On January 1, 2024, Work Hardening programs will become part of L&I’s specialized Work Rehabilitation program. To learn more about these changes, go to our Work Rehabilitation page.
Work hardening includes real or simulated work tasks, conditioning exercises, and education to restore physical, behavioral, and vocational abilities.
Programs are:
- Highly structured, multidisciplinary, and individualized for each worker.
- Delivered in a 4-week program which usually begins at 4 hours a day and progresses up to 8 hours 3-5 times per week.
- Delivered only by approved providers.
Criteria for admission
- The individual is able to participate for a minimum of 4 hours a day, 3 to 5 days a week.
- There is a specific return-to-work goal.
- The injury is typically less than 2 years old.
- The worker has a referral from their attending provider.
- The claim manager has given authorization.
L&I requirements can be found in the work hardening program standards.
Work hardening is a distinct special service and is different from work conditioning:
| Work hardening | Work conditioning |
|---|---|
| Recognized as a special treatment program by L&I | Not recognized as a special treatment program by L&I |
| Requires a specific return to work goal | No specific return to work goal required, although goals would focus on increasing physical capacities for work |
| Reimbursed according to the work hardening fee schedule | Reimbursed according to the physical and occupational therapy rules and policy |
| Addresses physical, functional, behavioral and vocational needs of the worker | Addresses physical and functional needs of the worker |
| Multidisciplinary | May be provided by one therapy discipline |
| Uses real or simulated work activities with some physical conditioning | Uses physical conditioning and functional activities related to work |
| Includes education (body mechanics, work pacing, safety, injury prevention) | May or may not include an educational component |
| Begins at 4 hours per day and builds to 8 hours per day over the course of 4 weeks | Typically 1-2 hours per day, 3-5 times per week for 4 weeks |