Workers' Comp Rehab programs & Graduated Return to Work PART1
Posted by Mike Crone on Wed, Dec 02, 2009 @ 02:03 PM
THIS IS THE 1ST OF A 2 PART ARTICLE. THE SECOND PART WILL BE FORTHCOMING
Secondary and Tertiary assessments are performed by the Workers' Compensation Insurer's contracted Rehabilitation Centers. These private organizations employ Physicians, Chiropractors and Rehabilitation Consultants, but the majority of care is left to the rehabilitation coordinators / physiotherapists. These programs effectively transfer care away from the Attending Physician to the rehabilitation facility which restarts the entire medical recovery process from square one. 
Almost all assessments made by a Rehabilitation Center result in referrals to an 8-12 week tertiary care program (comprehensive rehab programs) in its own facility, followed by a recommendation for Graduated Return to Work (GRTW). GRTW plans normally commence with a 2-4 hour a day placement with defined medical restrictions and gradually increase to full work hours over a 6-8 week period.
While GRTW plans are better than having no work approval, the principle of GRTW harkens back to the infancy stage of disability management theory twenty years ago. Recent studies have indicated that GRTW programs are not meeting Full Return to Work (FRTW) outcomes (<40% of employees maintain FRTW status after having been discharged from these programs). In fact evidence is showing GRTW may be extending average claim durations as Physicians, and rehabilitation providers commonly allow employees to determine their own timelines for FRTW readiness. This is evidenced by the fact that 50 % or more of all employees engaged in GRTW programs do not meet their full return to work goal-dates. Increasingly, employers are being forced to accommodate more temporary and permanent work placements.
Current medical data indicates that maintaining injured/disabled employees on sedentary or light duties at full hours, as opposed to a GRTW plan, is far more effective in achieving FRTW goal-dates and reducing average claim durations.
PART 2 COMING SOON!