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 |