As clinic owners, employers and as Physical Therapists, keeping ourselves, our staff and our community healthy is a primary focus. When an injury does occur, choosing the best facility to receive services to provide industrial rehabilitation can make the difference in the outcome achieved. Are all outpatient clinics able to handle this type of rehabilitation?
Most outpatient therapists are knowledgeable in the therapeutic services and treatment of industrial rehabilitation injuries and can provide adequate rehabilitation of injuries sustained on the job. However, many clinics may be unaware of OSHA standards, lack ergonomic program management or may not possess the depth of knowledge required to work with insurance companies, insurance adjusters, billing companies, lawyers and employers necessary to assist the injured worker back to work.
Any outpatient facility could perform their version of a Functional Capacity Evaluation or a work conditioning/work hardening program and bill the insurance company for reimbursement. However, much more must be required of a facility to work with this unique and specialized population.
When considering an industrial rehabilitation program there are several components to look for which, when provided together, benefit the individual as well as support the employer in returning the individual to work in a timely manner and in proper condition to execute the job duties safely. Program components should include
1. An experienced staff trained specifically in Ergonomic Analysis and rehabilitation
2. A complete compliment of services to meet the needs of the employee and employer throughout the rehabilitation process including:
a. Needs Assessment: The process by which appropriate company information related to ergonomics is reviewed and analyzed to determine appropriate recommendations and/or services to reduce ergonomic related problems. The needs assessment consists of any/all of the following: review of injury data, review of current ergonomic initiatives, and completion of a facility walk through.
b. Workstation Ergonomic Analysis: A facility walk through or a specific workstation analysis provides an understanding of jobs being performed, identifies risk factors, increases employee ergonomic awareness and work practices and assesses physical demands required. This process to identify specific musculoskeletal risk factors and create an opportunity to provide recommendations for ergonomic improvements to reduce or eliminate identified potential risk factors is a vital program component.
c. Pre-Work Screenings: In conjunction with pre-employment screenings, a candidate is tested on essential job tasks which are determined by a physical demands analysis. Results can be utilized to ensure a candidate has the appropriate physical abilities and to assure they meet ADA requirements.
d. Injury Prevention and Training Program: These programs are designed to provide educational support to employers on a variety of subjects including musculoskeletal injury prevention, common work related musculoskeletal disorders and their signs and symptoms, risk factors for injury, ergonomic solutions to reduce and/or eliminate risk factors, fitness and wellness programs and a healthy back program.
e. Worksite Exercise Program: Worksite exercises are used to enhance job performance and reduce physical stress. After identifying specific physical requirements of the job, appropriate exercises and education should be provided.
In addition to qualified staff and a well rounded ergonomic program, the most vital part of an Industrial Rehabilitation program is experience and knowledge. Experience and knowledge to treat the worker, work with the team to get the worker back to a safe work environment, and experience working with the unique team it requires to manage an injured worker.
Time is critical when working with individuals injured on the job. These workers’ compensation cases require timely and objective documentation of skills and abilities as well as of modifications required to return to their job. Not all therapists or facilities understand the unique needs of this population and of the parties involved. A lack of experienced teamwork can lead to inefficiencies, increased loss time from work, risk of re-occurring injury and lack of payment from insurance companies. An experienced staff, a complete, well managed program, and effective documentation and billing practices are keys to a successful industrial rehabilitation program.