Understanding of rehab process speeds recovery

Unless you have been injured on the job, it is difficult to understand the worries and concerns that beset the injured worker: Will I be able to work again? How long will I have to live with this pain? What kind of tests and treatments do I have to undergo? Does this injury put me at risk for future injuries?

In order to address these concerns, everyone involved, from the injured worker to the business owner, should understand the rehabilitation process and the services available to aid recovery.

Why is this essential?

For case managers, industrial and company nurses, and insurance adjusters, detailed knowledge of the rehabilitation process and services can help them provide cost-effective solutions for the employer and the insurance company.

For the physician, whose referral decisions are vital in the worker's physical recovery, a clear understanding of the rehabilitation options is necessary to provide the most appropriate care.

Knowing the rehabilitation process helps the work-injury lawyer in defending a client whose rights are at stake, while the employer should be aware not only how rehabilitation works, but how rehabilitation specialists can help prevent future work-related injuries.

Injury therapies.

Neck, back and lower extremity injuries are best treated by physical therapists, who specialize in the evaluation and treatment of these problems.

Cumulative traumas and injuries of the upper extremities are best handled by occupational therapists.

If complete recovery with physical or occupational therapy is achieved, the worker returns to work. If not, the worker may undergo a functional capacity evaluation or a work conditioning/work hardening program.

Functional capacity evaluation.

The functional capacity evaluation, tests the individual's ability to perform physical work. The test is used for vocational exploration or disability determination, and to determine whether it is safe for the worker to return to a specific job.

The outcome of the functional capacity evaluation gives the physician three options. A positive job match would indicate that the injured worker is safe to return to work without restriction.

A negative job match could indicate a return to work with certain restrictions or that the worker is unable to return to work.

In the case of return to work with restrictions, a physician-ordered work conditioning or work hardening program might benefit the worker.

In the case of the worker being unable to return to work, vocational rehabilitation would be an option.

Work conditioning/work hardening.

A work conditioning program is a work-related, intensive, goal-oriented treatment program specifically designed to restore the individual's systemic, neuromusculoskeletal and pulmonary functions.

The goal is to restore the worker's physical capacity and function so he can return to work.

A work hardening program is a highly structured, goal-oriented, individualized treatment program designed to return the person to work.

Successful completion of these types of programs can result in the worker returning to work with no restrictions, or, if safety is an issue, the physician may want a functional capacity evaluation to ensure the worker is safe to return to work.

Failure to complete the program or to comply with the tasks in a work simulation program could indicate it is not safe for the worker to return to the job.

Preventing injury and reinjury.

Potential problems in the workplace or challenges to the physical capabilities of the worker that may lead to further injury can now be detected through quantitative job demands analysis, hazard identification and post-offer screens.

Ergoscience defines quantitative job demands analysis as a systematic, objective process to more precisely quantify the physical demands of work. Hazard identification is the process of analyzing a job to point out those aspects which place excessive demands on the worker and so should be modified or abated.

The post-offer screen is an evaluation of physical fitness levels and spinal flexibility in performing a certain job or task, and it is proven to be effective in predicting the incidence and severity of lower-back injuries.

Taking advantage of these three industrial rehabilitation programs and diagnostic procedures can help prevent injuries.

(Gerard P. Catapang, PT, is director of rehabilitation services for Rogersville Physical Therapy Care, Manual Physical Therapy and Industrial Rehabilitation Center.)