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The Work Hardening Program is individualized and focuses on returning persons to work. The program is designed to minimize risk and optimize the work capability of the person served. The services provided are integrative, with the capability of addressing the work, health, and rehabilitation needs of the person served. In addition, such a program provides service coordination and management of the person’s injuries or illnesses. Our multidisciplinary team of healthcare providers includes physiotherapists, chiropractors, and occupational therapists.


The Work Hardening Program of Care is appropriate for a person served with the following scenarios:

  • 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. An exception may be made for hand injuries and other specialized diagnoses to begin at 2-3 hours per day.

  • A defined return-to-work goal:
    – A documented specific job to return to with Job Analysis
    – Documented on-the-job training
    – A job title agreed upon by the company and worker, verified and documented

  • The worker must be able to benefit from the program. Therefore, a screening process that includes file review, interview, and testing should be used to determine the likelihood of success in the program.

  • The worker must be no more than two years past the date of injury. Recent literature supports early rehabilitation and returns to work. Workers that have not returned to work by two years post-injury may not benefit. Exceptions may be made for workers with injuries that have required long-term medical care, i.e., extensive burns and diagnoses requiring multiple surgical procedures.


This care program has some exclusion criteria, which are significant red flags that may prevent the individual from being eligible to participate in this program. Please consult a healthcare practitioner or contact us to confirm eligibility.


A healthcare provider will assess treatment planning to initialize the care program. The assessment includes the following: taking a complete medical history, subjective evaluation of the primary complaints related to the injury, a thorough physical examination including range of motion evaluation, orthopedic testing, muscle testing, and neurological testing. The healthcare provider will also administer outcome measures to obtain baseline measures of pain and function. These may include but are not limited to the Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index, the Neck Disability Index (NDI), and the Lower Extremity Functional Scale (LEFS), or the Upper Extremity Functional Scale (UEFS).

The healthcare provider will also assess for possible Yellow flags, which can indicate psychological risk factors that may impact their recovery due to behavior, expectations, and recovery from injury. Finally, a discussion on achievable goals from the treatment program will be discussed as well as the responsibilities of the person served and health care provider throughout the program.


The duration of the Work Hardening Program of Care is determined after the initial assessment and depends on the needs of each person served, including the severity of the injury, and may vary based on factors that may delay recovery.


To be discharged from the Work Hardening Program, one or more of the following criteria must be met:

  • The worker has reached the goal stated in the plan.

  • However, the worker has not participated according to the program plan.
    a) Has not reached interim goals
    b) Number of absences exceeds those allowed by the program. Therefore, a maximum of 2 absences is recommended.
    c) Worker does not adhere to the schedule.

  • During the program, the goal was discovered not to be feasible.
    a) A previously unknown medical problem is discovered. Consultation with the attending physician is required to determine the treatment.
    b) The treating team judges that the physical goals are not attainable. The provider and employer/company then need to determine a new vocational plan based on the worker’s realistic physical capacities.
    c) The previously identified job is not available.

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