The applicant shall provide a report from a.licensed physician which deems the applicant's condition will not interfere with his/her ability to perform the essential functions of the job desired and what reasonable accommodation is needed, if any. Furthermore, the physician shall certify that with or without reasonable accommodation the applicant will not pose a direct threat to the applicant or others in the workplace. Hepatitis Acute hepatitis is unacceptable for.job groups A, B, and C if acute and liver enzymes have not returned to normal and the applicant poses a direct threat to' the health or safety of himself or others in the workplace. However, employment may, occur if after reasonable accommodation, at the time of the application, the condition does not interfere with the applicant's ability to perform the essential functions of the job desired; and the applicant does not pose "a direct threat to the health or safety of the applicant or others in the workplace. Chronic hepatitis is acceptable for groups A. B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to either perform the essential functions of the job or the applicant poses a direct threat to the health or safety of the applicant or others-in the workplace. 43 . ¦ Hernias of.the Umbilicus, Inguinal or Femoral Area These hernias are acceptable for job groups At B, and C providing the essential job requirements may not call for more thana minimum of static strength or that this essential job function can be reasonably accommodated such that the applicant can perform the essential.functions of the job and will not pose a direct threat to the health and safety, to the applicant or others in the workplace. Applicants with uncorrected hernias who are required to do any lifting shall be individually assessed to determine whether with or without reasonable accommodation, the applicant can perform the essential functions of the job and is not a direct threat to the health and safety of the applicant or others in the workplace. Ileostomy/Colostomy Functional ileostomy/colostomy is acceptable for job groups At B and 'C providing the applicant can perform the essential functions of the job desired with or without reasonable accommodation. The individual maintenance program must not interfere with his/her ability to perform the essential functions of the job with or without reasonable accommodation. Liver-Enzyme Elevation Significant liver enzyme elevations are acceptable for all job groups if a licensed physician who has thoroughly evaluated the applicant provides what reasonable accommodation is needed, if any, and that the condition and/or symptoms of the 44 condition do not interfere with the applicant's ability to perform the essential functions of the job desired. Further, the physician will certify that the applicant will not pose a direct threat to the health or safety to the applicant or others in the workplace. Malignant Disease of the Liver, Gallbladder, Stomach, Intestine, Rectum or Anus These diseases are unacceptable for all job groups, if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the.job desired or the applicant poses a direct threat to the health and safety of the applicant or others in the workplace. The applicant will present a report from a certified licensed physician who deems the applicant capable of performing the essential functions.of the job desired and specifying what reasonable accommodation is needed, if any. The examiner must concur with the licensed specialist that the symptoms of the condition do not interfere with the applicant's ability to perform the essential functions of the job. Applicants with mestastic disease are unacceptable for all job groups, providing at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the-health or safety of the applicant or others in the workplace. 45 6&'. Pancreatitis-Acute Acute pancreati.tis'is unacceptable for all job groups if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others-in the workplace. Peptic Ulcer Disease and Duodenal Ulcer Disease Peptic ulcer disease and duodenal ulcer disease are acceptable for job groups At B and C unless, despite reasonable accommodation, this condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Ulcerative Colitis and Chronic Enteritis (Crohns Disease) Ulcerative colitis and chronic enteritis is acceptable for job groups A. B, and C unless, despite reasonable accommodation, this condition interferes with the applicants ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace, 9. Genitourinary System Assessment: A complete genitourinary history and examination shall be done including a urinalysis on each applicant. 46 Chronic Nephritis Chronic nephritis is unacceptable for job,groups A, B, and C if 'at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential.functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. ' Epididymitis Epididymitis is acceptable for job groups A', B, and C unless, despite reasonable accommodation, the condition interferes with the applicant's' ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health and safety to the applicant or others in the workplace. Hydrocele/varicocele Hydrocele/varicocele is acceptable for job groups A, B, and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health and safety of the applicant or others in the workplace. Malignant Disease of the Genitourinary System Malignant disease of the bladder, breast, uterus, kidney, prostate, urethra, ureters, ovaries, fallopian tubes, cervix, vagina, adrenals or accessory structures of the genitourinary system may be acceptable for job groups A, B,,and C unless, 47 ¦ despite reasonable accommodation; the condition interferes with- the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. An applicant may be required to provide a report from a licensed physician stating that he/she is able to perform all the essential job functions of the job desired and what reasonable accommodation is needed if any. Untreated malignant disease as outlined above is unacceptable if, at the time of the application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Pregnancy Pregnancy is acceptable for job groups A, B and C providing the applicant can perform her job safely and efficiently and there is no scientific proof that there is a substantial risk of harm to the unborn fetus due to exposure to toxic hazards and that men are not similarly at risk and there is no acceptable alternative to promote fetal heal'L'-.h short of denial of employment. Pyeianephritis Pyelonephritis is acceptable for job groups A,. B and C if the applicant is able to perform the essential functions of the job with or without reasonable accommodation and the applicant 48 does not pose a direct threat to the health or safety of the applicant or others in the workplace. 'The work site must be free of nr:phrotoxic exposures. if nephrotoxic exposure is an essential job function which cannot be reasonably accommodated, the employment offer will be withdrawn. Renal Calculus. Renal calculus is acceptable for job groups Al R and C unless, despite reasonable accommodation, the condition interferes 'with the applicant's ability to perform the essential functions of the job desired or, the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Renal Dialysis Renal dialysis is unacceptable for all job groups if at the time. of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Renal Failure i Renal failure, impending or terminal nephritis is not acceptable for'all job groups if at the time of application, despite reasonable accommodation,- the condition interferes with the applicant's, ability to perform the essential functions of the job desired or, the applicant poses a direct 49 t threat'to the health or,safety of the applicant or.others in the workplace., Renal Transplant Renal transplant is acceptable for job groups A, B, and C, unless despite reasonable accommodation,' the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant would pose a direct threat to the health or safety of the applicant or others in the workplace. single Kidney A single kidney is acceptable for job groups A, B and C unless, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a.direct threat to the health or safety to the applicant or others in the workplace. ld. Musculoskeletal System Assessment: Examination shall include a complete history of present and past musculoskeletal injuries, fractures, hospitalizations, or surgeries. The physical examination shall include an inspection of the skin for scars, palpation for abnormalities, tenderness and examination of the musculoskeletal system to assess joint laxity, pain, stiffness, or weakness. Amputations and deformities shall be noted on the medical record. The applicant's gait shall be observed and gait abnormalities noted. Toe walking, heel walking 50 and Romberg testing shall be performed. Back range of motion, hip range,of motion, knee, shoulder and elbow range of,motion shall all be examined and noted as normal or abnormal on the medical record. Job group C applicants shall be required to have an A?/Lat view of the L-Spine. Standards: Amputations Amputations of limbs ,may be acceptable for job Groups A,,'B and' C, 'providing this condition does not interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodation. The .applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a ' City selected specialist also evaluate the applicant to assess specific essential job functions capacity and what reasonable accommodation is needed, if any. If work duties require working in cramped positions, working on slippery surfaces or work on hazardous equipment, disqualification, may be considered if these conditions significantly increase the rate of injury to those individuals, resulting in the applicant posing a direct threat to the safety of the applicant or 51 othere in the workplace. If applicants with an amputation apply for positions in jab group-C, please call the City. of Clearwater personnel department to discuss if the applicant is qualified for the position (the City will, with help of the supervisor of the offered position, outline to the examiner the specific essential job functions). Chronic and Recurring Back Disorders Chronic and recurring back disorders may be acceptable for job groups A, B and C, providing the condition does not interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodation. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity and reasonable accommodation needed, if any. A consultation with" the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation, is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant's to assess specific job function capacity and reasonable accommodation needed, if any. If work duties require.working in cramped body position, work on slippery surfaces, or work with hazardous equipment, disqualification shall -be considered. If these conditions significantly increase the rate of reinjury and as a result pose a direct threat to the health or safety of the applicant or others in 52 the workplace. The applicant shall be excluded from further employment. This condition may not - be acceptable for job groups B and C. Call the City of Clearwater personnel department to discuss if applicant is qualified for position. (The City will, with the help of the supervisor of the applicant for'the position,'outline to the examiner specific job functions.) Contracture, Paralysis (including JKlippel-Feil Syndrome), Spasticity, or Atrophy Paralysis, spasticity or atrophy or contracture may be acceptable for job groups A, B and C providing the symptoms of the condition do not interfere with the applicant's ability to perform the essential functions of the job desired, with or without reasonable accommodation. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request a City selected specialist evaluate the applicant to assess specific essential job functions capacity and what accommodation is needed, if any. After reasonable accommodation, performance of essential job functions which may pose a direct threat to the health or safety to the applicant or others in the workplace shall exclude the applicant from further consideration. if work duties require work in cramped body positions, work on slippery surfaces, or work with hazardous equipment, disqualification shall be considered if these conditions 53 significantly increase the rate of injury to the individual thereby posing a direct threat to the health or safety of the applicant or others in the workplace. The presence of such a direct threat shall exclude the applicant from further employment. Costotransversectomy Costotransversectomy is acceptable for job groups A, B, and C providing symptoms of this condition do not interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodation. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City'of Clearwater may request that a City selected specialist also evaluate the applicant to assess 'the specific job functions capacity and what reasonable accommodation is needed, if any. Derangement of Upper or Lower Extremities Derangement of upper or lower extremities (including dislocations or disarticulations) leading to instability, prosthetic replacement or other post surgical conditions may be acceptable for job groups A, B and C if the applicant can perform the essential functions of the job desired with or 54 { without reasonable accommodation. The applicant shall provide the examiner with a specialist report which states the, applicant's essential job functions capacity and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific job functions capacity of the applicant-and what reasonable accommodation is needed, if any. In addition, the City.of Clearwater may request that a City selected specialist also evaluate the applicant to assess specific essential job functions capacity and what reasonable accommodation is needed, if any. If work duties require working in cramped body- positions, work on slippery surfaces or work with hazardous equipment, disqualification shall be considered if those conditions significantly increase the rate of injury,to these individuals and as such pose a direct threat to the health or safety of the applicant.or others in the workplace. If after reasonable accommodation performance of essential job functions pose a direct threat to the health or safety to the applicant or others in the workplace, the applicant shall be excluded from further employment. Flat Foot Deformity Flat foot deformity is acceptable for job groups A, B and C providing this condition is corrected with an orthotic device or is asymptomatic, or does not interfere with the applicant's ability to perform the essential functions of the job with or without reasonable accommodation. 4 . i 55 Fractures fractures are acceptable for job groups A, B and C if treated, 4 completely healed or if the applicant is able to perform all the essential functions of the job desired with-or without reasonable accommodation and does not pose a direct threat to the health or safety of himself or others in the workplace. Joint Fixation. Joint fixation may be acceptable for groups A, B and C 'providing 'this condition does not interfere with the applicant's ability to.perform the essential, functions of the job desired with or without reasonable accommodation. The applicant shall provide the examiner with a specialist report which states the applicant's specific essential job functions capacity,"the underlying reason for the condition, reasonable accommodation needed, if any, and that the applicant will not pose a direct threat to the health or safety of himself or others in the workplace. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. in addition, the City of Clea.water may request the City selected a specialist also evaluate the applicant to assess the specific essential job functions capacity, what reasonable accommodation is needed, if any, and whether, after -reasonable accommodation, the applicant will pose a direct threat to the health or safety of himself or others in the workplace. If work duties require 56 ad, •'k l d b d it' k li f X ., wor n cramps o y pos ?.ons, wor on s ppery sur aces, or .working with hazardous equipment, disqualification shall be considered it these conditions significantly increase the rate of reinjury to these individuals and as a result pose a direct threat to the health or safety of the applicant or'others in the workplace. If. after' reasonable accommodation, such a direct -threat exists, the applicant shall be excluded from further employment. Malignant Disease of the Bone Malignant disease of the bone, metastatic or primary, is unacceptable to job groups A, B and C if, at the time of the application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to'the health or safety of the applicant or others in the workplace. Osteoarthritis Osteoarthritis is acceptable to job groups A providing the arthritis is inactive, without restricting range of motion, instability, prosthetic replacement, surgical correction or other restrictions which interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodation. For job groups B and C the applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity and reasonable accommodation needed, if 1 57 3 ' l any. A consultation with the applicant's physician may be necessary to determine the specific job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition,, the City of Clearwater may request that a City.selected specialist also evaluate the applicant to assess specific job functions .capacity. and what reasonable job' accommodation is needed, if any.. If work duties require work in cramped body positions, work on slippery surfaces or work with. hazardous equipment,' disqualification shall be considered if these conditions significantly increase the rate of injury to these' individuals resulting in a direct threat to the health'or safety of the applicant or others in the workplace. The presence of such a direct threat shall exclude the applicant from further employment. Osteochondrosis (Lumbar Scheurmann's) Osteochondrosis is acceptable for job groups A, B and C providing the condition does not interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodations. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reason for the condition, reasonable accommodation needed, if any, and a statement that after reasonable accommodation, the applicant will not pose a direct threat to the health or safety of others in the workplace. A consultation with the applicant's physician may be necessary 58 I'. , to determine the specific essential job,functions capacity of the applicant and reasonable accbmmodations needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the- specific essential job functions capacity and what reasonable accommodation is needed, if any. If the work duties require work in cramped body positions, work on slippery surfaces, or work with hazardous equipment, disqualification shall be considered if these conditions significantly increase the rate of injury to these individuals resulting in a direct threat to the health or safety of the applicant or others in the workplace. Presence of such a direct threat will result in excluding the applicant from further employment. Osteomyelitis Osteomyelitis of any bone is acceptable for job groups A, B and C, unless, after reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or would pose a direct threat to the health or safety of the applicant or others in the workplace. Rheumatoid Arthritis. Rheumatoid arthritis is acceptable for job groups A, B and C providing the arthritis does 'not 'interfere with the applicant's ability to perform the essential functions of the job desired with or without reasonable accommodation. All applicants shall provide the examiner with a specialist's e 59 L report which. states the applicant's essential job, functiona capacity and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. , Any addition, the City, of Clearwater may request that a City selected specialist also evaluate the applicant to assess specific essential job functions capacity and what reasonable accommodation is needed, if any. If work duties require working in cramped body positions, working on slippery surfaces or working with hazardous equipment, disqualification shall be considered if these conditions significantly increase the rate of injury to these individuals resulting in a direct threat to the applicant or others in the workplace. Existence of a direct threat shall exclude the applicant from further employment. Scoliosis, Kyphosis (with or without gibbus) or Vertebral Derangements Scoliosis, kyphosis or kyphoscoliosis of greater than thirty degrees is acceptable for J ob group A and for all other job groups where the work demands for dynamic flexibility, extent flexibility, stamina, dynamic strength, trunk strength, explosive strength and static strength do not exceed moderate level. The applicant shall provide the examiner with a specialist report which states-the applicant's essential job functions capacity, the underlying reason for condition, and what reasonable accommodation is needed, if any. A 60 1 consultation with the applicant's physician may be necessary 3 , to determine the specific essential job functions capacity of the applicant and'what reasonable accommodation is needed, if any. in addition, the City of Clearwater may request a City selected specialist alr;o evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodation is needed, if any. If work duties require working in cramped body positions, work on slippery surfaces, or'work with hazardous equipment, disqualification shall be considered if these conditions significantly increase the rate of injury to these individuals thereby posing a direct threat to the health and safety of the applicant or others in the workplace.- Presence of a direct threat shall exclude the applicant from further employment. For job groups B and C. call the.City of Clearwater personnel department to discuss if the applicant is,qualified for the position with or without reasonable accommodation. (The City will, with the help of the supervisor of the. offered position, outline to the examiner specific essential job functions.) After reasonable accommodation, an applicant who cannot perform the essential job functions or poses a direct threat to the health or safety of himself or others in the workplace will not be employed further. Shoulder, Wrists or Elbow Fusion Shoulder, wrist or.elbow fusion is acceptable for job groups A and B providing symptoms of the condition does not interfere 61 with the applicant's ability to perform the essential functions of. the job desired with or without-reasonable accommodation. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reason for the condition and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request a City selected specialist evaluate the applicant to assess specific job functions capacity and what reasonable accommodation is needed, if any. For job groups A, B and C, if work duties require working in cramped body positions, work on slipper surfaces, or work with hazardous equipment, disqualification shall be considered if these conditions significantly increase the rate of injury resulting in a direct threat to the health or safety of the applicant or others in the workplace. Existence of such a direct threat shall exclude the applicant from further employment. For job groups C call the City of Clearwater personnel department to discuss if the applicant is qualified for the position with or without reasonable accommodation (the City will with the help of the supervisor of the offered position 62 ?r outline to the examiner the specific job functions in more' detail). Spinal Fractures including Compression Fractures* Spinal 'fractures are acceptable for, job group A providing this I condition does not interfere with the applicant's ability to perform the .essential .functions of the job with or without reasonable accommodation. This condition is unacceptable for job..groups B and C after reasonable accommodation if the, examiner finds that the applicant cannot perform the essential functions of the job desired or poses a direct threat to the health or safety of the applicant or others in the workplace. For work duties which require work in cramped body positions, work on slipper surfaces, or work with hazardous equipment, disqualification shall be considered if these conditions significantly increase the rate of reinjury in these individuals. The existence of a direct threat shall exclude the applicant from further employment. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess specific job functions capacity and what reasonable accommodation is needed, if any. 63 } Spine Fusion , '.e Spine fusion, congenital or surgical, may be. acceptable for job groups A and S providing symptoms of this condition do not interfere with the applicant's ability to perform the essential job functions with or without reasonable accommodation. The applicant shall provide the examiner with a specialist report which.states the applicant's essential job functions capacity, the underlying reason for the condition, whether the condition is nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the essential job functions capacity of the applicant and what reasonable accommodation is needed, if any, in addition, the City of Clearwater may request the City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodation is needed, if any. If work duties require work in cramped body positions, work on slippery floors, work with hazardous equipment, disqualification shall be considered if the conditions significantly increase the rate of injury for these individuals resulting in a direct threat to the health or safety of the applicant or others in the workplace. Existence of such a threat shall exclude the applicant from further employment. For job group C, call the City of Clearwater personnel department to discuss if an applicant is qualified for the position with or without reasonable accommodation. 64 6W C (The. City, with help of the' supervisor of the offered position, will. outline to the examiner in more specific detail the specific essential job function.) Spinal Stenosis with or without Decompression Spinal stenosis with or without decompression shall be acceptable for job group A-if the applicant can perform the essential functions of the job desired with or without reasonable accommodation. After reasonable accommodation, the applicant must also not pose a direct threat to the health or safety of himself or others in the workplace. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reasons of the condition, whether the condition is nonprogressive and benign, and what reasonable accommodation is needed, if any. A consultation with the 'applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. in addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. If work duties require work in cramped positions, work on slippery surfaces or work with hazardous equipment, disqualification shall be considered if these conditions significantly increase the rate of injuries to these individuals, resulting in a direct threat to the 65 health or safety of the applicant or others in the workplace. Existence of such a threat shall exclude the applicant from further employment. For job groups B and C call the City of Clearwater's personnel department to discuss whether, with or without reasonable accommodation, the applicant can perform the essential functions of the job and does not pose a direct threat to the health and safety of the applicant or others in the workplace (The City will with the help of the supervisor of the offered position, outline to the examiner the specific essential job functions). Spondylolisthesis Spondylolisthesis is acceptable for job groups A. B and C if of grade I severity. Greater than grade I spandylolisthesis is acceptable for job group A if the condition does not interfere with the applicant's ability to perform the essential functions of the job desired after reasonable accommodation. Greater than grade I spondylolisthesis may not be acceptable for job groups B and C if the examiner finds that the condition interferes with the applicant's ability to perform the essential functions of the job with or without reasonable accommodation. After reasonable accommodation, the applicant must also not pose a direct threat to the health or safety to himself or others in the workplace. The applicant shall provide the examiner with a specialist's report which states the applicant's essential job functions capacity, the underlying reasons for the condition, whether the condition is 66 WV t nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected specialist evaluate the applicant to assess the specific essential job functions capacity and what. reasonable accommodation is needed, if any. If work duties require working in cramped body positions, work on slippery floors or working with hazardous equipment, disqualification shall be considered if these conditions significantly Increase the rate of injury resulting in a direct threat to the health or safety of the applicant or others in the workplace. Existence of such a direct threat shall exclude the applicant from further employment. Surgical Procedure of Back (Disectomy or Chymopapain, Facet Rhizotomy) Surgical procedures of the back may be acceptable for job groups A, B and C providing symptoms of the condition do not interfere with the applicant's ability to perform the essential functions of the job with or without reasonable accommodation. The applicant shall provide the examiner with a specialist's report which states the applicant's essential job capacity, the underlying reasons for the condition, whether the condition is progressive or benign, and what reasonable accommodation is needed, if any. A consultation with,the applicant's physician may be necessary to determine 67 1 the essential job functions capacity of the applicant and what reasonable accommodation-is needed, if any. In addition, the City of Clearwater may request that a City selected specialist evaluate the specific essential job functions capacity and what reasonable accommodation is needed, if any. If work duties require work in cramped body positions, work on +slippery surfaces or work with hazardous equipment,. disqualification shall be considered if these conditions significantly increase the rate of injuries to these individuals resulting in a direct threat to the health or safety of the applicant or others in the workplace. The existence of such a threat shall exclude the applicant from further employment. Tuberculosis of the Bone Tuberculosis of the bone is unacceptable for job groups A, B. and C if at the time of application, despite reasonable accommodation, the applicant is unable to perform the essential functions of the job desired or poses a direct threat to the health or safety of the applicant or others in the workplace. 11. Nervous System .Assessment: A complete history shall be taken to include information on neurosurgery, head trauma, convulsive disorders, paralysis, cerebral vascular accidents, multiple sclerosis, etc. The physical examination shall include testing of deep tendon 68 L... reflexes, gross sensory, motor testing and a gross examination of the cranial nerves unless a more thorough examination is '. indicated. Standards: Central Nervous System Infections Central nervous system infections which are untreatable are unacceptable for job groups A, B and C, if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health and safety of the applicant or others in the workplace. Cerebral Palsy cerebral palsy is acceptable for job groups A providing the applicant can perform the essential functions of the job with or without reasonable accommodation. The applicant shall provide the examiner with a specialist's report which states the applicant's specific essential job functions capacity and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. 'In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodations are needed, if any. This condition 69 may be disqualifying for job groups B and •C. Call the City of Clearwater personnel department to discuss if the applicant is qualified for the 'position. The applicant will.-be disqualified if the condition interferes with his ability-to perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation, if the individual poses.a direct threat to the health or safety of the applicant or. the others in the workplace, the applicant will also be disqualified. (The City will, with the help of the supervisor of the offered position, more specifically outline to the examiner specific essential job functions.) Cerebral Vascular Accident (CVA) Post cerebral vascular accident is acceptable for job groups At B and C if the applicant is able to perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation, the-applicant must not pose a direct threat to the health or safety of himself or others in the workplace. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reason for .the condition, if any, whether the condition is nonprogreesive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is 70 4:V s . needed, if any.. in addition, the City of Clearwater may request that .a City selected specialist also evaluate the applicant to'assess specific essential job functions capacity and what reasonable accommodation is needed, if any. Convulsive Disorders Convulsive disorders are acceptable for job groups A providing the applicant can perform the essential functions of the job with or without reasonable accommodation. Applicants for job groups B and C must be.considered on an individual basis to determine if qualified for hire. All applicants for group B and C should present a copy of a recent medical evaluation by a licensed. physician. The applicant with a history of convulsive 'disorders applying for a job which requires driving, muss have a valid drivers license, must present a copy of a. recent medical evaluation which demonstrates therapeutic,. levels of anti--convulsant medication, an acceptable EEG, and a physician's statement reporting that the applicant is able to safely operate a vehicle. Applicants who pose a direct threat to the health or safety of themselves or others in the desired position will not be employed. Degenerative Disorders and Extrapyramidal Disorders (parkinsonism, paralysis agitans, chorea, multiple sclerosis or muscular atrophies) Degenerative disorders and extrapyramidal disorders are unacceptable except for job group A providing the applicant can perform the essential job functions with or without reasonable accommodation. After reasonable accommodation, if 71 the applicant pones' a direct threat to the health or - safety of the applicant or others in'the workplace, employment would be denied, These conditions tend to cause delayed' motor responses so this is ' a special consideration in qualifying these applicant's for placement. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reasons for the condition, whether the condition is nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess specific essential job functions capacity and what reasonable accommodation is needed, if any. These conditions are disqualifying for job groups B and C, unless, it is determined that the applicant can perform the essential functions of the job with or without reasonable accommodation. After reasonable accommodation, the applicant may also not pose a direct threat to the health or safety of the applicant or others in the workplace. Malignant Disease with or without Metastasis of the Brain and Spinal Cord Malignant disease of the brain or spinal cord are unacceptable for job groups A, B and C if at the time of application, despite reasonable accommodation, the condition interferes 72 m•- i - i with the applicant's ability to perform the essential functions of'the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Minor Paralysis or Sensory Deficits Minor paralysis or sensory deficits may be acceptable for job groups A, P and C providing the applicant is able to perform the 'essential functions of the job with or without reasonable accommodation. The applicant shall provide the examiner with a specialist's report which states the applicant's essential job functions capacity, the underlying reason for the condition, if any, whether the condition is nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed., if any. in addition, the City.of Clearwater may request that a City. selected specialist also evaluate the applicant to assess the specific essential, job functions capacity and what reasonable accommodations are needed, if any. Applicants with sensory deficits shall be screened carefully when being considered for positions requiring heavy or dangerous equipment use as these individuals are at increased risk for lacerations or burns because of their sensory deficits. if, after reasonable accommodation, the applicant poses a direct 73 threat,to the health or safety of the applicant or others in the workplace, the employment offer will be withdrawn. Major Paralysis (Hemiplegia, Paraplegia, Quadriplegia) Paralysis of one or more extremities is acceptable for job groups A, providing the applicant can perform the essential functions of the job with or without reasonable accommodation. The applicant shall provide the examiner with a specialist's report which states the applicant's specific job functions capacity, the underlying reason for the condition,, -if any, whether the condition is nonprogressive and benign and reasonable accommodation needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job, functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodation is needed, if any. Major paralysis may be unacceptable for job groups 8 and C. The condition will be unacceptable if it renders the applicant unable to perform the essential functions of the job with or without reasonable accommodation. Further, after accommodation, the applicant must not pose a direct threat to the health or safety of the applicant or others in the workplace. Call the City of Clearwater personnel department to discuss if the applicant is qualified for the position. (The City will, with the help of 74 1 b?r ' the supervisor of 'the . offered position, outline to the examiner in more detail the specific essential job functions.), Nerve Trauma Nerva trauma with or without 'residual symptoms may -be' acceptable for job groups A. B and C providing the applicant can perform the essential functions of the job with or without reasonable accommodation. The applicant shall provida the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reasons for the condition, if any, whether the condition is nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. in addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions i capacity and the reasonable accommodation needed, if any. Nerve trauma with residual sensory or motor loss may be unacceptable for certain positions as described in the paralysis standard if the applicant after reasonable accommodation poses a direct threat to the health or safety of the applicant or others in the workplace. 75 12. Endocrine, Metaha c and ut t onal _System Assessments: .A complete history ..and physical examination shall be performed. Urine dipstick is required on all physicals. Measurement of blood sugar is required for job group C. Thyroid levels and calcium levels.are required for applicants -applying.for job group C. Standards: Diabetes Diabetes controlled by diet only is acceptable for all job groups. Diabetes controlled with oral agents is acceptable for job group A. For job groups B and C, diabetes controlled by oral agents is acceptable providing the applicant can perform the essential functions of the job with or without reasonable accommodation. After reasonable accommodation, the applicant must not pose a direct threat to the health or safety of the applicant or others in the workplace. Diabetics on insulin are acceptable for job groups A and B. Job group B and C applicants who are on insulin may not qualify for jobs which involve driving heavy or commercial vehicles, using motorized equipment or transporting passengers. Applicants must present a valid drivers' license and physician's statement reporting the applicant is able to safely.operate these vehicles. Insulin dependent diabetics should not be assigned jobs working at unsafe distances from the ground such as scaffolds, bridge, towers, 'or ladders, without a statement 76 i 7 from their physician stating'they are.able to work in these positions. Such essential job functions may'pose a direct threat to the health or safety of the applicant or others in . the workplace. Individuals with this.condition shall carry identification cards. Call the.City of Clearwater personnel department to discuss if an applicant is qualified for a position.when in doubt. (The City will, with the.help of the supervisor of the offered position, outline to the examiner specific essential job functions.) Diabetics with severe, frequent and recent insulin reactions are unacceptable for job groups H and C if after reasonable accommodation they would pose a direct threat to the health or safety of the applicant or others in the workplace. Dwarfism Dwarfism, pituitary or achondroplastic is acceptable for all job groups providing the applicant can safely perform all job functions of the job with or without reasonable. accommodation. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reason for the condition, if any, whether the condition is nonprogressive and any reasonable accommodation needed, if any. A consultation with the applicant's physician may be. necessary to determine the specific essential job functions capacity of the applicant and the reasonable accommodation needed, if any. in addition, the City of Clearwater may request that a City selected specialist 77 1 ! also evaluate the'applicant to assess specific essential job functions capacity and reasonable accommodation needed, if any. After reasonable accommodation, the applicant must not pose a • direct threat to the health or safety 'of himself or others in the workplace. -Hypercalcemia or Hypocalcemia' Significant hypercalcemia or hypocalcemia of unknown etiology or untreated maybe unacceptable for job groups A, 8 and,C'if the condition interferes with the applicant's ability to perform the essential function of the job with or without reasonable accommodation. If after reasonable accommodation, the applicant poses a direct threat to the health or safety of the applicant or others.in the workplace the employment offer. will be withdrawn. Obesity Obesity with associated clinical disorder shall be evaluated for all job groups in accordance with applicant's ability to perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation, the applicant may not pose a direct threat to the health or safety of the applicant or' others in the workplace. Pancreatic Carcinoma Pancreatic carcinoma is unacceptable for all jobs if at the time of the application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform 78 the essential functions of the job desired or the applicant poses a direct threat to .the health or safety of the individual or others in the workplace. Thyroid Carcinoma Thyroid Carcinoma is acceptable for all job groups if the applicant is able to perform the essential functions of the job with or without reasonable accommodation. Further, after reasonable accommodation, the applicant must not pose a direct threat to the health or safety of the applicant or others in the workplace. The applicant shall provide the examiner with a specialist's report which states the applicant's essential job functions capacity, the underlying reasons for the condition, if any, whether the condition is nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. Thyroid Disease (Hypothyroidism, Hyperthyroidism, Thyroiditis). Thyroid disease is acceptable for job groups A, B, and C if the applicant can perform the essential. functions of the job with or without reasonable accommodation. In addition, after reasonable accommodation the applicant may not pose a direct 79 } threat to the health or-safety of.the applicant or others in the workplace. The applicant-shall provide the examiner with a specialist report which states the applicant's essential job functions capacity, the underlying reasons for the condition, if any, whether the condition is nonprogressive and benign and' what reasonable accommodation is needed, if any. A , consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation-is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. Specific symptoms of the condition such as heat/cold intolerance should not interfere with the applicant's ability to perform the essential functions of the job after reasonable accommodations or pose a direct threat to health or safety of himself or others in the workplace. 13,. Hematopoieti,.c and Lymphatic Systems Assessment: A complete history and physical examination shall be dome of the lymphatic and hematopoietic systems. A complete blood count will be performed to include a platelet count on individuals applying for job group C. I 80 Standards: A.I.D.S. A.I.D.S. is acceptable for, all job groups so long as an applicant at the time of the application is able to perform the essential functions 'of the'job desired with or without reasonable accommmodation. The applicant also must not'pose a direct threat to the health or safety himself or others in the workplace. Anemia Anemia secondary to impaired nutrition or blood loss is acceptable for job groups A. B and C providing the applicant can perform the essential functions of -the job desired with or without reasonable accommodation. Further, after reasonable accommodation the applicant may not pose .a direct threat to the health or safety of the applicant or others in the j workplace. j Acute Leukemia Acute leukemia is unacceptable for job groups A, B and C, if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or poses a direct threat to the health or safety of the applicant-or others in the workplace. Chronic Granulyuocytic Leukemia Chronic granulyuocytic leukemia is unacceptable for job groups A, B and C if at the time of application, despite reasonable !' 81 l accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace.. Chronic Lymphocytic Leukemia i Chronic lymphocytic leukemia is unacceptable for job groups A, B and C if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the applicant or others in the workplace. Clotting Disorders and Hemophilia i Clotting- disorders are acceptable for job groups A and B providing the applicant can perform the essential functions of the job with or without reasonable accommodations. Further, the applicant must not pose a direct threat to the health or safety of himself or others in the workplace. The job desired should not require work on heavy machinery, moving objects, slippery surfaces, or other environments with high injury i potential.. This qualification will not apply if the applicant provides a report from a specialist which states the i` applicant's job functions capacity should not be so limited. The report should also state the underlying reason for the condition, whether the condition its nonprogressive and benign and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary 82 to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In'addition,, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. Clotting disorders may not be acceptable for'job groups,C if the applicant would pose. a. direct threat to the health and safety of the applicant or others in the workplace. Call the City of Clearwater personnel department to discuss if the applicant is qualified for the. position , and what constitutes reasonable accommodations. (The City will with the help of the I ' supervisor of the offered position, outline to the examiner i specific essential job functions.) H.I.V. Positive 'Applicants who are H.I.V, positive are acceptable for job groups A, B and C provided the applicant can perform the essential functions of the job with or without reasonable accommodation. After reasonable accommodation, the applicant may not pose a direct threat to the health or safety of the applicant or others in the workplace. j Hodgkin's Disease Hodgkin's Disease may be acceptable for job groups A, B and C providing the applicant can perform the essential functions of the job desired with or without reasonable accommodation. After reasonable accommodation, the applicant may not posea i 83 i. direct threat to the health or safety of..the applicant or others in the. workplace. The applicant shall provide the examiner with a specialist's report which states the applicant's essential job functions capacity and reasonable accommodation needed, if any. A consultation with the applicant's physician may -be necessary to determine the specific essential job functions capacity'of the applicant. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. Non--Hodgkin's Lymphoma Non-hodgkin's lymphoma is unacceptable for job groups A, B and C, if at the time of the application after reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of.the applicant or others in the workplace. Metastic Disease to the Lymphnodes Metastic disease to the lymphnodes is unacceptable for all job groups, if at the time of application, despite reasonable accommodation, the condition interferes with the applicant's ability to perform the essential functions of the job desired or the applicant poses a direct threat to the health or safety of the individual or others in the workplace. 84 i Polycythemia Vera Polycythemia vera may be.acceptable for job groups A, B and,C provided the applicant can perform the essential functions of the job with or without reasonable accommodation. After, reasonable accommodation, the applicant may not pose a direct threat to the health or safety of the applicant or others in the workplace. The applicant shall provide the examiner with a specialist report which states the applicant's essential job functions capacity and what reasonable accommodation is needed, if any., A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed, if any. In addition, the City of Clearwater, may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and what reasonable accommodation is needed,.if any. Sickle Cell Disease Sickle cell disease may be acceptable for job groups A, B and C if the applicant is able to perform the essential functions of the job desired with or without reasonable accommodation. After reasonable accommodation, the applicant may not pose a direct threat to the health or safety of the applicant or others in the workplace. The applicant shall provide the examiner with a licensed specialist report which states the applicant's essential job functions capacity and reasonable 85 accommodation needed 'if any. A consultation with the applicant's physician may, be necessary to determine the specific essential job functions capacity, of the applicant and .what reasonable accommodation, is needed, if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. .Sickle Cell Trait Sickle Cell Trait is acceptable for job groups A, B and C. 14. Pycho -Social SXs3tem Assessment: A complete medical history shall be take to include questions ' regarding previous psychiatric problems. A medical examination shall be done assessing the appropriateness of the applicant's behavior, social interaction and affect. A psychiatric evaluation by a Florida licensed specialist shall be recommended for any applicant where the City examiner deer.,s "further assessment is required. Standards: Anxiety Disorders Anxiety disorders which do not interfere with the applicant's ability to perform the essential functions of the job with or without reasonable accommodation is acceptable for job groups A, B and C. Further, after reasonable accommodation, the applicant may not pose a direct threat to the health or safety 86 1 . .MEMO! to the applicant or others in the workplace. Prescribed medication must not be sedating or disorienting for the applicant. The applicant shall provide the examiner with a specialist report which,states the applicants essential job functions capacity and reasonable .accommodation needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant and what reasonable accommodation is needed,. if any. In addition, the City of Clearwater may request that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. Depression Depression is acceptable for job groups At B and C. providing the individual can perform all essential. job functions with or without reasonable accommodation. Further, after reasonable accommodation the applicant may not pose a direct threat to the health or safety to the applicant or others in the workplace. Medication prescribed for this condition should not interfere with the applicant's ability to perform the essential job functions. The applicant shall provide the medical examiner with a specialist report which states the applicant's essential job functions capacity and what reasonable accommodation is needed, if any. A consultation with the applicant's physician may be necessary to determine the specific essential job functions capacity of the applicant 87 ' S and what reasonable accommodation is needed, if. any. In addition, the City of Clearwater may request, that a City selected specialist also evaluate the applicant to assess the specific essential job functions capacity and the reasonable accommodation needed, if any. Applicants for job group C with this condition will be considered individually in consultation with the City of Clearwater personnel department and a City physician. Again, the applicant must be able to perform all essential job functions with or without reasonable accommodations. Further, after reasonable accommodation, the applicant may not pose a direct threat to the health or safety of the applicant or others in the workplace. Organic Brain Syndrome, Alzheimer's Disease, or Dementia organic brain syndrome, Alzheimer's disease or dementia are unacceptable for job groups A, B and C, if at the time of the application, despite reasonable accommodation, the applicant cannot perform the essential functions of the job desired or would pose a direct threat to the health or safety of the applicant or others in the workplace. Schizophrenia Schizophrenia which is non-acute, controlled and under the treatment of a Florida licensed psychiatrist may be acceptable for job groups A, B and C. Applicants with this condition will be considered individually in consultation with the City of Clearwater personnel department and the City psychiatrist. The individual must be able to perform all essential job 88 ' r .l )J 1 r ? ? ` . }}yt`trt,. •I'?.`k: ?1. ?f'. ? ? ?Y ?t?. Sr 1 , , .,1 r Y?si (' •.y'•'JF` .'?'?`> . -' Afi'? `1, ?I:( p.i ? ' ? ? ?_? ? ` 4 i .. : . ?I 3 ? ? ' r . ..k, . ., l:l.l.. ,7 i. .t.'. •1'° ? ii. . 4 ?'.'?'. •1 .. 1 ' .. • ° ?? I ? ? ? - ? ' . ? `:e?hJ-`??':aS:r:f nl5i'i;.Y.f,uF7:,?rtf? T Vti P4r ¢S?'`y,'fsii ?,Y???A^M1?, rye.l5?.ec ..?.wrr v. ., ..... ? .. •r,. ,r:...?r. :`S f: . , '}C i.o-<, '^rtr° functions with or, without reasonable accommodation.. After- reasonable,. accommodation, the applicant. must not, pose ar direct threat ' t6the health or safety of the -applicant or. others 'in the work force. i 3 • .1 ' INC 89 I JAMES M CRAIG OC600AN S. CRUMaLCT THOMAS M, GONZALEZ nowN C.ORC1wE MARK A, MANLCY ORCOORY A. HCARIM0 WILLIAM C. S12CMORC MARRISON C.TNOMPSON.JR, LAW Orrlctl TiiompsoN, SIZEMORE & GONZALEZ ^n0rK5910Nf4 •590CIAVO11 109 i10 RTH ORUSH YTAeeT SUITE 200 POST Orrice rox 639 T^mPA,FLORIQA 33001 1x131273.0050 . FAX NO I8131 273,0072 November 25, 1992 VIA FACSIMILE AND U.S. MAIL 1 1?. c1 V a+-Fnen5tori rn1 i t ??o H. M. Laursen Human Resources Director City of Clearwater P.O. Box 4748 Clearwater, FL 34618-4748 Re: ADA Concerns.Regarding City Employees' Pension Plan Dear Mr. Laursen: Referencing your correspondence of November a, 1992, set forth .below is our opinion as to the issues raised concerning the interplay between the City's General Employees Pension Plan and the Americans with Disabilities Act ("ADA"). Before going into any substantive discussion of the issues, please allow me to state my understanding that the City is in the process of attempting to qualify the City's pension plan for IRS tax purposes. That issue and the possible impact or IRS ramifications of the exclusion of certain individuals from participation in the plan or other tax related consequences are beyond the scope of this correspondence and is not addressed herein.. Rather, this letter is only concerned with the implications of the ADA an the pension plan. Issue 1 Alternative Emnlovment As I understand the first issue, the City wishes to know its rights and obligations under the ADA when an employee becomes .unable to' perform his, or her job due to a job-connected or non-job- connected disability and therefore seeks a disability retirement. The questions presented in relation to this issue are as follows: 1. What actions can or must the City take with respect to accommodating the employee through the provision of another job that is within the capability of the employee to perform even with his or her disability when that employee is unable to perform his or her own duties, even with reasonable accommodation,; I '. H. M. -Laursen November 25, 1992 Page 2 2. Assuming the City can identify and make available an alternative job as a reasonable accommodation, is the employee obligated to accept such job change in lieu of pursuing the requested disability pension; 3. With respect to the above requirements and obligations to seek or provide alternative employment, is there any significant difference between the treatment of employees in the Police officer and Firefighter categories as opposed to "general" employees. Each of these questions will be answered below. 1. What actions can or must the City take with respect to accommodating the employee through the provision of another job that is within the capability of the employee to perform even with his or her disability when that employee is unable to perform his or her own duties, even with reasonable accommodation? Under the AAA, it is unlawful for the City to fail to make reasonable accommodation to the known physical and mental limitations of an otherwise qualified individual with a disability who is an employee, unless the City can demonstrate that the accommodation would impose an undue hardship on the operation of its activities. 42 U.S.C. 512112(b)(5)(A). The term "reasonable accommodation" can include, with regard to current employees, "reassignment to a vacant position." 42 U.S.C. §12111(9). Therefore, the answer to the first question is yes, the city is obligated to offer available alternative employment to a current employee who becomes disabled and unable to perform his or her job functions even with accommodation. Let me add, however, that the interpretive: guidance and regulations issued by the Equal Employment Opportunity Commission explains that while reassignment is listed as a potential reasonable accommodation, in general, reassignment should be considered only when accommodation within the individual's current position would pose an undue hardship. Reassignment is not available to applicants. . . Employers should reassign the individual to an equivalent position, in terms of pay, status, etc., if the individuals is qualified, and if the position is vacant within a reasonable amount of time. A "reasonable amount of time" should be determined in light of the totality of the circumstances. 6- j H. M. Laursen November 25, 1992 Page 3 ADA Handbook at I-43. The interpretive guidance goes on to give as an example that if there is no vacant position at the time an individual with a disability requests -reassignment, but the employer knows of an equivalent position for which the individual is qualified which will become vacant within the next two weeks, the employer should reassign the individual to the position when it becomes available. The interpretive guidance also clarifies that an employer may assign an individual to a lower graded position if there are no accommodations that would enable the individual to remain in his or her current position and there are no vacant equivalent positions for which the individual is qualified with or without reasonable accommodation. if such a situation should occur, the City is not required to maintain the reassigned individual with a disability at the-salary of the higher graded position if it does not so maintain reassigned employees who are not disabled. Further, the legislative history is also clear that an employer is not required to promote an employee with a disability as an accommodation. ADA Handbook at I-43. 2. Assuming the City can identify and make available an alternative job as a reasonable accommodation, is the employee obligated to accept such job change in lieu of pursuing the requested disability pension? The regulations provide that a qualified individual with a disability is not required to accept an accommodation that he or chooses not to accept. 29 C.F.R. §1630.9(d). Thus, in regard to the question of whether the City could require an individual to accept as an accommodation a transfer from their current position to an equal or lesser position available in the City, the City could not require such a transfer under the ADA. With regard to the issue of whether an employee is obligated to accept alternative employment in lieu of pursuing a requested disability pension under the terms of the plan, the answer also appears to be no. Under §26.34 of the pension plan, an employee becomes entitled to a disability pension when: in the opinion of the advisory committee, [the employee has become) permanently, physically or mentally inca acitated to erform their duties, [the employee] may retire after continuous service of the City for a period of ten (10) years or more, provided that such retirement shall continue only as long as the physical or mental incapacity exists. H. M. Laursen November 25, 1992 Page 4 $26.34; City Code (emphas'is supplied). My understanding of the way the City has interpreted this language is that if an employee, in the opinion of the advisory committee, is unable to perform their duties (as opposed to the duties of another available position), the employee may retire under a disability pension if injured in the line of duty or if the employee has been in service with the City for ten years or more for a non-line of duty injury. Under the pension plan, the City apparently does have the ability to cut off the disability pension if the physical or mental incapacity is later determined not to be permanent and the employee is able to return to work. 'In addition, disability benefits can presumably be cut off under §26.42 of the pension plan if the employee accepts employment in an occupation or line of work similar to the occupation or line of work which resulted in the disability pension. 3. With respect to the above requirements and obligations to seek or provide alternative employment, is there any significant difference between the treatment of employees in the Police Officer and Firefighter categories as opposed to "general" employees. With regard to question 3, it makes no difference whether an employee is a Police Officer or Firefighter as opposed to a "general" employee with regard to the City's obligation to provide alternative employment. The phrase "incapacitated to perform their duties" is not limited to hazardous occupations. Further, the issue of state certification is relevant only to the employee's ability to continue in their current position, much like the issue of whether an individual is qualified for a vacant position (i.e., does the employee have the necessary licenses, skills, certifications and qualifications to meet the essential requirements). The only general employee pension plan distinctions having to do with police and fire are related to the years of service and benefit provisions for hazardous duty positions. Issue 2 Exclusion of Particination in Pension Plan for New Emplovees The next question presented concerns whether a disabled individual hired by the City can be excluded from participation in the pension plan. Under Section 2.44 of the pension plan, employees "who have failed to pass a comprehensive physical exam" are excluded from the pension plan. In order to be accepted for employment with the City, all employees must pass a post-job offer medical examination which approves the individual for hare. The question is whether the City can approve a candidate for hire but reject that candidate for participation in the pension plan when the person is able to perform the essential functions of the H. M. Laursen November 25,. 1992 Page 5 offered position but an existing medical condition may be presumed to indicate that at some future point, the candidate's ability.to perform the essential functions may come into question. In essence, the question is what it is the relationship between medical standards used to make 'a hiring decision and medical standards used to'make benefits entitlement decision. Unfortunately, this is probably the area most lacking in interpretive guidance from the EEOC. Under 29 C.F.R. 51630.5, it is unlawful for the city to limit, segregate, or classify an applicant or employee in a way that adversely affects his or her employment opportunities or status based on disability. This has been interpreted by the EEOC to mean that individuals with disabilities be accorded equal access to whatever health insurance coverage the employer provides other employees, but does not affect pre-existing condition clauses included in health insurance policies offered by employers. ADA Handbook, I--53. What the law does allow is that insurers or any agency or entity that administers benefit plane "may underwrite risks, classify risks, or administer such risks that are basted on or are not inconsistent with State law." 29 C.F.R. §1630.16(f). The law further allows the City to "establish, sponsor, observe or administer the terms of a bona fide benefit plan based on underwriting risks, classifying risks, or administering such risks that are based on or not inconsistent with State law." 29 C.F.R. 51630.16(f)(2). The activities are permitted so long as they are not "a subterfuge to evade" the law. As explained by the EEOC, this provision of the ADA is not intended to disrupt the current regulatory structure for self-insured employers. The purpose is explained as requiring employees not to make decisions on employee benefits based on disability alone, if the disability does not pose increased risks. We interpret this to mean that unless the City had a sound actuarial basis for excluding an individual with' a particular disability from participation in the pension plan because of their disability, they would be precluded from doing so. The obvious problem that comes to light is the exclusion from participation based can a justifiable actuarial basis also denies a qualified individual with a disability the chance to obtain a years of service pension (as opposed to a disability pension). Since the pension and disability aspects of the plan are not currently severable, presumably if you had a lawful basis for excluding an individual from participation, this would not be a problem. In light of the above, some possible suggestions for you to consider in amending the plan to address these concerns are as follows: .?,.4 ?' . .. :S`i4"?a.?l: ;her , H. M. Laursen November 25, 1992 Page 6 (1) Separating the disability and pension benefits to allow individuals lawfully excluded from disability benefits by virtue of a preexisting condition-to have a chance at, obtaining a "years of service" pension; (2) Redefine disability as a permanent physical or mental impairment which precludes an individual from rendering useful and efficient service to the City in any capacity with or without accommodation; (3) Requiring employees who become disabled in their current occupation to accept other available employment with the City or be denied a disability pension benefit; (4) Provide a set-off against future earnings if an employee takes other employment after receiving a disability pension; (5) Provide for the Board of Trustees to make the final decision as to entitlement to a disability pension; (6) Redefine disability to include the concept of reasonable, accommodation. (7) Have an actuary provide the Trustees and the pension advisory committee with a list of conditions that represent underwriting risks which warrant exclusion from the pension plan. Since any changes in the pension plan must be negotiated with the City's four unions, these issues are properly raised in an "out of the sunshine" executive session. However, Robin Griewe of our firm, who you have worked with extensively on the medical standards for hiring, will be available at the Commission's November 300 1992 ,workshop to answer questions. I.hope you find the above responsive to your concerns. With kind regards, I remain, Very truly yours, Deborah S. Crumbley DSC/jmh' cc: Kathy Rice f i