Domain 4 - Rehabilitation Concepts and Strategies

Question 1

Rehabilitation

Answer 1

Rehabilitation is a component of both illness and disability. Vocational aspects of both chronic illness and disability can put a significant strain on the client and family. Reduction or loss of income make these cases a challenge to manage.

Question 2

Goals of Rehabilitation

Answer 2

The goals of rehabilitation are Restore clients’ initial function and abilities or
* Maximize functional level.
* Prevent deterioration or complications in client’s health by teaching the client alternative techniques to effectively adapt to their health, behavioral, and/or physical condition and to adhere to health regimen.
* Promote client’s quality of life by providing, services or devices that allow the client to overcome impairment or to augment functioning.
* Facilitate client’s independence
* Modifying client’s environment
* Reduce or eliminate barriers to independent functioning
* Enhance safety.
* Enhance access to timely, safe, quality, and cost-effective services

Question 3

ADA

Answer 3

Americans with Disabilities Act (ADA)

Question 4

When did Americans with Disabilities Act (ADA) become enacted

Answer 4

Originally enacted in 1990; Amendments Act of 2008 became effective January 1, 2009

Question 5

What does the Title I in the Americans with Disabilities Act (ADA) do

Answer 5

prohibits private employers, state and local
governments, employment agencies, and labor unions from discriminating against qualified individuals with disabilities in job application, hiring, firing, advancement, compensation, job training, and other terms, conditions, or privileges of employment

Enacted to provide clear mandate for elimination of discrimination against
disabled persons

Question 6

How are reasonable accommodations evaluated since ADA was enacted

Answer 6

Reasonable accommodation is evaluated based on both effectiveness and feasibility for the typical employer, and the employer has the final discretion to choose a reasonable accommodation (must prove that it would cause an undue
hardship)

Question 7

What is Disability management

Answer 7

Disability management is a workplace prevention and remediation strategy that aims to prevent disability from occurring or to intervene early following the onset of an injury or illness known to potentially result in a disability.

Question 8

Disability management programs may consist of several specific components including:

Answer 8

• prevention of work-related injury or illness,
• support for the worker’s recovery (e.g., medical and vocational rehabilitation, catastrophic case management, and life care planning)
• reasonable accommodations for the worker’s limitations.

Question 9

What does disability management do for workers?

Answer 9

-assist with return to work (RTW) in timely manner
-improve quality of like

The purpose of disability management programs is to assist the worker to return to work as soon as appropriate, and therefore improve the individual’s quality of life by resuming function and productive
employment.

Question 10

What does disability management do for employers?

Answer 10

-return experiences and trained workers to job
-reduce unnecessary expenses
-retain engaged, satisfied workers

The purpose is for experienced and trained
workers to quickly return to work. This also reduces unnecessary expenses and maintains engaged and satisfied workers.

Question 11

What are the goals of disability management

Answer 11

1. Connect - care, benefits, case management services to complement each other
2. Integrate - sick leave, paid leave, and disability benefits to achieve early return to work
3. Coordinate - medical, behavioral, health services

Question 12

Components of disability management programs include:

Answer 12

• Processing of applications for health benefits, and coordination of benefits to ensure timely access
• Clarification of job limitations and modifications, linking all stakeholders for return to work, coordinating care with treating providers and ensuring appropriate timely treatment, identifying essential job functions in order to seek reasonable accommodation
• Working within ADA regulations to develop modified job and return to work options, with reasonable accommodation and determination
  of essential job functions as appropriate
• Assisting the worker to return to work with understanding and acceptance from supervisors, gain agreement with job accommodation
  options
• Safety and illness prevention programs, aiding with reasonable accommodation, identification of job aids, assistive devices, ergonomics
• Education of supervisors, treating physicians, and others about the return-to-work process

Question 13

Are workers compensation benefits standardized federally or by state?

Answer 13

State

Question 14

Workers’ compensation is a benefits program created by state law to

Answer 14

Provide medical, rehabilitation, income, death, and other benefits to workers and their dependents due to injury, occupational illness, or death resulting from a compensable work-related claim covered by the law.

Question 15

What are some examples of reasonable accomodations?

Answer 15

Accessible facilities
Flexi-time
Modifying work schedules
Modifying work sites
Flexi-place
Providing readers and interpreters
Assistive devices
Reassignment

Question 16

RTW

Answer 16

Return To Work

Question 17

What kind of workers compensation benefits are provided:

Answer 17

Benefits provided:
* Medical and rehabilitation
* Disability and lost wages
* Survivorship or death benefits

Question 18

Maximum Medical Improvement

Answer 18

Term to indicate that the injured worker has recovered from injuries to a level at which a physician states that further treatment will not substantively change the medical outcome.

Question 19

FCE

Answer 19

Functional Capacity Evaluation (FCE)

Question 20

What is a Functional Capacity Evaluation (FCE)

Answer 20

A systematic process of assessing an individual’s physical capacities and functional abilities. It is a comprehensive exam that can be used to determine job placement, job accommodation, or return to work.

The FCE is used in occupational health case management to directly measure the client’s ability to perform work related activities. It can be part of the initial assessment, used to determine the work conditioning plan or to reassess progress and ability to return to work.

During the FCE the client is evaluated as they perform activities they are required to do in their job. This may include, but is not limited to:
* Squatting
* sitting
* pushing
* pulling
* turning
* standing
* kneeling
* balancing
* navigating stairs
* hand grip

The amount of time the client can perform each of these tasks is important.

Question 21

FIM

Answer 21

Functional Independence Measure (FIM)

Question 22

Functional Independence Measure (FIM)

Answer 22

• 18 measure instrument
• Scale rangesfrom 1 (total assistance) to 7 (complete independence)
• Used worldwide in an inpatient rehabilitation setting
• Measures client’s ability to function independently
• Allows for evaluation of the amount of assistance required by the client to safely
  and effectively perform basic life functions
• Can also be used to assess cognitive abilities (comprehension, expression, social interaction, problem solving, and memory)

Question 23

Job accommodation

Answer 23

A job accommodation is a reasonable adjustment to a job or work environment that makes it possible for a disabled person to perform job
duties.

The job accommodation is individualized and focused on access. It can be the use of voice recognition software or an adjustable height desk to accommodate a wheelchair.

Question 24

Job Analysis

Answer 24

A process to identify and determine in detail the job duties and requirements and their relative
importance for a given job.

Key information is gathered through interviews, questionnaires, or direct observation to develop a description or specifications of the job. It is not a
description of the person.

The purpose is to establish and document the job relatedness of employment procedures such as training, selection, compensation, and performance appraisal.

Question 25

Job Placement

Answer 25

It is assisting an injured worker to find employment by matching the skills, knowledge, and abilities of the worker with a potential job.

Question 26

Work Adjustment

Answer 26

The use of real or simulated work activity under close supervision at a rehabilitation facility or other work setting to develop appropriate work behaviors, attitudes, or personal characteristics

Question 27

Work Conditioning

Answer 27

An intensive, work-related, goal-oriented conditioning program designed specifically to restore systemic neuromusculoskeletal
functions (e.g., joint integrity and mobility, muscle performance (including strength, power, and endurance), motor function (motor control and motor learning), range of motion (including muscle length), and cardiovascular/pulmonary functions (e.g., aerobic capacity/endurance,
circulation, and ventilation and respiration/gas exchange).

The objective of the work conditioning program is to restore physical capacity and function to enable the client to return to work.

Question 28

Work Hardening

Answer 28

In contrast to work adjustment, which focuses on more personal issues, work hardening is a program that is a highly structured, goal-oriented, and individualized intervention program, providing clients with a transition between
the acute injury stage and a safe, productive return to work, and focuses on endurance.

Treatment is designed to maximize the worker’s ability to return to work safely with less likelihood of repeat injury

Question 29

Work Modification

Answer 29

Altering the work environment to accommodate a person’s physical or mental limitations by making changes in equipment, in the methods of completing tasks, or in job duties.