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Return to Work

L5 what are the three systems for providing vocational rehabilitation support in Canada? 1. Government Programs and Services 2. Workers' Compensation 3. Private Insurance *Each overlap and change based on location
L5 What is the workers compensation board? An employer funded service to absolve their legal liability if you injured ON the job
L5 What does the workers compensation provide the worker? Rehabilitation, income, medical and employment support
L5 What is private insurance? Varying coverage what's NOT covered by workers comp. Use of private insurance might negate government services
L5 Under what area of government do clients with disabilities fit? There is not comprehensive legislation esp. reserves or aboriginal clients
L5 What section of the Canadian of Charter of Rights and Freedoms applies to disabilities? Section 15- Equality Rights
L5 What is the Human Rights Act, who does it cover? It applies only to federally regulated activities and undo hardship.
L5 What is the Employment Equity Act? it ensures equity only for federal industries
L5 What is the Alberta Human Rights Act? Legislation preventing descrimination
L5. What are national employment Supports? For clients with limited conditions through advocacy organizations (eg.CNIB)
L5 What provincial organization may be responsible for AISH and worker supports? Alberta Suppors and new Human Services Dept
L5. What is Disability Related Program Supports DRES? What do you need to be eligible? Provides supports and resources to individuals with permanent disabilities in alberta. Just a doctors note, and intake worker
L5. What are the three areas DRES centres on? Job search supports(resume/interview work shop) Workplace Supports Education Supports-hard area to access
L6.What are the 3 goals of ergonomics? Reduction of injury Optimize performance Increase efficiency
L6. What are the 7 components of ergonomics in the workplace? The organization, The equipment, The workstation, The enviroment The information systems, Job design, Training and Supervision
L6. What are the three domains of ergonomics? Physical, Cognitive, Organizational
L6. What are the 4 components of the physical domain in ergonomics? Postures Motions Layout Safety and Health
L6. What are 4 the components of the cognitive domain in ergonomics? Mental workload Computer interaction Work stress Human error
L6. What are the 7 components of the organizational domain in ergonomics? Communication Staff managment Work design Scheduals Telework Teamwork Quality managment
L6. What are the 4 deliverable objectives in Human Resource ergonomics? Job satisfaction Employee retention Improved labor relations Reduced Absenteeism
L6. What are the 3 deliverable objectives in Occupational Health in ergonomics? Reduced injury Reduced disability costs Improved satisfaction
L6. What are the 3 deliverable objective in Productivity in ergonomics? Less waste More efficient work Higher productivity
L6. When 5 factors suggest a need for workplace ergonomics? Increased Productivity/Quality Demands Increased Overtime Attractive/Retaining Employees Aging workforce Increasing injury/illness costs
L6.What are the 4 indirect costs of an injury? Training costs Moral Loss of productivity Hiring and recruitment costs 5-7 times the direct costs
L6. What are the 6 physical risk factors of injury? Posture High hand forces Repetition Repeated impact Heavy, frequent, awkward lifting Vibration *Especially in combination
L6. How is High hand force classified? a force held more than 2 hours perday A pinch of more than 2 lbs of force
L6. How are repetitive forces classified? not more than 15% of 1RM repetitively, not more than 30% 1RM for occational, not more than 50% for infrequent tasks Not more than 5% for static exertion
L6. What 3 factors affect grip strength? Gloves Age Wrist posture Dominance of Hand
L6. How is high repetition classified? Cycles less than 30sec apart. More than 50% of the work day. More than 1000 times per hour
L6. How is awkward posture classified? Posture is held more than 2 hours, or repeated more than 10 times
L6. What are the four methods of preventing workplace injury? Engineering Protective Equipment Administration Education/training
L7. What is a restriction? A potential risk point they shouldn't go beyond
L7. What is a limitation? Something beyond a persons capabilities
L7. In the insurance world what does limitation mean? If they can return to the same job, how much compensation they might get
L7. How does prolongued work absence effect the individual? It makes it less likely to return to work, Detrimental to mental, physical, social wellbeing Increased deconditioning
L7. What is the SPICE System, how does it represent factors influencing return to work? Simplicity-treat conditions Proximity-connection with workplace Immediacy-deal with claims quickly Centrality-collaborating to return Expectancy-can they fulfill expectations
L7. What is a way to ensure centrality of goals? Make sure that stakeholders all right them down
L7. What are the 4 key elements of return to work? Supportive enviroment Key stakeholders work together Needs of stakeholders need to still be met Creative work interventions
L7. What four issues predict a failure of return to work? Work issues, Health issues, Claim issues or Rehab issues
L7. What 4 kinds of work issue contexts predict failure to return to work? Return to early, Accessibility, Lack of accomodation, Embarassing return duties
L7. What 3 kinds of health context issues predict a failure to return to work? Undiagnosed or complicated health issues Medication use problems Progression of issue or re-injury
L7.What 4 kinds of rehab context issues predict a failure? Lack of vocational training Fast pace Lack of belief Lack of experience
L7. Who are usually the 6 key stakeholders in Return to work planning? Workplace Supervisor Worker Human Resources Occupational Health and Safety Insurer Union
L7. What are the two most powerful ways of modifying return to work planning? Modified hours and Work from home
L7. What are 3 parts of the transitional return to work plan? Increasing hours, increasing pace, increasing load
L1 What are 3 of the benefits of work on the health of the individual? Social-economic benefits, Unemployment stress, Psycho-social benefits
L1 What are the 3 best motivators for work? Autonomy, Mastery, Purpose
L1 What are 3 trends in the workforce? Aging workforce, Controllable lifestyle factors >influence Under-utilization of Disabled
L1 What are 4 can disabled workers be better utilized? Educate employers, Network employees and employers, Provide training and interships Adapt enviroment
L2 What is the difference between acute musculoskeletal, neuropathic and chronic pain? Acute-warns of injury <3months Neuropathic- damage to nervous system Chronic-No longer injured 3+ months
L2 What are the 4 most common issues of chronic pain? Loss of function Loss of social role, Uncertainty in diagnoses, Stigma
L2 What is are the 4 roles of occupational therapy in dealing with chronic pain and return to work? Exploring the story Identify barriers Explore function Resume enjoyable activity
L2 What is the best treatment for chronic pain, what is a way to do this? Exploration of their narrative, how their view of themself has changed, artistic expression
L3 What are the three things a Functional Capacity Evaluation (FCE) is used for? Determines ability to do work and change, If able or disabled, Liability/Litigation
L3 Who can Perform an FCE? Any professional with specific FCE training
L3 Where are the two locations (types of) FCE's can be performed in? In the clinic (commercial)or on the worksite
L3 What are the 3 steps of an FCE? Info gathering from stakeholders Physical assessment Functional test
L3 What are the 5 features of a well designed FCE? Comprehensive, Standardized, Reflects function, Valid/reliable, Safe
L3 What 4 pieces of information need to be gathered before performing a Functional Capacity Analysis? Background of injury, Treatments, Physical demands analysis of job, Worksite visit
L3 What is maligering? Exaggerating or fabricating symptoms for secondary benifits
L3 Why is strength, ROM, Grip, Pain, and cardiovascular health assessed? Because some functional impacts can sometimes be interpreted (though research says this might not be true)
L3 What 5 physical measures are commony assessed as part of a FCE physical demands analysis? Grip/Pinch, Functional ROM, Dexterity Sensation, Manual Handling
L2 What is the most common disabler amoung workers? Chronic pain esp. lower back
L4 What is a job analysis? Evaluation of the essential demands of a job, and limitations of the client
L4 What are the 4 parts of a job analysis? Purpose, Work plan, Evaluation methods, recommendations
L4 What 7 steps are part of a job analysis? Job title, Job description, Work hours, Physical demands, Cognitive demands, Psychosocial demands, Environment
L4 What physical measurements are part of a job analysis? There is no standards
L4 What are 6 socail demands of work? Relationships, Teamwork, Time pressure, Communication, Supervision, Schedualing
L4 What are 5 cognitive demands of work? Decision making, Info processing, Evaluation/Judgement, Perception, Education/skill
L4 What is the National Occupational Classification (NOC)? A description of the job demands
L4 What is the Dictionary of Occupational Titles (DOT)? A description of the job demands
L5. Who supports the disabled worker? There is no consistency within provinces, WCB and private insurance systems, get to know local supports
The Model of Human Occupation is the theoretical framework for the WRI, this is because: It attempts to explain the psychosocial and environmental factors that influence human performance and disability
The Worker Role Interview consists of five steps these are: Preparing the interview Conducting the interview physical, work capacity or functional assessments Completing evaluation scoring Conducting the interview
What is a solution to set aside the time to complete the WRI interview (40–60 minutes)? Break the interview up, include parts of it during the functional capacity portion of the assessment.
What is a possible solution to the percieved difficulty of asking a series of probing questions in the WRI? Asking questions while the client is focused on manual tasks can facilitate responses to the more personal or emotionally-laden questions.
Should you score the interview rating scale if have enough information from the interview alone? Yes, It allows the therapist to reflect on the accumulated information, draw conclusions and make informed predictions about the client’s ability to benefit from treatment and eventually return to work
Why should you score the WRI? The visual picture of the person’s pattern of responses (strengths and weaknesses) assists the therapist in prioritizing areas for treatment intervention and follow up discussion.
What is a possible way to conduct the WRI when the insurer won't pay for an instrument that focuses on factors beyond functional capacity ? Incorporate the WRI into the normal work hardening assessment process and treatment planning process. For example, therapists include the WRI as part of the comprehensive work capacity evaluation, rather than billing it separately.
What is a way to inform the insurer and employer, that addressing non-work issues in an WRI will prolong time off work and be costly to treat? Use more work-oriented term and the therapists can also point to data that shows the factors measured by the WRI are more predictive of return-to-work than demographic factors such as time since injury.
What is a way around resistance from the employer and insurer about addressing non-work roles in the work hardening program? Addressing selfcare tasks such as getting out of bed, putting clothing on, and getting in a car using correct body mechanics are all relevant for return-to-work and prevention of re-injury.
Can motivation issues be addressed by using the client’s desire to return to non-work roles to facilitate involvement in work hardening? Yes.
Assessing from the "top down" Why should therapists assess clients from the “top down”, looking at role competency and meaningfulness first, and then at abilities and developed capacities? Because the [meaning] that the occupation has for the individual directly affects the individual's [physical performance]
The Worker Role Interview includes what kind of interview and how many items? a semi-structured interview a 17 item rating scale
What is the original WRI designed to assess? Injured worker
What is the combined OSCAIRS and WRI designed to measure? Longstanding illnesses and injuries
Is the worker role interview is suitable to use with any person? No. It is important to only use this interview format with clients who you believe are able to give reliable information
What is meant by MOHO volition in the WRI? Valuable/important in their job, Competence at work, Satisfaction in work
In the WRI MOHO the term habituation refers to: semi-autonomous work that one finds enjoyable, patterning of behaviour which is a function of roles and habits
Do WRI questions about the enviroment focus specifically on the workplace? No, they also focus on home and social environment, as family and peer support of work is also important
The therapists should explore malingering and work in what 3 ways? Are they doing what they want? What is important to the individual What is an incentive?
When developing an FCE report, you must utilize what 3 skills? Clinical reasoning, Objective and Subjective measures
There are two main FCE approaches: psychophysical and kinesiophysical. When using a kinesiophysical approach, what is the best way to determine maximum levels? The rater will determine maximum levels using physiological indicators.
When conducting an FCE, the client's pain is: assessed using objective and subjective measures before, during and after the evaluation, in addition to a post-evaluation follow-up.
Why do some evaluees do not give maximum effort during a FCE? Factors such as depression, test anxiety, and language barriers influence performance
Why do clinicians use theoretical frameworks to guide how they conduct a FCE? Provide conceptual systems that assist in guiding and justifying decisions made throughout each stage of the FCE process
Functional Capacity Evaluations (FCE) provide information regarding physical capacity, suitability for employment, and areas for vocational rehabilitation. When an injured worker is referred by the insurer for a FCE who is your primary client? both the referral source and the evaluee are considered clients, it is important to remain impartial and objective
Functional capacity evaluations are used to provide information for what? For planning for rehabilitation services, conducting baseline assessments, planning for RTW, entitlement to benefits, or for medico-legal purposes
When a Functional Capacity Evaluation is conducted in a clinic-based setting, the results provide a greater level of what kind of data? standardized and generalized
Johnny injured his left shoulder at work when trying to lifting and carrying boxes the most appropriate standardized assessments to use in the FCE for Johnny would be: EPIC Lift & Carry Capacity, VALPAR 9
Should the EPIC Lift Capacity test must be performed only by persons who have been trained and certified by EPIC? Yes
You have a client who experiences sever wrist pain and types for more than 4 hours a day at work what would be possible intervetions? Adjust the chair or desk height, Educate the worker to take breaks, Alternate tasks to take break
For a vocation that involves a lot of gripping, what is a good intervention? Providing ergonomic bent handles
Which of the following is the most hazardous: prolongued bending, prolongued overhead work, moderate vibration Prolongued bending
What are the three main elements of an ergonomic assessment? The task, the employee, the work enviroment
Name 3 factors that provide a ergonomic risk? Repeated impact, heavy/frequent awkward lifting, repetative motion, awkward static postures
Why do manufacturing and processing jobs have the highest level of injury? They often have one repetative task, without break
What is the primary purpose of a Job Demand Analysis? To determine the physical demands of the job that an employee must be able to perform
The most successful way to conduct the Job Demand Analysis is by: Gathering data about the job, measure the activities and demands of the job & environment from employee, supervisor,&HR
What is a danger of the EPIC lift test? Demonstrates employee can lift something once, not multiple times in the work enviroment
If a client continures to experinece negative symptoms at work what shoud you re-evaluate ? the details of each of the work tasks and any other tasks the client is having difficulty with
According to the Rehabilitation Systems Approach (1998), the 'performance gap' represents the discrepancy between two key components within the context of the work environment, these components are: the functional limitations of a person and essential task functions
The "Entry Level" Employability Skills Training program requires the individual to: Be ready, willing and able to attend a full-time training program.
the most effective ways to increase hiring of workers with a disability include: Education, contact with people with disabilities, company policies that support
What would the 5 roles of OT be at an employment service for persons with disabilities such as EmployAbilities? To assess physical and mental health, demands analysis, audit the workplace for accessibility, consult with the employer, complete ergonomic assessments.
Which is the correct process for referring a person with a disability (PWD) to EmployAbilities? Identify needs, Contact EmployAbilities, Register for Information Session, Meet with an Employment Coach, and Referral to specific program
What disabilities are required to be reported to the employer? The employee is not obligated to disclose any disability.
The primary objective of the Opportunities Fund for Person's with Disabilities is to provide: organizations with funding to support people with disabilities in preparing for, obtaining, and keeping employment
Is there a comprehensive, across the board legislation for people with disabilities in Canada? No
What are the three levels of emplyoment supports for people with disabilities? Regional, provincial, federal
DRES offers three disability related program supports. Which of these services is NOT offered? Job search, Workplace, Medical, or Educational supports Medical
Are Disability Related Employment Supports (DRES) available to persons receiving AISH funding? No
What are the three primary systems for providing vocational rehabilitation/employment supports in Canada? 1) Government Programs & Services 2) Workers’ Compensation Systems 3) Private Insurance (e.g. – Long Term Disability)
the Canadian Charter of rights and Freedoms (Equality Rights) and The Alberta Human Rights Act that the Alberta Legislation included the following categories: marital status, Family status, Source of income, Sexual orientation
Which is an example of a National Employment Support Service Employabilities or CNIB? CNIB, Employabilities is Regionally funded
According to the research by Smith and Osborne (2007) what are the psychosocial impacts of chronic pain? triggers negative thoughts of self, significant others and feelings of being punished
What is the physiological process of chronic pain? both nociceptive and neurogenic stimulation “wind up”.
What are the two types of pain in 'mixed pain'? Neuropathic pain and nociceptive pain. Neuropathic pain is chronic pain resulting after injury due to changes to the CNS or PNS. Nociceptive pain is time limited pain resulting from injury.
How do emotions affect pain? Emotional information is carried to the limbic system, then back down, amplifying the pain at the level of the spinal cord
The current best approach to reducing neuropathic pain is using: Tricyclic anti-depressants
What are the 3 biggest concerns surrounding the onset of the chronic pain cycle? Loss of function, loss of social role, uncertainty of aetiology and diagnosis and the stigma of the illness.
Modifications including job reassignment & training. These are recommendations under the category of: Administration
What is the strongest predictor of disability in the chronic phase of injury? Psychosocial factors
To build a treatment plan to avoid as many barriers as possible return to work, which component would be the most important to consider as you create your treatment plan? A supportive workplace agreement
a "restriction" is defined as: activities that an individual should not perform as it may pose harm or risk of re-injury
What kind of culture is linked to a shortened duration of disability leave from the workplace? a people orientated culture
He reports still experiencing headaches and dizziness. He is asked to work in the office until he receives medical clearance to return to his previous duties. This is an example of: a restriction
Why is it important to consider the psychosocial and environmental factors that are impacting a client’s return to work outcomes during an assessment? psychosocial and environmental factors play a significant role in affecting the incidence of work injury and return to work outcomes
Why would an occupational therapist want to re-score a client at discharge using the Worker Role Interview? identify change or progress since the initial assessment and to highlight any areas that may remain a concern
You have used the Worker Role Interview for assessment of your client. What is THE MOST important information that should be considered when deciding if your client should return to work? Information from the Worker Role Interview (WRI) and observations made during the physical and behavioural assessment of a physical and/or work capacity evaluation
According to the TED talk video with Dan Pink, what role do motivators/rewards play in worker performance? Intrinsic motivation always improves worker performance, even more so than external rewards
If you are an injured worker, what is the best time to report your injury to your employer? Immediately because it is the law to report workplace injuries
A WCB claim can be denied if: the claim was filed more than 24 months after the injury
The 'No Fault Compensation' Meredith Principle states that: Workplace injuries are compensated regardless of fault
Who pays for WCB and how is the annual premium determined? Alberta employers pay into WCB. The premiums are based salaries & past accidents
At Millard Health every team member’s primary focus for the client is: Focused on the goal to return to work
When a WCB insured worker injures themselves at work but does not miss work and has less than $1000 of related medical costs it is called a: "no time loss claim"
Under the Meredith Principles the WCB has "exclusive jurisdiction", this means that; The board has autonomy, power and authority
True or False. Under the Alberta Workers Compensation Act (2004) prospective or future earnings are taken into account when calculating "loss of earnings" False
How long do clients typically attend Millard Health? more than 28 days
1) In the TED talk with Dan Pink, what three intrinsic factors have been found to best motivate people in a working situation. In what ways can OTs ensure these three motivators are present in RTW rehabilitation? Encourage the client to pursue meaningful employment that allows them to become experts in a specific area and allows for self-directed work. (Correct – ‘meaningful’ refers to purpose, ‘expert’ refers to mastery, and ‘creativity’ refers to autonomy)
In the TED Talk Video, the motivational strategy of "Pay for Performance" was described to work best for which type of tasks simple tasks
What is a potential job performance concern of an employer that may be contributing to the low employment rate among PWD? PWD will be less productive than employees without a disability.
4) When scoring the WRI on the four point scale (SS, S, I or SI), the best method to use to determine the appropriate rating when criteria are chosen in 2 different criteria statements and it is not clear which rating to choose is: Choose the lower of the two possible ratings
What is the best way employers can facilitate integration of people with disabilities (PWD) as employees? focus on ability, capability, and experience of PWD to do the job and not focus on disability
) Observation of the job is a key component of a job demands analysis. However, the occupational therapist should also use a variety of additional measurement tools because: Observation alone may not provide information on psychosocial and cognitive factors that affect a person’s performance, such as teamwork levels and decision making
What are the three components that make up a task analysis? Define work activities, define percentage of time spent performing specific work activities, and determine the current physical demands of each work activity
Which wrist position is associated with the greatest loss in grip strength? Wrist Flexion
Within ergonomic assessments, absenteeism, fines, hazard assessments, incident and illness statistics and reactions to production problems are all examples of ? Trailing indicators
CPP Disability Plan: An individual may be eligible to receive the Canada Pension Plan disability benefit if they: Are under the age of 65, stopped working because of a medical condition, have paid into the CPP for at least four of the last six years, have paid into the CPP for at least 25 years and made valid contributions to the Plan in three of the last six years.
Within the Meredith Principles, Security of Payment ensures that: A fund is established to guarantee that compensation monies will be available
The Worker’s Compensation Board of Alberta has their own rehabilitation facility because: a) The WCB can appropriately price rehabilitation assessment, treatment and vocational services as they know the cost of delivery
Created by: swcherry



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