County of Los Angeles

Department of Human Resources

 ILL-AT-WORK EVALUATION

Updated May 4, 2020

 

The County of Los Angeles (County) strives to provide a safe and healthy work environment for its employees. As noted in the Chief Executive Office (CEO) memorandums dated October 9, 2009, and January 11, 2010, Department Management is expected to take an active role in preventing the spread of communicable diseases such as the flu in the workplace.

Because only a healthcare professional can diagnose a medical condition, the Ill-at-Work Evaluation was established to assist management in difficult cases by providing a professional assessment of potential illness.

Contagious Illness

The contagious period for a typical respiratory illness exists until all symptoms have disappeared for at least 24 hours.  Some symptoms that may be easily apparent to management include frequent coughing, flushed skin, red and watery eyes, and/or reported fever.  When these cases are suspected, it is important for Department Management to first talk to the employee.  The employee should be encouraged to go home and not return to work until they have been symptom-free for at least 24 hours.

Employees should also be instructed to seek care from their personal physician immediately if they experience any of the following symptoms:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Vomiting and diarrhea
  • Fever and/or Chills
  • Disorientation or confusion

 

Special Note Related to COVID-19

 Symptoms for COVID-19 are similar to symptoms exhibited by the flu and other respiratory illnesses; these symptoms can include fever, coughing, shortness of breath, and severe illness.  Please keep in mind that an individual with a chronic non-contagious condition like asthma, chronic bronchitis, or allergies may exhibit similar symptoms.

Employees who have these symptoms during this period of COVID-19 prevention/mitigation should remain at home until at least 10 days have passed after symptoms first appeared AND at least 3 days after they have recovered.

 

REFERRAL OF EMPLOYEE FOR ILL-AT-WORK EVALUATION

If an employee declines management’s recommendation to go home or be evaluated by a personal medical provider despite exhibiting typical symptoms of a contagious illness, the Department should consider an Ill-at-Work Evaluation to be conducted by one of the Department of Human Resources (DHR) Occupational Health Program (OHP)-contracted medical clinics.  Departments are to contact the selected clinic by phone to obtain the appropriate instructions to provide to the employee for the service referral.

Departments may visit the bottom of this page to find:

  • A list of DHR OHP-contracted medical clinics that will conduct Ill‑at‑Work Evaluations, the clinics’ contact information, and the pricing that will be billed to the referring Department (see “Table of Employee Medical Contractors”); and
  • An Employee Examination Work Order to request the Ill-at-Work Evaluation.

 

To Initiate the Ill-at-Work Evaluation, Department Management:

  1. Call the nearest DHR OHP-contracted medical clinic and inform clinic staff that an employee is being referred to the clinic for an ill-at-work evaluation. Obtain specific instructions from the clinic to provide the employee for the service referral (e.g., should employee go to the clinic or go home and contact the clinic by phone prior to going to the medical facility.)

If there is a concern about COVID-19 symptoms, please be sure to let the clinic know.  Clinic staff will let you know whether a phone screening with the employee will be the first step before having an in-person assessment.

  1. Fax the completed Employee Examination Work Order, requesting the Ill-at-Work Evaluation, to the clinic.
  2. Inform the employee to immediately follow the instructions provided by the clinic to obtain services.

e.g., report directly to the clinic, go home and contact the clinic by phone prior to going to the clinic, etc.  The employee may also decide to go home and see their own medical provider.

 

Conclusion of the Ill-at-Work Evaluation

If the DHR OHP-contracted physician concludes:

  1. That the employee is ill and contagious, the employee may be ordered to not return to the work site and be placed off work for the remainder of the day.

For COVID-19, this will be after at least 10 days have passed after symptoms first appeared AND at least 3 days after they have recovered.

The contract physician will notify the Department that the employee has been placed off-duty. An employee placed off-duty by the clinic does not need to return to the clinic prior to returning to work.

Assuming that at least 24 hours have transpired since being ordered to not return to the work site and being placed off work, Department Management would handle their absence and return as they would for any employee who is returning from a medical leave.

For COVID-19, this will be after at least 10 days have passed after symptoms first appeared AND at least 3 days after they have recovered.

Being directed back to the clinic for a second Ill-at-Work Evaluation would be contingent on repeated observations by Department Management of symptoms consistent with a contagious condition, such as the flu.

  1. That the employee is not ill or contagious, the contract physician will notify the Department that the employee is able to return to the workplace.

 

ADDITIONAL ASSISTANCE

Departments with additional questions or needing assistance with the medical evaluation process, may contact DHR OHP Hotline at (213) 738-2187, or Dr. Kenichi Carrigan at (213) 738‑2186 or KCarrigan@hr.lacounty.gov.

 

Ill at Work Work Order

Table of County-Contracted Clinics

Ill at Work Procedures – Printable