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Preparing difficult clients to return to work
Kelly M Chapman-Day1, Leonard N Matheson, Dean Schimanski
1PRORehab. kellymday@hotmail.com
Objective:
Investigate the effect of the symptom magnification syndrome (SMS) behavior pattern on industrial rehabilitation on return to work and maintenance at work.
Participants:
A sample of 99 clients with active workers' compensation claims was studied; 25 identified as having SMS.
Methods:
A protocol-driven functional capacity evaluation (FCE) was administered and the presence of SMS was determined from a standard protocol that considered 13 factors.
Results:
Upon conclusion of intervention, 80 of the 99 clients were classified as ready to return to full-time usual and customary employment. The readiness for full-time return to work among those who did not have SMS (84%) was not statistically different from those with the syndrome (72%). Six months after discharge, follow-up work status data were obtained for 63 clients. Among those that did not display SMS, 76% continued to work full time, while 39% of those initially identified as SMS were working, a statistically significant difference.
Conclusions:
SMS had no significant bearing on work readiness, but appears to impact maintenance of employment. The value of return to work on a modified basis may need to be reconsidered, because none of the clients who had been discharged ready for modified work were employed at the six-month follow-up.
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