You have heard about “work hardening” for the employee who’s been off work for months due to a workers’ compensation claim. But you may wonder exactly what is it and how does it work?
The rehabilitation textbook definition reads something like . . . “work hardening is a systematic, individualized program created to provide the necessary activity for a person to physically and psychologically recondition their body to be able to return to work.”
In plain English, the employee who performed physical labor for years was strong enough to do the job before the accident. Since the accident, the employee lay around watching daytime TV soap operas and the body became soft and much weaker than it was before the injury. In the doctor’s opinion, the employee has recuperated enough to almost be able to go back to work, but the doctor is concerned the employee will suffer a re-injury due to loss of muscle tone.
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This is where the treating physician in collaboration with a rehabilitation specialist may recommend an occupational or physical therapist. Prior to recommending the employee for work hardening, the employee’s medical history is reviewed , and possibly the employee is tested, to see if the employee is a proper candidate for the work hardening program. With the physician’s approval the employee can start the work hardening program.
The goal of the work hardening program is to create real or simulated work tasks providing a gradual improvement in the employee’s strength to the point where the employee becomes able to perform the work assigned when s/he returns to prior employment. If the prior employer does not have a position available for the employee, work hardening allows the employee to be physically capable of working for a different employer.
The physician can either recommend starting the employee with work conditioning or work hardening. The choice between work conditioning and work hardening depends on the physician’s evaluation of the employee’s physical status. If the employee is severely out of physical shape, the work-conditioning program will be utilized followed by the work hardening program. If the employee is not grossly out of shape, the employee can start the work hardening program without the work-conditioning program.
If work conditioning is chosen, the employee starts with a physical therapist who works on the employee’s ability to stretch, lift, and bend and to perform the physical functions needed by the employer. The physical therapist utilizes lighter and easier exercises at the start and gradually increases the difficulty. At the beginning of the work-conditioning program, the physical therapist may work with the employee only an hour a day, but steadily increases the time to up four hours per day.
Once the physical therapist completes the work-conditioning program, the employee is reassessed by the treating physician. If the physician agrees, the employee will then be started on a work hardening program.
The work hardening program is customized to address the physical needs of the employee including both vocational and functional needs. The vocational rehabilitator works with the employer’s personnel office to obtain a precise job description for the employee. This will allow the voc rehab person to tailor the work hardening program to the employer’s needs and to the employee’s capabilities. Considerations in creating the customized work hardening program should include:
- How to simulate the work that is performed on the job
- How to increase the endurance and strength of the employee
- The type of equipment that will be needed – weights, treadmills, circuit training, etc.
- How to measure the improvement of the employee
- How to educate the worker on body mechanics, work posture and pain management
- The daily recording of progress made and the goals for the short term
The work hardening program also includes educational information for the employee on proper lifting techniques, safety, and how to prevent injury or re-injury.
The work hardening program must be completed within a specific time frame of 2 to 4 weeks. The program runs three to five days per week. At the start of the work hardening program, the employee participates for at least 4 hours per day and by the time the program ends, the employee will spend a full 8 hours per day at rehab. Once the employee is rehabbing for 8 hour a day, s/he is ready to start work at the employer on the following day.
A work hardening program is not for every employee out of work for a long period of time. A work hardening program will not change an employee who is more interested in maximizing the disability settlement then in returning to full employment. The programs are most successful with employees who are motivated to return to work and an employer who wants them back at work.
Author Rebecca Shafer, Consultant / Attorney, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers’ comp issues.
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