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Journal of Occupational Rehabilitation

, Volume 20, Issue 3, pp 367–377 | Cite as

Do Clinicians Working Within the Same Context Make Consistent Return-to-Work Recommendations?

  • Yoko Ikezawa
  • Michele C. Battié
  • Jeremy Beach
  • Douglas GrossEmail author
Article

Abstract

Introduction Healthcare providers play important roles in the process of making return-to-work (RTW) recommendations, which have important consequences for injured workers and their employers. We studied the inter-rater reliability of RTW determinations between clinicians in a specific workers’ compensation setting. Methods Three case scenarios were given to clinicians working at one rehabilitation facility to examine consistency between clinicians in RTW recommendations. Additionally, we examined what information clinicians relied on to make decisions. Analysis included percentage agreement and other descriptive statistics. Results Thirty-six clinicians (13 physiotherapists, 10 occupational therapists, 8 exercise therapists, and 5 physicians) responded to the questionnaire. Subjects showed a high percentage agreement regarding RTW readiness on fracture and dislocation scenarios (97.2 and 94.4%, respectively), while agreement on a back pain scenario was modest (55.6%). In all cases, more than 50% of clinicians relied on biomedical information, such as physical examination. Conclusions Clinicians demonstrated a high level of agreement (>94%) when making RTW recommendations for injuries with clear pathology. However, a lower level of agreement (56%) was observed for back pain where the etiology of pain and disability is often more complex. Clinicians most commonly recommended RTW with restrictions, underlining the importance of workplace accommodations and modified duties in facilitating resumption of work.

Keywords

Return-to-work recommendations Work disability prevention Reliability Workers’ compensation Musculoskeletal 

Notes

Acknowledgments

This research was financially supported by a grant from the Workers’ Compensation Board of Alberta. This research was conducted in partial fulfillment of Masters’ degree requirements for the lead author. Dr. Battié is supported by the Canada Research Chairs Program.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Yoko Ikezawa
    • 1
  • Michele C. Battié
    • 1
  • Jeremy Beach
    • 2
  • Douglas Gross
    • 1
    Email author
  1. 1.Faculty of Rehabilitation MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada

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