Active situations in The Engine

Physician portal · #25 Occupational Medicine

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Accepted work restriction, not carried into floor operations

A lifting restriction (max 7 kg) was issued, delivered to the employer, and acknowledged — but it was not carried into floor operations, and the associate was assigned tasks that exceeded it.

Occupational health (first implementation domain) · A regional distribution center. Manual palletizing and order picking. · A six-week window from the date of the restriction.

Source depth: Level D

Perspective

Same case · facts preserved

The clinician whose plan must be carried into operations.

One action, every portal updates

Carry the accepted restriction into floor operations — held by Shift supervisor / operations scheduling. Set the modified-duty flag on the assignment sheet and align tasks to the 7 kg restriction for the remaining period.

Obligation open — all six portals reflect the departure.

Patient
Modified duty not yet confirmed on the floor.
Physicianviewing
Restriction accepted but not yet carried into operations.
Employer
Avoidable exposure active; loss pattern continues.
Administrator
Obligation open: modified-duty flag not set.
Benefits Adviser
Delay exposure is still accruing.
Fiduciary / Legal
Execution not yet evidenced; departure stands on the record.

The $17,500 demonstrable avoidable cost is already incurred and does not change when the action completes. What changes is forward status: the avoidable exposure stops accruing.

Physician asks

Was my care plan carried out?

No. Your restriction was received and accepted by the employer, but it was not carried into floor operations — the assignment sheet and scan log show lifting above 7 kg.

5. Current status

Accepted restriction NOT carried into floor operations. Obligation open and overdue on the floor.

6. Timing / delay

Delay elapsed: from Day 4 (first non-compliant assignment) through Day 39 (incident). Exposure accrued across the window.

3. What matters now

The break is between acceptance and execution — downstream of your clinical decision.

4. Responsible party or process

Employer scheduling / operations, not the clinical team.

7. Economic consequence

Demonstrable avoidable cost: $17,500 (fixed, already incurred). Forward avoidable exposure continues while the obligation stays open.

Demonstrable avoidable cost$17,500

8. Next action

No clinical change is required from you. The accountable step is operational: set modified duty and align assignments.

11. Relevant beneficiary

The patient the plan was written for.

9. Evidence (2)

E5 · Shift task-assignment sheet

verified

Day 4, 06:00 (recurring)

Shift assignment sheet — palletizing 20–25 kg, no modified-duty flag.

E6 · Handheld scan log

verified

Day 4 through Day 39

Handheld scan log — items over 7 kg lifted across Days 4–39 (machine log).

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10. Boundary

Confirms execution failure. It does not reinterpret your clinical judgment, which the record supports.

The dollar result — seven categories, never collapsed

Knowledge as of Close of the six-week restriction window and immediate follow-up.

Demonstrable avoidable cost

$30,000 − $3,500 − $9,000 = $17,500

Employer-paid − supported necessary cost − excluded uncertainty. This $17,500 is a demonstrable avoidable cost already incurred — not a post-Engine cost, and not a claimed saving.

What the employer paid (4 lines)

Medical claim paid$14,200
Wage replacement paid$9,800
Operational backfill$4,600
Administrative handling$1,400

1.Necessary supported cost

$3,500

What correct execution (the accepted modified-duty accommodation) would have cost.

Benchmark — supported reference

2.Cost already incurred

$30,000

What the employer plan and payroll actually paid for this episode.

Stored — recorded payment

3.Current avoidable exposure

$17,500

The avoidable portion of the incurred cost — exposure created by the departure, before recovery.

Derived — calculated

4.Demonstrable avoidable cost

$17,500

Employer-paid − supported alternative − excluded uncertainty. The defensible figure.

Derived — calculated

5.Excluded uncertainty

$9,000

Causation the record does not establish — deliberately NOT claimed.

Derived — calculated

6.Realized savings

Not yet realized

No savings are claimed as realized on this illustrative episode. Realized savings are shown only where recovery is evidenced.

Boundary — not claimed

7.Remaining dollars at risk

$17,500

The demonstrable avoidable cost not yet recovered, and the pattern that recurs while the corrective obligation stays open.

Derived — calculated

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