What is Work Conditioning?

Work Conditioning is an individualized rehabilitation program designed to prepare the injured worker for returning to a particular job. It helps the employee regain pre-injury competence, increase endurance and help reduce the chance of a repetitive injury. This program has been developed as a second step in the rehabilitation process. The work conditioning program is seen as a follow-up to a chronic or acute rehabilitation program and it is coordinated with such programs as the patient progresses from a hands-on treatment approach to an independent strengthening and conditioning program. Our work conditioning program is designed to provide the strengthening, conditioning, body mechanics education and job simulation necessary to enable the worker to progress to the point of returning to work or to be as physically fit as possible to begin vocational rehabilitation.

How Long Can I expect to be in the Work Conditioning Program?

A work conditioning program typically last between 2-6 weeks. This time can vary depending upon the physical demand level of the job and/or how quickly the patient can reach their work goals. A work conditioning patient is seen 2-5 times per week for 1-4 hours per day depending on physician referral and patient progress.

What are my Responsibilities as a Work Conditioning Patient?

• Give your best efforts to the program.
• Keep discussion open with your work conditioning specialist: what's working, where you are having difficulties.
• Follow the program prescribed by the work conditioning specialist both at the clinic and at home.
• Work with your work conditioning specialist to find ways that you can control your symptoms.
• Keep in touch with your employer/case manager and agree to do the tasks you are safely able to do as part of your return to work program.

The Goal of our Work Conditioning Program:

Is to return the injured worker to gainful employment as safely and efficiently as possible. We achieve this goal through direct communication with referring physicians, case managers, insurance adjusters and patient to ensure that all parties are working toward the same goal of efficient case resolution.

What is an FCE?

FCE is an abbreviation for Functional Capacity Evaluation. FCE is a comprehensive objective test of an individual's ability to perform work-related tasks. FCE is known by other terms including physical performance testing, work capacity evaluation, physical ability testing, etc. FCE typically includes testing to determine the worker's ability to handle material (weight), walking and balance abilities, and positional tolerances such as sitting, standing, bending, or squatting. Your treating physician has ordered this test as one of many tools and resources to accurately determine what a safe and acceptable physical demand level for you as it relates to the job you were performing at the time of your injury. A thorough review and history of your injury will be discussed prior to the start of any tests. You will be given several opportunities to ask questions to make sure you understand what the test is about, how the test will be administered and what information will be gathered from the testing process. You will be tested on your strength, flexibility, functional ability, material handling, and non material handling ability in numerous postures, positions and work simulated tasks. Each test will be thoroughly explained before the test is initiated. We will document your test results in several ways.

The Criteria of Functional Capacity Evaluation

The Functional Capacity Evaluation (FCE) is a one or two-day assessment of the client's functional capabilities. The test safely and objectively measures:

• Repetitive lifting capacity at various levels
• Repetitive push, pull, and carrying capacities
• Hand grip strength
• Tolerance for elevated work
• Prolonged trunk flexion in sitting and standing
• Prolonged trunk rotation in sitting and standing
• Prolonged crawl, knee and sustained crouch positions
• Repetitive squat
• Tolerance for prolonged sitting and standing
• Maximum walking, stairs and stepladder capacity
• Balance
• Hand coordination

Following the FCE, results and recommendations are discussed with the client and referral source.

What Should I Wear or Bring to my Evaluation?

The tests we will ask you to perform do involve and require physical movement and agility. We recommend that you wear clothing that is comfortable to move around in while performing the same duties and tasks as if you were working. If you have a lower extremity injury we ask that you bring or wear a pair of shorts. If you have an upper extremity injury we ask that you wear a loose t-shirt or tank top (females are asked to wear a jog bra).

In summary, the FCE Should Answer the Following Questions:

• What is the client's overall level of work?
• What is the client's tolerance to an 8-hour day?
• What was the client's level of cooperation?
• What are the client's specific limitations?
• Do the client's abilities match the job demands?
• What specific interventions need consideration for the client?

An FCE is without question the most comprehensive examination performed in the therapy setting. It provides objective data for the rehabilitation team establishes client abilities and disabilities and determines if the client will be able to successfully return to work and meet the demands of the job.

In today's market, it is worth the time and effort to seek functional, objective data that will help you make decisions for your patients. It is worth the time to objectively determine if your client will have a safe and productive return to work. It is worth the time to seek a provider who administers quality, standardized and validated FCE that will support your decisions and underscore an accurate picture of your client's abilities.

If you would like to learn more about the Functional Capacity Evaluation and how it can assist you in making return to work decisions, please contact us at (708) 361-8052.

A job analysis is a process used to identify the important tasks of a job and the essential skills a person needs to successfully and safely perform the job. An analysis can be instrumental in selecting individuals for employment and in determining if an employee is ready to work following an injury.

What is the Purpose of a Job Site Analysis?

A job site analysis can be performed for several reasons. It is typically performed to evaluate an employee's workstation and determine if the set-up is ergonomically correct. A job site analysis can also be performed for an injured worker to correct any flaws in the workstation design or for a group of non-injured employees as a preventative measure to avoid future injuries. In either case, a job site analysis will provide ergonomic recommendations that enable a better fit between the worker and his or her workstation. Finally, a job site analysis can be performed to determine causal relationship between an employee's injury and his or her work demands.

What should be Included in a Report Following a Job Site Analysis?

The written report of a job site analysis may have a variety of formats. However, the most important concern is that the report is organized, easy to read, and supplies the appropriate information. Other information within the report includes:

1. The company's name, employee's name and the employee contact
2. The purpose of the job site analysis and a definitive statement regarding that purpose
3. Employee, co-worker and supervisor interviews
4. Significant objective data
5. Risk factors, solutions and/or recommendations depending on the report's purpose

Functional Job Analysis (FJA) involves analysis of a particular job with a detailed descriptive write-up. The analysis is consistent with the philosophy of the Americans with Disabilities Act (ADA) and utilizes input from the employee and employer. Information is acquired through objective measurements from on-site observation and videotaping. Once the job description is developed, our experienced staff will provide information on how the job could be modified to make the work site safer for all employees.

Pre-Work Screen (PWS) is a job-specific screening process. It involves functional testing to screen a client for a particular job. While the evaluating therapist may determine whether the client can meet the job demands, it is the sole responsibility of the employer to make the hiring decisions.

What is Work Hardening?

Work Hardening is a highly structured goal-oriented, individualized treatment program designed to return a person to work. Work Hardening programs, which are interdisciplinary in nature, use real or simulated work activities designed to restore physical, behavioral, and vocational functions. Work hardening addresses the issues of productivity, safety, physical tolerances, and worker behaviors."

What is the vocational counselor's role in a work hardening program?

The vocational counselors may:

• Identify potential work hardening candidates.
• Facilitate referrals to a work hardening program, if approved by the physician and authorized by the claim manager.
• Provide a job analysis for the job goal.
• Explore return-to-work options with workers in order to identify a job goal.
• Assist in the development of job modifications, if appropriate.
• They may also, communicate with work hardening program staff.
• Attend conferences as needed. Work with the work hardening team to facilitate a transition to work if appropriate at the completion of the program.

Back Injury Prevention Programs: The Back Injury Prevention programs help patients lift weights in the correct way. A physical therapist works with a patient to eliminate bad habits and instill good ones. The program offers body mechanics training, body evaluation, repetitive lifting and bending flexibility exercise. Clients assist in setting goals every week and are discharged from the program if the goals are not met. The length of the program can range from two to six weeks.