Physical therapy is often prescribed 2-3 days per week, but physical therapy alone is not conducive to conditioning someone to return to work. That is why work conditioning was created to bridge the gap between therapy and returning to work and why work conditioning should be a daily program.
Work conditioning and work hardening are NOT the same thing! Work conditioning is a structured program of physical conditioning, ergonomics training, and education in safe work practices to address the individualized needs of the injured worker as it relates to their return to a specific job or job type. Work hardening programs include Psychologist, Vocational Counseling and Physician intervention with the addition of work conditioning to address physical work deficits.
Programs typically run 2-4 weeks with re-evaluations of the worker’s progress every 2 weeks to identify objective improvements, effort levels and progress towards attaining the goal of returning to work. If the worker has not been doing much at home in the way of exercises or has not been doing light duty work, the first 3 days may prove to be difficult. Increased soreness and pain will likely occur, but this is normal and the best way to alleviate that pain is to continue the work conditioning instead of staying home being inactive, which contributes to the cycle of pain.
Daily programs may scare some employers: won’t these programs be expensive? Some recent data from OSHA cited in Professional Safety Magazine indicates musculoskeletal disorders “continue for the 2nd year in a row to comprise almost 30% of all workplace injuries and illnesses requiring time away from work.” The OSHA website also indicates the indirect costs of any injury can be as much as 4.5 times higher than the direct costs. For example, a claim costing $42,000 (the average worker’s comp claim cost in NC) can end up costing $189,000 with all of the indirect costs (which the employer ALWAYS pays). If a work conditioning program can assist an injured worker to return to work even one day earlier than expected, the program pays for itself (and more!)
One of the most controversial aspects of return to work for injured workers is sustainability. The big question, after physical capabilities are determined, is “Can the injured worker work an eight-hour (or twelve hour) work day within job demands?”
If they are only attending 2-3 times per week, can this question be reasonably and objectively answered unless their job was part time at injury?
A progressive daily program offers the opportunity to determine the injured workers daily work tolerance. Once the worker meets his return to work demands and demonstrates the ability to perform at a greater demand level indicating a strength reserve to perform repetitive work, return to work should be recommended. A gradual return to work should be considered with an opportunity to transition worker back into the work place as research indicates improved outcomes when the worker is present in the workplace.
Alternatively, if no progression is made, then discharge should be recommended and worker should possibly be referred for FCE to address objective work abilities. Waiting for an injured worker to be 100% to return to work is futile as the worker cannot be deemed 100% until they have successfully returned to work.
We have found that a worker who is able to complete a 4 hr/day aggressive work conditioning program demonstrating work tolerance within their job demands with a level of reserve is safe to return to the workplace.
For more information about work conditioning, Functional Capacity Evaluations, Fit for Duty testing, Employment testing, Job Analyses and Ergonomic Assessments, contact Job Ready Services: www.jobreadyservices.net or call: 919-256-1400.