OT Services at the Workplace: Transitional Return To Work Programs
Transitional work (TWP) is an interim step in the physical recovery of an injured worker. It uses a process of structured programming to identify the ultimate goal-based, return-to-work job and productive, temporary, alternative positions to maximize the safe work capacity of the injured worker. Transitional programs emphasize real work activities or jobs as the principal means in the worker's physical recovery and structure a productive, compensated return to full duty.
Transitional work is not an occupational goal, but rather a means to a successful and gradual transition back to full or regular duty for an injured individual. Ultimately, the objective of TWP is to provide case resolution with all goals met within a multidisciplinary team approach. Transitional work programs take place at the work site and require therapeutic monitoring.
What Are the Benefits of a Transitional Work Program?
Injured individuals return to work and/or their regular job duties more quickly and safely.
Employers receive assurance that the employee is physically able to perform the essential functions of the job. The employer may realize a reduction in lost workdays, lost productivity, claims, and associated workers' compensation costs.
Transitional work represents a proactive disability management strategy that formalizes the return-to-work process by providing organization, structure, and accountability.
Transitional work focuses on removing or minimizing the individual's residual physical limitations.
Transitional work allows for the use of environmentally focused interventions, including ergonomic job modification and associated accommodation strategies.
Transitional work allows the medical professional, supervisor, and safety coordinator to explore suitable work within the safe physical abilities of the worker.
Who Should Be Considered/Referred for Transitional Work?
Individuals who are no longer in need of clinically based treatment and are capable of resuming some form of modified work
Individuals who seek to reenter a job but require assistance in overcoming physical or behavioral barriers
What Are the Goals of Transitional Work?
To gradually transition a worker back to full duty within a reasonable time with or without accommodation
To transition the individual worker to a regular, full-time job within an agreed upon time frame
To monitor the worker's progress regularly with reassessment followed by an upgrade of work tasks and time spent as the individual gains work tolerance and endurance
To determine if tool or job site modifications or ergonomic and/or assistive technology will remove barriers to return to work
To develop a physical tolerance for work, including strength and endurance
What Are the Components of Transitional Work Programs?
Transitional work can be very flexible, based on worker and employer needs. Job tasks, working hours, position changes, increased rest breaks, specialized equipment, and other things may be adjusted.
Transitional work must be a company-wide plan recognizing the responsibility of the employer, union, and employees to participate actively in the rehabilitation of injured or ill workers.
Transitional work assignments must be meaningful, productive, and rehabilitative. These assignments should contribute to the company's operations and provide the returning worker with a worthwhile job. Creation of meaningless jobs or tasks at the work site for the sole purpose of bringing the worker to the workplace insults the worker's integrity and undermines the therapeutic value to transitional work.
On-site supervision by the occupational therapist is essential to facilitate the work task progression designed to recondition the worker to perform essential full-duty work functions.
Transitional work programs that succeed in today's workplace encourage the use of environmentally focused interventions including ergonomic job modifications and associated accommodation strategies.
Who Pays For Transitional Work Services?
Workers' compensation insurance plans
Employers
Individual insurance plans
State and/or local agencies
What Specialized Education and Experience Do Occupational Therapy Practitioners Bring to Transitional Work Programs?
The occupational therapy practitioner has the unique combination of skills and abilities to assess the physiological, psychophysical, biomechanical, and psychosocial function of the individual engaged in occupation. Occupational therapists have the observational skills, training, and expertise to perform complex task analysis and assessment of environmental factors affecting work performance.
What Does the Future Hold?
Changes in the workforce will continue to affect how workers with injuries are treated and return to work. Decreasing numbers of skilled workers and increasing use of temporary workers, the aging workforce, and a labor market changing from predominantly male to predominantly female are all affecting work-based rehabilitation. Many governmental and independent agencies, such as the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH), are working on proactively adjusting guidelines, initiatives, and protocols to address new and changing focus areas. The challenge for future transitional work programs and work rehabilitation in general will be to devise new strategies to address the changes and emerging trends in the workforce.
Revised by the Work Programs SIS, January 2007
Kathy Maltchev, Jeff Clinger, Matthew Dodson, Jill Page
Updated 3/2007