On September 25, 2008, the ADA Amendments Act of 2008 was passed that significantly broadened the scope of protection under the Americans with Disabilities Act of 1990.

Many experts in the workers' compensation and disability professions including insurance companies and attorneys are saying, "It's been a long time coming". The intention of ADA of 1990 was to create an equal playing field in the employment arena, for all individuals, disabled or not.

The fact is, since 1990, more than 90% of ADA lawsuits have been won by employers, usually based on whether an employee had a "disability" under the ADA.

NOT ANYMORE! The critical inquiry under this amended law is no longer whether the individual has a disability, but whether covered entities have engaged in an interactive process that supports reasonable accommodation of qualified disabled applicants and employees.

Employers will now, really for the first time, start litigating issues like scope and meaning of reasonable accommodation and undue hardship; essential job functions; what workplace standards are "job related and consistent with business necessity"; workplace risks that satisfy the standards of direct threat; and the scope of the reassignment obligation.

Illnesses such as diabetes, hypertension, heart disease, cancer, depression and pregnancy complications as well as injuries such as broken bones, back impairments, carpal tunnel and other strains/sprains are all impacted by the new ADA. From a practical standpoint, the time is now for employers to start taking a hard look at their practices regarding risk management and human resources and how they interact. The fact is the obligation to provide reasonable accommodation will increase. Employers should establish clear, individualized assessment procedures for injured and ill employees and communicate these procedures to their employees.

Moreover, employers would be wise to be aware of the following 10 Myths that could get them in trouble under the new ADA:

Employers need only accommodate "permanent restrictions". Employers providing "light duty" are satisfying their ADA obligations Repetitive Strain Injuries are not ADA disabilities Medical information and documentation obtained through workers' comp and STD programs must be withheld from Human Resources and managers attempting to accommodate employees Workers' Compensation settlements resolve ADA liability and/or claims Employers may terminate employees unable to return to work after reaching MMI Employers may insist employees be released to "full duty" before returning to work Employees may be disciplined or discharged for failing to comply with return-to-work program requirements Employers may require comprehensive medical exams before retuning injured or ill employees to work The ability to perform jobs safely is an "essential job function"

Sanford Goldstein, PT, CLCP, MSCC is a physical therapist and a disability management consultant. He can be contacted at 602-320-2452 or sgoldstein@pptsonline.com to discuss ADAAA compliance.

For the New Year I will promise to lose weight and keep it off! Many of us say it but many of us also never do it. Weight loss is an important component to an overall fitness. Weight maintenance is the companion piece, and it is much tougher!

Whether you are training for a sport, planning for a wedding, or putting together a fitness program for 2009, it is helpful to lay out the various elements to each goal and focus on each one individually.

When we talk about fitness in general, it can be hard to grasp the overall idea, and then it becomes difficult to implement the various components - like eating well, getting enough rest, and exercising. On the other hand, when we look at just one or two key components the task becomes more easily defined and the execution becomes more efficient. Weight loss can be looked at as a short-term goal. For example outline a plan for specific period of time depending on how much weight you have to lose and how rigorous your plan. You may be able to stick to a particular weight loss regime for say 4-6 weeks that would be impossible to maintain over 8-10 months, so plan accordingly. Weight maintenance is absolutely critical to your fitness plan and without it your weight loss achievement will soon disappear. Golden Rule: You must set up an exercise and eating program (and goals) that are realistic! Diet - Most people know what they should eat, their choices don't reflect what they know to be healthy food selections.

One suggestion is to record (write it down) everything you eat and drink - everything - for a week at first. At the end of the week look over all that you have consumed and ask yourself why you think you ate what you did (convenience, habit), and what you would like, and be willing, to change. Recording your eating habits will help you plan, shop, and prepare food (if necessary) ahead of time that is healthy. This will provide you with awareness and control, and with that you can make choices rather than eat out of habit.

If you accept the positive and negative aspects of your program, you will be able to stay on the road rather than starting over anytime you go off course. Keep moving forward! Long term success means accepting even the unplanned as part of the plan.

Another suggestion to ensure success of your long-term goals is to invite others to travel the road with you. Find someone that you can discuss your program with and talk about your victories and setbacks with productively.

Exercise - Walking is one of the best forms of exercise to weight loss and weight maintenance. Advise your physician (if needed) of your desire to establish a walking regiment. Walking is both aerobic and weight bearing, which makes it a very effective exercise, it is also the safest and easiest way to lose weight and keep it off.

More people maintain weight loss through walking than any other exercise because it is so easily available, so inexpensive (all you need is a decent pair of walking/running shoes), and anyone can do it! And because so many people love to walk, it's easy to set up a supportive network of walking buddies.  Is walking enough? There are tools to help you make your walking workout time super efficient and effective. You may vary your walking terrain and time by walking in the hills for 30 minutes, or on flat terrain for 60 minutes. You can increase the intensity of your walk, too, by doing intervals of fast walking periods (walk one minute extremely fast) followed by slower periods of recovery.

Remember, your instinct and desire to lose weight quickly is common and understandable. But ultimately you'll have to embrace an eating and exercise plan that is sustainable within the scope of your lifestyle. Most importantly BE REALISTIC, make changes little by little to establish routine and maintain weight loss over time.

The following has been cited from John C. Maxwell's; Developing the Leader Within.

I've chosen this particular part of the book because it asks us a good questions, what kind of level of leadership do you have? The following levels start at one, as the lowest level of leadership to five, the highest and most desirable level of leadership. Ask yourself where do I fall?

Level One: Rights; people follow because they have to. Your influence will not extend beyond the lines of your job description. The longer you stay here, the higher the turnover and the lower the morale.

Level Two: Relationships; People follow because they want to. If level one is the door to leadership than level two would be the foundation. In order to become an effective leader we cannot skip this step. Relationships involve a process that provides the glue and much of the staying power for long-term, consistent production. Moreover, you can love people without leading them, but you cannot lead people without loving them.

Level Three: Production; People follow because of what you have done for the organization. This is where success is sensed by most people. They like you and what you are doing. Momentum has been built and productivity increases. Leading and influencing other is fun, problems are solved with minimum effort. You get together to get to together but you love to get together to accomplish something. In other words, your are all results-oriented. Once last thing to remember is, many people have produced great results that were not "qualified."

Level Four: People Development; People follow because of what you have done for them. This is where long-range growth occurs. Your commitment to developing leaders will ensure ongoing growth to the organization and to people. Success without a successor is failure. We notice that at this level the followers become loyal to the leader because of the love and admiration built in the previous two levels. You can win people's hearts and loyalty by helping them grow personally. Do whatever you can to achieve and stay on this level.

Level Five; People follow because of who you are and what you represent. This step is reserved for leaders who have spent years growing people and organizations. Few make it. Those who do are bigger than life. It is achievable!

We can all strive for success as leaderships regardless of our title in work or in life. Everyone is a leader, because everyone influences someone. Not everyone can be a great leader, but everyone can become a better leader.

The joy of giving was never more apparent than when we visited Children First Academy to deliver gifts for Christmas.

Ms. Smith's 2nd grade class was sweet and very well behaved and best of all they were all very grateful for the generous donations from everyone. With the help of the staff and patients at our Mesa- Gateway, Arrowhead, Phoenix and Scottsdale clinic's we were able to get all kids the gifts they asked Santa for and bring a bright smile to their faces.

Our day consisted of helping the class create their own snowmen on paper and make foam reindeer antlers! After some pizza and cookies we all sang Christmas songs and finally handed out the gifts. The billing staff was wonderful - helping the kids with their arts and crafts as well as handing out the gifts. Special thanks to them for dedicating their time and for being so caring.

A fun-filled day was had by all and the gratitude shown by all the kids to us was very special. So in the holiday spirit we should all remember that it is always better to give than to receive and to not forget about those less fortunate than us during the holiday season. For many of these students, the gifts donated by PPTS staff and patients will be the only gift they receive this Christmas.

Thank you to Ms. Smith and her wonderful students for hosting us!