Occupational Rehabilitation Programs Presented by: [name]

Occupational Rehabilitation

Programs

Presented by: [name]

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.).

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.

At Work Program Length of Disability

(Injury Interval) Intake

Assessments Case Management

Interview Musculoskeletal

Assessment Biopsychosocial

Screening Questionnaire

Job Demands Questionnaire

Functional Scan

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

The Tier System

Length of Disability / Injury Interval0-30 Days

Program Length – Hours per dayAverage of 4 weeks, 1-3 hours/day

TIER 1

Length of Disability / Injury Interval30-90 Days

Program Length – Hours per dayAverage of 6 weeks, 2-4 hours/day

TIER 2

The Tier System

Length of Disability / Injury Interval3 - 24 Months

Program Length – Hours per dayAverage of 8 weeks, 4-8 hours/day

TIER 3

Length of Disability / Injury IntervalBeyond 24 Months

Program Length – Hours per dayLength varies, usually 4-8 hours/day

TIER 4

The Tier SystemIn 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.

The Tier SystemBarriers to recovery must be addressed by an assessment that can identify the

barriers, and treatment that can focus on these barriers.

The Tier System

Fixed VariablesAge Gender

Modifiable VariablesInjury Interval

Biological/Medical Barriers (Red Flags)Psychosocial Barriers(Yellow Flags)Occupational Barriers(Blue Flags)

Addressing Delayed Recovery: Biopsycholsocial Model

TIER 1Length of Disability (Injury Interval)

0-30 Days

Intake Assessments

Case Management Interview Musculoskeletal AssessmentBiopsychosocial Screening QuestionnaireJob Demands QuestionnaireFunctional Scan

Program (Rehab): Physiotherapy / Work Conditioning

Physiotherapy Education

Body MechanicsHurt Vs. Harm

Program LengthAverage of 4 weeks

Hours Per Day1-3 hours/day

Other ComponentsAccurate Job DemandsReturn-to-Work PlanningPsychosocial Issues

Functional ScanTwo week intervals

Reports to Stakeholders

Two week intervals or more frequent, if required

Tier 2

Special ConsiderationsPsychosocial issuesJob AvailabilityDelayed Recovery

Intake AssessmentsRehabilitation Assessment(Includes advanced screening of psychological and/or psychosocial issues and functional measures, as well as a standard musculoskeletal assessment)

Length of Disability / Injury Interval is 30-90 Days

Program: (Rehab) Work Conditioning

Program Components

Program OrientationCardiovascularStretchingMuscle-Specific ConditioningWork Simulation/Functional Circuit

Educational Classes

Body MechanicsPsychosocial IssuesStress Reduction Hurt vs. HarmLifestyle / Wellness

Physiotherapy: as required based on the Rehabilitation Assessment.

Other ComponentsProgram Length

Average of 6 weeks

Hours per Day 2-4 hours/day

Functional ScanTwo-week intervals

Reports to Stakeholders Two week intervals

or more frequent, if required

Other Program Components

Job Site Visit/AnalysisAs required for return-to-work Planning

Return to Work ProgramCase Management:

Meetings with employer, Case Manager, M.D., Insurer, etc., as appropriate

Exit Functional Scan

Tier 3

Special ConsiderationsPsychosocial IssuesJob AvailabilityChronicity

Intake AssessmentsRehabilitation 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

Program (Rehab):Work Hardening (Comprehensive)

Program ComponentsProgram OrientationCardiovascularStretchingMuscle-Specific ConditioningWork Simulation/Functional Circuit

Psychological Management If indicated from

Psychological Inventories Medical Consultation

As Required

Educational ClassesBody MechanicsPsychosocial IssuesStress ReductionHurt Vs. HarmLifestyle / Wellness

Transitional Work Plan

Other ComponentsProgram Length

Average of 8 weeks

Hours per Day4-8 hours/day

Functional ScanTwo week intervals

Reports to Stakeholders

Two week intervals or more frequent, if required

Other Program Components

Job Site Visit / AnalysisTransitional Work PlanVocational GuidanceJob CoachingCase Management

Meetings with Employer, Case Manager, M.D., Insurer, etc. (as appropriate)

Exit Functional Scan

Tier 4Clients 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.

Thank you