1. Occupational Rehabilitation Programs Presented by: [name]

2. At Work Program Full Duties Tier Programs Off Work* or modified duties Programs * Unable to complete regular activities of daily living (i.e. paid work), whether remunerated or otherwise (household work, student related work, etc.).

3. At Work Program When clients present for Initial Assessment and treatment, while they are maintaining a full work schedule, they are entered into the Eastern Rehabilitation At Work Program. The assessment includes a Case management interview, a Musculoskeletal Examination, and a Biopsychosocial Screening Questionnaire. A functional scan is performed at the earliest appropriate opportunity, and no later than two weeks from the time of the initial assessment. Treatments for each individual patient proceed based on assessment findings; treatments may include modalities, manual therapy, exercise and body mechanics training. Job Site Visits, Ergonomic advice and any additional instructions and education consultations are performed as needed.

4. At Work Program Length of Disability (Injury Interval) Intake Assessments Case Management Interview Musculoskeletal Assessment Biopsychosocial Screening Questionnaire Job Demands Questionnaire Functional Scan

5. Program (Rehab): Physiotherapy Physiotherapy modalities, Manual Therapy, Exercises Body Mechanics / Postural Training Job Site Visit, Ergonomic Advice, Additional Educational Consultations, as required. Program Length Average of 4 weeks Hours per day 1 Hour

6. The Tier System Length of Disability / Injury Interval 0-30 Days Program Length – Hours per day Average of 4 weeks, 1-3 hours/day TIER 1 Length of Disability / Injury Interval 30-90 Days Program Length – Hours per day Average of 6 weeks, 2-4 hours/day TIER 2

7. The Tier System Length of Disability / Injury Interval 3 - 24 Months Program Length – Hours per day Average of 8 weeks, 4-8 hours/day TIER 3 Length of Disability / Injury Interval Beyond 24 Months Program Length – Hours per day Length varies, usually 4-8 hours/day TIER 4

8. The Tier System In an effort to communicate the flow of our injury management programs, we have divided the overall continuum of musculoskeletal injuries into TIERS. One advantage of doing so is so that we can identify, using a “tier-specific” intake screen, the relative complexity of the individual case, and therefore, the most appropriate avenue of management.

9. The Tier System Barriers to recovery must be addressed by an assessment that can identify the barriers, and treatment that can focus on these barriers.

10. The Tier System Fixed Variables Age Gender Modifiable Variables Injury Interval Biological/Medical Barriers (Red Flags) Psychosocial Barriers (Yellow Flags) Occupational Barriers (Blue Flags) Addressing Delayed Recovery: Biopsycholsocial Model

11. TIER 1 Length of Disability (Injury Interval) 0-30 Days Intake Assessments Case Management Interview Musculoskeletal Assessment Biopsychosocial Screening Questionnaire Job Demands Questionnaire Functional Scan

12. Program (Rehab): Physiotherapy / Work Conditioning Physiotherapy Education Body Mechanics Hurt Vs. Harm Program Length Average of 4 weeks Hours Per Day 1-3 hours/day

13. Other Components Accurate Job Demands Return-to-Work Planning Psychosocial Issues Functional Scan Two week intervals Reports to Stakeholders Two week intervals or more frequent, if required

14. Tier 2 Special Considerations Psychosocial issues Job Availability Delayed Recovery Intake Assessments Rehabilitation Assessment (Includes advanced screeningof psychological and/or psychosocial issues and functional measures, as well as a standard musculoskeletal assessment) Length of Disability / Injury Interval is 30-90 Days

15. Program: (Rehab) Work Conditioning Program Components Program Orientation Cardiovascular Stretching Muscle-Specific Conditioning Work Simulation/Functional Circuit Educational Classes Body Mechanics Psychosocial Issues Stress Reduction Hurt vs. Harm Lifestyle / Wellness Physiotherapy: as required based on the Rehabilitation Assessment.

16. Other Components Program Length Average of 6 weeks Hours per Day 2-4 hours/day Functional Scan Two-week intervals Reports to Stakeholders Two week intervals or more frequent, if required

17. Other Program Components Job Site Visit/Analysis As required for return-to-work Planning Return to Work Program Case Management: Meetings with employer, Case Manager, M.D., Insurer, etc., as appropriate Exit Functional Scan

18. Tier 3 Special Considerations Psychosocial Issues Job Availability Chronicity Intake Assessments Rehabilitation Assessment (Includes advanced screening of psychosocial and/or psychological issues and functional measures, as well as standard musculoskeletal assessment). Length of Disability / Injury Interval is 3-24 months

19. Program (Rehab): Work Hardening (Comprehensive) Program Components Program Orientation Cardiovascular Stretching Muscle-Specific Conditioning Work Simulation/Functional Circuit Psychological Management If indicated from Psychological Inventories Medical Consultation As Required Educational Classes Body Mechanics Psychosocial Issues Stress Reduction Hurt Vs. Harm Lifestyle / Wellness Transitional Work Plan

20. Other Components Program Length Average of 8 weeks Hours per Day 4-8 hours/day Functional Scan Two week intervals Reports to Stakeholders Two week intervals or more frequent, if required

21. Other Program Components Job Site Visit / Analysis Transitional Work Plan Vocational Guidance Job Coaching Case Management Meetings with Employer, Case Manager, M.D., Insurer, etc. (as appropriate) Exit Functional Scan

22. Tier 4 Clients with Length of Disability Beyond 24 Months Long term chronic pain clients require special consideration. Certain Chronic pain conditions can not be improved by comprehensive functional restoration programs. These cases are assessed on a case by case basis.

23. Thank you