Nuts and BoIts of Returning Employees to Work

1. Nuts and BoIts of Returning Employees to Work Shelley Stoyles BSc. OT And Todd Lewin BSc. PT Eastern Rehabilitation Inc.

2. 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

3. WhyImplement 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

4. Building a Relationship with the Physician

5. The Traditional Role of the Physician Diagnosis ¹ Function

6. 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

7. Current Role of the Physician • Collaborate with employers & multidisciplinary team • Provide medical-related dx, prognosis & restrictions • Look forRED FLAGS that would indicate need for further medical investigation • If none found, return to work process commences ASAP

8. 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

9. DETERMINING ABILITIES

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

11. Determining Abilities • How Do We Measure This ? • Functional Information

12. The Spectrum Of Functional Information!

13. Spectrum of Functional Information • Ask The Employee

14. Spectrum of Functional Information • Ask The Physician (Fitness For Work)

15. Spectrum of Functional Information FUNCTIONAL ASSESSMENTS

16. Spectrum of Functional Information • Functional Scan

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

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

20. Spectrum of Functional Information Key Functional Assessment

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

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

25. Spectrum of Functional Information Hanoun Assessment

26. 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

27. When To Request ? • 2-4 Weeks Post Injury! • Prior To RTW

28. Which Assessment ? • File Review with Service Provider !

29. Determining The Physical Demands of the Job

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

31. 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

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

33. Data Collection • Demographic • Work Environment • Positioning • Mobility • Strength

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

35. 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

36. COMPARISON Determination Of Abilities Determination Of Job Demands  Return to work

37. Transitional Work Plans

38. Transitional Work Plans What is it? • Individualized • Structured • Progressive Re-integration back into the workplace

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

40. Transitional Work Plans How is it established? • Consent • Doctor Approval • Functional Abilities • Job Requirements - physical

41. Transitional Work Plans How is it established? • Initial TWP Meeting • Team • Location • Establish clear action plan

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

43. Transitional Work Plans How is it established? • Documentation • Initial report • Progress report • Discharge report

44. 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

45. For more information please contact: Shelley Stoyles Director, Disability Management Eastern Rehabilitation Inc 6155 North Street Halifax, NS B3K 5R3 Tel: 902-455-4911 Fax: 902-455-1866 E-mail: sstoyles@easternrehab.com