Nuts and BoIts of Nuts and BoIts of Returning Returning

Employees to WorkEmployees to Work

Presented by: [name]Presented by: [name]

Outline of WorkshopReturn to Work ProgramsBuilding the Relationship with the PhysicianDetermining the Employee’s AbilitiesDetermining Physical Demands of the JobComparison: Abilities & DemandsFacilitating The Return to Work ProcessCase Study

Disability ManagementDisability Management

“The process of minimizing the impact of and impairment

(resulting from injury, illness or disease) on the individual's capacity to participate competitively in the

work environment.”

Dr. Donald Shrey, Sourcebook of Occupational Rehabilitation, Plenum Press, New York

WhatWhat is Workplace-based is Workplace-based Disability ManagementDisability Management?

Encompass all individuals who require assistance to return-to-work after a disabling injury or illnessRTW component requires full involvement and cooperation by: injured/ill employee, disability management coordinator, managers, supervisors, union, treatment providers and benefit carriers

** National Institute of Disability Management and Research

WhyWhy Early Early InterventionIntervention?

50% chance of returning to work after a 6 month absence20% chance after a 1 year absence10% chance after a 2 year absence

** National Institute of Disability Management and Research

WhyWhy Implement a RTW Process?

Individual regains their former income levels and a chance to perform meaningful workUnion satisfies their role in protecting the employability of one of their members while still maintaining rights and principlesEmployer retains a valuable employee and decreases their total costs

** National Institute of Disability Management and Research

Characteristics of Success

Joint workplace agreementJoint labor/management committeeDisability management coordinatorEarly intervention and effective RTW strategyTransitional RTW opportunitiesMonitor incidents, costs and outcomesPolicy and procedures manualOngoing education and awareness programSupport of front line supervisorsCooperation and support of benefit carriers

** 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 teamProvide medical-related dx, prognosis & restrictionsLook for RED FLAGS that would indicate need for further medical investigationIf 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 questionClarity concerning information requestedPay reasonable fee promptly

DETERMINING ABILITIES

Determining Abilities

What Does This Mean ?What Is The Purpose ?

Treatment MonitoringComparison To Job Demands / 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 D ate: __________________ 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 Tolera nce

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, WalkJob Information Required

Spectrum of Functional Information

Standardized AssessmentsKey Functional AssessmentIsernhagenHanoun/ArconMatheson

Spectrum of Functional Information

Key Functional Assessment

Spectrum of Functional Information

Key Functional AssessmentStandardizedValidity ComponentsActivity Tolerance Extrapolations Work Day Tolerance Recommendation

Spectrum of Functional Information

2 Day Key Functional AssessmentDay I – Standardized KFADay II- Reproducibility

- Job Simulation

Spectrum of Functional Information

Hanoun Assessment

Spectrum of Functional Information

Hanoun/Arcon Assessment1 or 2 Day AssessmentCOV For Consistency CheckComputerized Non-StandardizedNo 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 Determining The Physical Demands of Physical Demands of

the Jobthe 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 Ergonomics Job rotations and/or enlargement Post Offer Pre- Placement Screening Tool

Physical Demands Analysis

Standardized FormatConcise FormatObjective MeasurementsDigital PhotographsEssential vs. Non-Essential Physical DemandsLabour & Management Endorsement

Data Collection

DemographicWork EnvironmentPositioningMobilityStrength

Frequency

Not at allSeldom or not dailyMinimalOccasionalFrequentContinuous

Essential FunctionPosition exists to perform the functionMore than 50% of the workers’ shift Requires special expertiseNot requiring will cause undue hardshipLimited # of workers whom the function can be reassignedMust be performed in the manner demonstrated

COMPARISON

Determination Of

Abilities

Determination Of Job

Demands

Return to work

Transitional Work Plans

What is it?

Individualized Structured Progressive

Re-integration back into the workplace

Transitional Work Plans

Who is appropriate?“Employees who do not fully meet their job requirements

may benefit from a structured Transitional Work

Plan.”

Transitional Work Plans

How is it established? Consent Doctor Approval Functional Abilities Job Requirements - physical

Transitional Work Plans

How is it established? Initial TWP Meeting

TeamLocationEstablish clear action plan

Transitional Work Plans

How is it established? Monitoring

TeamLocationDocumenting achievements Modify action plan

Transitional Work Plans

How is it established? Documentation

Initial reportProgress report Discharge report

Transitional Work Plans

KEY ELEMENTS Structured plan with timelines Communication Written daily plan - documented Progress is monitored Plan is adjusted, if needed Education Connection with stakeholders

Transitional Work Plans

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