Nuts and BoIts of Returning Employees to Work

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Nuts and BoIts of Returning Employees to Work

• Shelley Stoyles BSc. OT
• And
• Todd Lewin BSc. PT
• Eastern Rehabilitation Inc.

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Outline of Workshop

• Why Implement a Return to Work Program
• Building the Relationship with the Physician
• Determining the Employees Abilities
• Determining Physical Demands of the Job
• Comparison Abilities Demands
• Facilitating The Return to Work Process
• Case Study

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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

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Building a Relationship with the Physician
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The Traditional Role of the Physician
Diagnosis
¹ Function
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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 physicians
  recommendations concerning an employees RTW can
  be accommodated

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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

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How to Work with the Physician

• Provide essential function job requirements and
  obtain FCE /or physicians opinion regarding
  specific job in question
• Clarity concerning information requested
• Pay reasonable fee promptly

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DETERMINING ABILITIES
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Determining Abilities

• What Does This Mean ?
• What Is The Purpose ?
• Treatment Monitoring
• Comparison To Job Demands / Abilities

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Determining Abilities

• How Do We Measure This ?
• Functional Information

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• The Spectrum Of
• Functional Information!

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Spectrum of Functional Information

• Ask The Employee

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Spectrum of Functional Information

• Ask The Physician
• (Fitness For Work)

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Spectrum of Functional Information

• FUNCTIONAL ASSESSMENTS

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Spectrum of Functional Information

• Functional Scan

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Spectrum of Functional Information

• Job Specific Assessment
• Simulation
• Demonstrated Sit, Stand, Walk
• Job Information Required

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Spectrum of Functional Information

• Standardized Assessments
• Key Functional Assessment
• Isernhagen
• Hanoun/Arcon
• Matheson

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Spectrum of Functional Information

• Key Functional Assessment

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Spectrum of Functional Information

• Key Functional Assessment
• Standardized
• Validity Components
• Activity Tolerance Extrapolations
• Work Day Tolerance Recommendation

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Spectrum of Functional Information

• 2 Day Key Functional Assessment
• Day I Standardized KFA
• Day II- Reproducibility
• - Job Simulation

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Spectrum of Functional Information

• Hanoun Assessment

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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

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When To Request ?

• 2-4 Weeks Post Injury!
• Prior To RTW

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Which Assessment ?

• File Review with Service Provider !

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Determining The Physical Demands of the Job
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Physical Demands Analysis

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

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Physical Demands Analysis

• 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

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Physical Demands Analysis

• Standardized Format
• Concise Format
• Objective Measurements
• Digital Photographs
• Essential vs. Non-Essential Physical Demands
• Labour Management Endorsement

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Data Collection

• Demographic
• Work Environment
• Positioning
• Mobility
• Strength

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Frequency

• Not at all
• Seldom or not daily
• Minimal
• Occasional
• Frequent
• continuous

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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

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COMPARISON
Determination Of Abilities
Determination Of Job Demands
?
Return to work
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Transitional Work Plans
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Transitional Work Plans

• What is it?
• Individualized
• Structured
• Progressive
• Re-integration back into the workplace

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Transitional Work Plans

• Who is appropriate?
• Employees who do not fully meet their job
  requirements may benefit from a structured
• Transitional Work Plan.

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Transitional Work Plans

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

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Transitional Work Plans

• How is it established?
• Initial TWP Meeting
• Team
• Location
• Establish clear action plan

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Transitional Work Plans

• How is it established?
• Monitoring
• Team
• Location
• Documenting achievements
• Modify action plan

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Transitional Work Plans

• How is it established?
• Documentation
• Initial report
• Progress report
• Discharge report

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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

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For more information please contact
Shelley Stoyles Director, Disability
Management Eastern Rehabilitation Inc 6155 North
Street Halifax, NS B3K 5R3 Tel [phone] Fax
902-455-1866 E-mail sstoyles_at_easternrehab.com