WORK HARDENING PROGRAM

NTPRC’s Work Hardening Program is a highly structured, intensive, time-limited interdisciplinary treatment program designed to help a patient return to work.  The program is specific for the job to which the patient is returning.  The program typically strives to increase aerobic capacity, muscle strength, endurance, range of motion and coordination.  Specific activities simulates the patient’s chosen vocation is included in treatment.  NTPRC’s Work Hardening Program incorporates specialized equipment, hand tools, driving simulator and various work station to facilities this process.  Psychological treatment is also included to address any psychosocial barriers that might interfere with returning to work.

Upon being referred to the Work Hardening Program, the patient will complete a functional capacity evaluation and a behavioral health assessment.  These evaluations will be used to generate an individualized treatment plan for the patient.  At this time the patient will be assigned a case-manager with the designated responsibility of coordinating treatments, monitoring progress, and facilitating communication within the treatment team and to the referral source.  The treatment plan will be reviewed by the treatment team on a weekly basis. 

The treatment team includes: 

• physical therapist,
• psychologist,
• physician,
• social worker,
• chemical dependency counselor,
• case manager, and
• vocational counselor.

PROGRAM ACCREDITATION

NTPRC’s Work Hardening Program is accredited by CARF (the Rehabilitation Accreditation Commission).   NTPRC’s compliance with CARF’s high standards of practice has consistently earn it a 3-year term of accreditation, the longest term awarded by CARF.

WHO SHOULD BE REFERRED TO THE

WORK HARDENING PROGRAM?

According to the Official Disability Guidelines, the treatment guidelines adopted by the Texas Department of Insurance’s Division of Workers’ Compensation, a referral to a work hardening program should be considered when:

1. The patient’s physical capacity and level of function prevent him/her from returning to work,
2. The patient’s physical recovery is sufficient to allow for progressive reactivation and participation for a minimum of 4 hours a day for three to five days a week, and
3. The patient has a specific job to return to or will enter vocational retraining.  (www.odg-twc.com/odgtwc/low_back.htm#Workconditioningworkhardening)

WHAT IS THE DIFFERENCE BETWEEN THE CHRONIC PAIN MANAGEMENT PROGRAM AND THE WORK HARDENING PROGRAM?

Both programs are highly individualized and interdisciplinary, however there are significant difference.  The Chronic Pain Management Program is designed for the patient whose pain and/or fear of reinjury adversely impacts level of function.  This program utilizes psychological treatments to teach pain control strategies and increase pain tolerance.  Meanwhile, with the typical work hardening patient deconditioning, poor range of motion and muscle weakness are their biggest hurdle to returning to work.  Psychological support, while necessary, is not required to the extent it is with a chronic pain patient.  In the Work Hardening Program more time is spent doing job simulation, specific to the particular job the patient will be returning.

Work Hardening Outcomes

(Cumulative over the past 3 years)

Average Length of time off work:  22 months

ü      99% of NTPRC’s work hardening patients were satisfied with their treatment.

ü      100% of NTPRC’s referral sources were satisfied with the care their patients received at NTPRC.

ü      92% of NTPRC’s patients either returned to work or started job retraining  at the conclusion of work hardening.

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Last modified: 09/09/07