Australia National Standard for Health Assessment of Rail Safety Workers 2024 3.5: Additional tests and referral: use functional or practical assessments only to supplement where the Standard is imprecise, aware they are a snapshot, may injure a worker not fit to attempt them, do not assess injury risk and are not standardised; apply psychometric, aptitude and neuropsychological tests through experienced psychologists interpreted against the Standard; refer to a specialist chosen with the worker and their GP (the existing treating specialist where there is one), explain the rail safety tasks and concerns, have the specialist report to the health professional, not the operator, with copies to the GP, and require a Fit for Duty Subject to Review worker to see their specialist before each review; set review periods from the Standard or, where unspecified, on the condition, treatment response and work, relaxing to periodic monitoring with a treating doctor's report where the condition is cured

What does 3.5 require?

A clinical assessment may need a functional or practical test to confirm fitness, for example of neurological or musculoskeletal capacity, but such tests can only supplement the decision where the Standard is imprecise and never override the criteria; the Authorised Health Professional considers that they are a snapshot not proving a full working day, may place an unfit person at risk of injury (if fitness to perform the test is doubtful so is fitness for the role), do not assess injury risk such as an unstable knee, and are not standardised or transferable, and decides in advance how any result would affect the decision. Practical tests for colour vision or hearing are not recommended. Psychometric and aptitude tests may be used at recruitment, and neuropsychological tests, applied by an experienced psychologist or neuropsychologist and interpreted against the Standard, help gauge severity, recovery and suitability after injury or conditions affecting mental processes. Where a condition warrants specialist referral to assess fitness and advise or start treatment, the worker and their general practitioner are involved in choosing the specialist, an existing treating specialist is used where there is one, the Authorised Health Professional explains the rail safety tasks and concerns, and the specialist's report goes to the Authorised Health Professional and not to the operator, with copies of correspondence and results to the general practitioner and other treating doctors; a worker assessed Fit for Duty Subject to Review is generally required to see their treating specialist before each review appointment and provide a report, with exceptions the Standard names, and telemedicine may facilitate specialist opinion by agreement. Review periods come from the Standard where specified; otherwise the Authorised Health Professional recommends one on the nature of the condition, response to treatment and the work, revising it as treatment settles, and where a condition is cured may recommend monitoring at periodic assessments with a treating doctor's report.