Nuts and BoIts of Returning Employees to Work
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Transcript of Nuts and BoIts of Returning Employees to Work
Nuts and BoIts of Returning Employees to Work
Shelley Stoyles BSc. OT
And
Todd Lewin BSc. PT
Eastern Rehabilitation Inc.
Outline of Workshop
Why Implement a Return to Work Program
Building the Relationship with the Physician
Determining the Employee’s Abilities
Determining Physical Demands of the Job
Comparison: Abilities & Demands
Facilitating The Return to Work Process
Case Study
WhyWhy Implement a RTW Process?
Individual regains their former income levels and a chance to perform meaningful work
Union satisfies their role in protecting the employability of one of their members while still maintaining rights and principles
Employer retains a valuable employee and decreases their total costs
** National Institute of Disability Management and Research
Building a Relationship with the Physician
The Traditional Role of the Physician
DiagnosisDiagnosis
FunctionFunction
Canadian Medical Association
CMA Paper – 1994, Updated in 2000Physician should facilitate and promote timely RTWShould knowledgeably utilize other health care professionals when appropriateUltimately the employer determines the type of work available and whether a physician’s recommendations concerning an employee’s RTW can be accommodated
Current Role of the Physician
Collaborate with employers & multidisciplinary team
Provide medical-related dx, prognosis & restrictions
Look for RED FLAGS that would indicate need for further medical investigation
If none found, return to work process commences ASAP
How to Work with the Physician
Provide essential function job requirements and obtain FCE &/or physician’s opinion regarding specific job in question
Clarity concerning information requested
Pay reasonable fee promptly
DETERMINING ABILITIES
Determining Abilities
What Does This Mean ?
What Is The Purpose ?Treatment Monitoring
Comparison To Job Demands / Abilities
Determining Abilities
How Do We Measure This ?
Functional InformationFunctional Information
The Spectrum Of
Functional Information!
Spectrum of Functional Information
Ask The Employee
Spectrum of Functional Information
Ask The Physician
(Fitness For Work)
Spectrum of Functional Information
FUNCTIONAL ASSESSMENTS
Spectrum of Functional Information
Functional Scan
Functional Scan Intake Form Name: ____________________________________ Date: _____________________ Therapist Completing Assessment _________________________________________ Injury Date: ____________________ Injury Location: _______________________ Physio Start Date: _____________ Family Doctor: ________________________ Occupation: ____________________ Employer/Contact: _____________________ Date Off Work: ________________ RTW Date: ___________________________ WC/WH Start Date: __________________ Insurer/Contact: ______________________ Job Status: Working Not Working Modified Duties Modified hours Job Demands Reviewed: Questionnaire Yes Or No With Employment: Yes Or No
F = Frequent O = Occasional Frequent - 33-66% of time Occasional = 0-33% of time (all weights measured in pounds)
Date
Initial Functional Activities
Job/Lifestyle Demands
Limited By F O
F O F O Comments/ Observations
Above Shoulders
Desk to Chair
Chair to Floor
Push
Pull
Unilateral Carry- Right
Unilateral Carry- Left
Bilateral Carry
Walking Tolerance
Standing Tolerance
Sitting Tolerance
Body Mechanics: Poor Fair Good Excellent Comment (e.g. Forward Bend at Waist; Trunk Twist in Lift):
________________________________________________________________________________________________________________________________________
Affiliated with Eastern Rehabilitation Inc.
Injury Management Centres Form No. 1302 V1 – 02/2002
Spectrum of Functional Information
Job Specific AssessmentSimulation
Demonstrated Sit, Stand, Walk
Job Information Required
Spectrum of Functional Information
Standardized AssessmentsKey Functional Assessment
Isernhagen
Hanoun/Arcon
Matheson
Spectrum of Functional Information
Key Functional Assessment
Spectrum of Functional Information
Key Functional AssessmentStandardized
Validity Components
Activity Tolerance Extrapolations
Work Day Tolerance Recommendation
Spectrum of Functional Information
2 Day Key Functional AssessmentDay I – Standardized KFA
Day II- Reproducibility
- Job Simulation
Spectrum of Functional Information
Hanoun Assessment
Spectrum of Functional Information
Hanoun/Arcon Assessment1 or 2 Day Assessment
COV For Consistency Check
Computerized
Non-Standardized
No WDT
No Postural Tolerances/ Extrapolations
When To Request ?
2-4 Weeks Post Injury!
Prior To RTW
Which Assessment ?
File Review with Service Provider !
Determining The Physical Determining The Physical Demands of the JobDemands of the Job
Physical Demands Analysis
WhatWhat is it?
A PDA is an objective measurement of the essential physical demands associatedwith a specific job classification.
Physical Demands Analysis
WhyWhy do it?
Basis of any Work Injury Management Program
Return to work program Injury Prevention/Early Intervention Program
Job Library ErgonomicsJob rotations and/or enlargementPost Offer Pre- Placement Screening Tool
Physical Demands Analysis
Standardized Format
Concise Format
Objective Measurements
Digital Photographs
Essential vs. Non-Essential Physical Demands
Labour & Management Endorsement
Data Collection
Demographic
Work Environment
Positioning
Mobility
Strength
Frequency
Not at all
Seldom or not daily
Minimal
Occasional
Frequent
continuous
Essential Function
Position exists to perform the function
More than 50% of the workers’ shift
Requires special expertise
Not requiring will cause undue hardship
Limited # of workers whom the function can be reassigned
Must be performed in the manner demonstrated
COMPARISON
Determination Of
Abilities
Determination Of Job
Demands
Return to work
Transitional Work PlansTransitional Work Plans
What is it?
Individualized Structured Progressive
Re-integration back into the workplace
Transitional Work PlansTransitional Work Plans
Who is appropriate?
“Employees who do not fully meet their job requirements may benefit from a structured
Transitional Work Plan.”
Transitional Work PlansTransitional Work Plans
How is it established?
Consent Doctor Approval Functional Abilities Job Requirements - physical
Transitional Work PlansTransitional Work Plans
How is it established?
Initial TWP MeetingTeamLocationEstablish clear action plan
Transitional Work PlansTransitional Work Plans
How is it established?
MonitoringTeamLocationDocumenting achievements Modify action plan
Transitional Work PlansTransitional Work Plans
How is it established?
DocumentationInitial reportProgress report Discharge report
Transitional Work PlansTransitional Work Plans
KEY ELEMENTS Structured plan with timelinesCommunicationWritten daily plan - documentedProgress is monitoredPlan is adjusted, if neededEducationConnection with stakeholders
Transitional Work PlansTransitional Work Plans
Shelley StoylesDirector, Disability ManagementEastern Rehabilitation Inc6155 North StreetHalifax, NS B3K 5R3
Tel: 902-455-4911Fax: 902-455-1866E-mail: [email protected]
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