The majority of the those who may be injured in the workplace will only need standard medical care to return to work, and workers who need rehabilitation will typically recover completely with physical therapy or occupational therapy. However, some workers may not recover enough of their physical capabilities to return to work even though they have recovered from their injury. This is a result of the muscles becoming atrophic or if the worker becomes deconditioned due to lack of physical activities during the injury recovery time. Sometimes the worker is still struggling with residual pain, and fearful of potential reinjury, this is when Work Hardening Can Get You Back to Work.
What is Work Hardening?
Work Hardening is a more intensive structured therapy program in which the physical activities of a specific job are simulated to prepare a worker to return to their specific occupation. Additionally, work hardening provides a comprehensive and systematic therapy plan which is created specifically for the injured worker to help them get back to the physical condition they were in prior to the injury.
The duration of this type of program is typically 5 days per week beginning with 4 hours per day, gradually increasing to 8 hours per day over a 4 to 6-week period. At NWRTW, our Work Hardening program is provided by physical and occupational therapists who specialize in treating injured workers.
Objective to Bring Skills Back to Prior Levels
The objective of work hardening is to return not only the worker’s physical ability but also to bring the worker’s functional, behavioral, and vocational skills back to the skill level present prior to the injury. The therapist administering the work hardening program is provided a detailed job description and will also interview the client in order to understand the work they need to sustain at their job and to help tailor the work hardening program to the specific job requirements of the injured worker.
Program Involves Coordinated Care between the Client, Physician, Claim Manager and or Nurse Case Manager, Vocational Counselors, and Therapists
For an injured worker to be in a work hardening program, the treating physician will make the request, and NWRTW support staff will coordinate insurance approval and the program intake with NWRTW’s therapists who specialize in Work Hardening.
There can be significant variations in the work hardening treatment plans depending on type and frequency of treatment and variations in the amount of time needed to complete the program. The work hardening plan created for each worker will acknowledge and incorporate these factors in the individualized program design, as the goal of work hardening is to get you back to work.
Optimize Work Capability of Worker
The work hardening program or plan designed for the worker will optimize the work capability of the worker while minimizing the worker’s risk of re-injury when the worker returns to work. Each individual plan may incorporate one or more of the following:
- Simulation of specific work tasks
- Simulation of general work tasks
- Physical reconditioning
- Training on how to prevent future injury
- Training on how to perform the work tasks to minimize pain
- Training on how to modify work tasks
- Training on how to modify daily living activities
The worker who understands the reasoning for work hardening and wants to maximize their recovery following their workplace injury will embrace the concept, such as a worker who has been on modified duty and understands what is needed to return to work full duty.
However, if the worker has, behavioral issues, chronic pain or psychological issues interfering with a return to work, work hardening can still be effective and our therapists screen for these issues during our intake assessments and re-evaluations. When any of these interfering factors are present NWRTW will communicate this in the client reports and when appropriate in direct consultation with the referring provider, nurse case manager, vocational counselors, and other stakeholders. In some instances, we may contact the physician to request additional behavioral health support which can be provided by NWRTW’s onsite clinical psychologists or master’s level therapists.
Success Measured in Several Areas
The success of the work hardening program is measured in several different areas. Such as:
- Musculoskeletal improvement
- Cardiovascular status
- Vocational status (in relation to job specific requirements)
Is Work Hardening for You?
If you are still recovering from an injury and believe work hardening will get you back to work, please Contact Northwest Return to Work in Lynnwood, WA, Washington’s premiere rehabilitation center for work injury. If you’ve been injured at work and need more information, begin with Labor and Industries, and start the process, you can find more information HERE.
Learn more about Work Hardening.
Josh Cobbley, OT
CEO, Northwest Return to Work