Work Hardening Program

Work Hardening Program

A Work Hardening Program is individualized, focused on return to work, and designed to minimize risk to and optimize the work capability of the person served. The services provided are integrative in nature, with the capability of addressing the work, health, and rehabilitation needs of the person served. Such a program provides for service coordination and management of the person injuries or illnesses.

Who Can Enrol?

  • Physical recovery sufficient to allow for progressive reactivation and participation for a minimum of 4 hours a day for three to five days a week. An exception may be made for hand injuries and other specialized diagnoses to begin at 2-3 hours per day.
  • A defined return to work goal:
    • A documented specific job to return to with Job Analysis
    • Documented on-the-job training
    • A job title agreed upon by the company and worker, verified and documented
  • The worker must be able to benefit from the program. A screening process that includes file review, interview and testing should be used to determine likelihood of success in the program.
  • The worker must be no more than 2 years past date of injury. Recent literature supports early rehabilitation and return to work. Workers that have not returned to work by two years post injury may not benefit. Exceptions may be made for workers with injuries that have required long-term medical care; i.e., extensive burns, diagnoses requiring multiple surgical procedures.

Exclusion Criteria

The above eligibility criteria exclude individuals who have significant red flags, such as Neurological deficit (major motor weakness, disturbance of bowel or bladder control), Infection (Fever, Urinary Tract Infection, Intravenous Drug Use, Immune Suppression), Fracture, Tumour.

What Can I Expect On My First Visit?

An initial assessment for treatment planning is conducted by a Health Care Provider at the start of the Program of Care. The assessment includes the taking of a complete history, subjective evaluation of the primary complaints related to the injury, a thorough physical examination including range of motion evaluation, orthopaedic testing, muscle testing, and neurological testing. The Health Care Provider will also administer outcome measures to obtain baseline measures of pain and function. These may include, but are not limited to the Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index, the Neck Disability Index (NDI), the Lower Extremity Functional Scale (LEFS), or the Upper Extremity Functional Scale (UEFS).

The Health Care Provider will also assess for possible Yellow flags, which can indicate psychological risk factors that may have an impact on their recovery as a result of  behaviour, expectations and recovery from injury. A discussion on achievable goals from the treatment program will be discussed as well as responsibilities of the person served and Health Care Provider through the duration of the program.

What Is The Duration Of The Program?

The duration of the Work Hardening Program of Care is determined after the initial assessment and is dependent on the needs of each individual served.

Discharge Criteria

To be discharged from the Work Hardening Program, one or more of the following criteria must be met:

1)      The worker has reached the goal stated in the plan.

2)      The worker has not participated according to the program plan.

a)  Has not reached interim goals

b)  Number of absences exceeds those allowed by the program. A maximum of 2 absences is recommended.

c)  Worker does not adhere to the schedule.

3)      During the course of the program the goal was discovered not to be feasible.

a) A previously unknown medical problem is discovered. Consultation with the attending physician is required to determine the treatment.

b) The treating team’s judgment is that the physical goals are not attainable. The provider and company then need to determine a new vocational goal based on the worker’s realistic physical capacities.

c) The previously identified job is not available.

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