A strong indication of case management gone wrong, is how many days a worker is on modified duty. The number of days a worker is performing modified duty needs to be managed by the return-to-work team, typically comprised of a physical or occupational therapist, a return-to-work coordinator and the worker's supervisor.
We have known for a long time that "work is therapy" and that workers' job tasks can be reassigned in a progressive manner, simply by adding more physically demanding job tasks as the worker heals. The primary goal is to bring the worker back to full duty with no restrictions as safely and efficiently as we can. The secondary goal is to identify potential ergonomic adaptations that may be effective in preventing an exacerbation or reaggravation of the worker's condition.
A visit by the work site team can yield extraordinary results
In order to progressively reassign job tasks, we have to first determine what the job tasks are. Often times, a simple work site visit by the return-to-work team can provide detailed job task information that can be used to determine the best route to take to progress the worker back. More often than not, this team is led by a physical or occupational therapist that has expertise in occupational health and knowledge in how to make ergonomic adaptations at the work site.
Once the detailed job task information is determined, the therapists can now develop functional tests that are specific to the physical demands of the job. This information can provide a baseline of the worker's function prior to returning to work. This way, the worker can be retested each week, and job task progression decisions can be made using real-time functional data regarding the worker's improvements in function.
Return to the same job, same employer is the primary goal. By providing weekly functional tests that are specific to the physical demands of the job, workers are able to return more efficiently and safely.
Sandy Goldstein, PT, CDMS is the principal of Sandy Goldstein & Associates based in Scottsdale, Arizona. He has developed hundreds of formalized return to work programs for employers including Burger King, Kent State University, Western Reserve Historical Society, Subway, and McGraw Hill, to name a few. His specialties include functional testing, development of fitness-for-duty and return-to-work programs and injury prevention. He can be reached at sgoldstein@measurabilities.com or www.measurabilities.com.