OT Services in Work Rehabilitation
Supporting Human Endeavors in Meaningful Occupation—
A Systematic Approach
Goals of work rehabilitation programming:
- Maximizing levels of function post-accident/injury to maintain a desired quality of life for the injured worker
- Timely resolution of work-related injuries
- Safe return of injured workers to their place of employment
- Facilitation of corporate safety and economic security
- Remediation and/or prevention of future injury risks
Levels of Involvement
Acute Injury Management
- Determine the history of current condition or injury
- Evaluate occupational/job performance demands
- Perform physical examination
- Determine gaps in existing performance and job demands
- Remediate the differences in a timely manner with a focus on case resolution
Work Conditioning
- Systematic approach used in the restoration of work performance skills of injured workers recovering from long-term injury or illness
- Single discipline involvement
- Focuses on the restoration of musculoskeletal, cardiovascular, and safe work demand performances
- Typically 3–5 days/week for 2–4 hours/session
- Circuit training and work simulation
Work Hardening
- Multidisciplinary, systematic approach used in the restoration of work performance skills of injured workers recovering from long-term injury or illness
- Identical to work conditioning design with the addition of psychomedical counseling, ergonomics, and job coaching/transitional work development
- Typically 5 days/week for 2–4+ hours/day
- Work-hardening clients may progress to transitional work programming with actual performance of job duties at their site of employment. If necessary, final determination of reasonable accommodations can be made during this period of transition.
Functional Capacity Testing
- Standardized and validated advanced levels of testing for the purposes of:
- Determining safe job matches for return to work
- Assessing the level of reasonable accommodations necessary for the reinstatement of an injured worker
- Assignment of level of disability for permanent and partial Impairment ratings following the determination, by the medical provider, that the injured worker has achieved maximum medical improvement
Referral Sources:
- Medical providers
- Insurance case managers and adjusters
- Attorneys
- State agencies
Payer Sources:
- Workers’ compensation carriers
- State agencies (Bureaus of Vocational Rehabilitation)
- Legal settlements
Possible Location of Services:
- Outpatient rehabilitation centers
- Hospitals
- Private industry (on-site clinics)
- Private practices
Occupational Therapy: Uniquely Qualified
The occupational therapy practitioner possesses the unique ability to evaluate workers’ interaction with their work environment through a detailed and scientifically based task analysis. Occupational therapists can evaluate and understand the environmental impact of wellness, cognition, physical disabilities, and medical conditions. The occupational therapist can evaluate the worker role outside the medical model. The occupational therapy evaluation can identify lack of work experience, poor role models, and failure to develop requisite work behaviors. These problems can diminish success in the work environment. Evaluation skills allow the occupational therapist to understand and deliver results in the complex psychosocial and physical work environment (Ellexson, 2000).
Ellexson, M. (2000). Blueprint for ergonomics. Work, 15(2), 107–112. Retrieved January 14, 2008, from the PubMed database, PMID 12441496.
Revised by the Work and Industry SIS, January 2007
Jeff Clinger, Matthew Dodson, Kathy Maltchev, Jill Page
Updated 1/2008