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

Why Why 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 Diagnosis  Function

Canadian Medical Association CMA Paper – 1994, Updated in 2000 Physician should facilitate and promote timely RTW Should knowledgeably utilize other health care professionals when appropriate Ultimately 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 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

Spectrum of Functional Information Job Specific Assessment Simulation Demonstrated Sit, Stand, Walk Job Information Required

Spectrum of Functional Information Standardized Assessments Key Functional Assessment Isernhagen Hanoun/Arcon Matheson

Spectrum of Functional Information Key Functional Assessment

Spectrum of Functional Information Key Functional Assessment Standardized Validity Components Activity Tolerance Extrapolations Work Day Tolerance Recommendation

Spectrum of Functional Information 2 Day Key Functional Assessment Day I – Standardized KFA Day II- Reproducibility - Job Simulation

Spectrum of Functional Information Hanoun Assessment

Spectrum of Functional Information Hanoun/Arcon Assessment 1 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 Demands of the Job

Physical Demands Analysis What What is it? A PDA is an objective measurement of the essential physical demands associated with a specific job classification.

Physical Demands Analysis Why Why 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 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 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 Team Location Establish clear action plan Transitional Work Plans

How is it established?  Monitoring Team Location Documenting achievements Modify action plan Transitional Work Plans

How is it established?  Documentation Initial report Progress 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

Shelley Stoyles Director, Disability Management Eastern Rehabilitation Inc 6155 North Street Halifax, NS B3K 5R3 Tel: Fax: For more information please contact: