Yesterday you had an employee with a 10 lb lifting restriction who had been out of work for 6 months. Today they show up with a piece of paper that says “FULL DUTY RELEASE – NO RESTRICTIONS”. So what do you do? – 1) the “Happy Dance” or 2) tremble in your shoes because you are not confident in your employee’s abilities and concerned about re-injury? Do you ever ask yourself, “What is the difference between today and yesterday?” The difference is just a piece of paper with some words on it. Here are your options:
- Let the employee “take it easy” for the next couple of weeks until you’re comfortable letting them try their regular job.
- Throw them back in the regular job on day one and hope (cross your fingers!) that they can do it.
- Let them go later when they wind up not being able to do what was written on that piece of paper or worse, when a re-injury occurs, which of course, leads to yet another piece of paper that may or may not be correct. Do you see that vicious cycle?
The fact is, workers are released when they are medically safe to be in the workplace. That is really the physician’s only job, in regards to return to work for their patients – to determine MEDICAL safety. It is the employer’s responsibility to ensure the employee’s safety in performing job duties.
Here is our reality as Industrial Rehab providers: Injured worker comes in for a Functional Capacity Evaluation. Injured in 11/2013, the worker has had 19 PT visits for 7 weeks from June to August, 2014. Notes indicated he met all goals and was discharged with recommendation to work in a gym for 1-2 months with return to work release. FCE was done in 11/14, one year after accident. In the interview the worker described his job as building pallets of boxes from tractor trailer load and then unloading boxes and placing items into correct warehouse bins for order selection. Job description provided by the employer indicated constant handling of boxes weighing 10 to 30 lbs and occasional lifting up to 50 lbs. When asked about his rehab, he indicated he had been lifting 10 lb dumbbells for 3 sets of 10 during therapy and had not handled even one box.
Not surprisingly, this worker did not meet his goals to return to work at 1 year post injury because one key element was missing. That missing element, Ladies and Gentlemen, is work conditioning. Work Conditioning makes return to safe work as the primary goal of the rehab process. Not an afterthought at MMI when a FCE is ordered.
We have heard many excuses as to why someone was not referred to work conditioning – cost, ineffectiveness, and increased potential for re-injury. Who benefits from these excuses? Certainly not the injured worker. And whose responsibility is it to provide the optimal return to work scenario? – the Employer.
The average cost of a worker sitting at home can be $300/hour or more and every day decreases the probability of getting that employee back to work. If work conditioning can reduce that time by 3 days, the savings will cover all the cost of a work conditioning program with a significant return on investment. Optimal outcomes are dependent on the time from injury to the initiation of work conditioning and if the acute treatment had been successful, the likelihood of re-injury is very small. Reports of increased pain are a result of increasing activity levels with soreness as the number one complaint. We all know that if you are not sore then you’re not going to progress.
To this end, we challenge employers to assume the responsibility of preparing their workers to return to work post injury or illness by investing in their safe abilities to perform job demands via a referral to a progressive work conditioning program.
To learn more about using work conditioning as a tool to increase safe return to work, please contact Job Ready at 919-256-1400 or firstname.lastname@example.org .
-Submitted by Debra Lord, Co-Founder of Job Ready Services