Work Hardening Program

What is a Work-Hardening Program?

work hardeningA Work-Hardening Program is an interdisciplinary, individualized, exercise, and therapeutic program tailored toward returning an injured individual to work in a specific job or field.  The Department of Labor and Industries defines “work hardening” as an interdisciplinary, individualized, job-specific program of activity with the goal of return to work.” Work-hardening programs are designed to provide injured workers with a higher level of therapeutic intervention. The primary goal of this program is to restore the physical capacity and function of an injured worker to continue the tasks they were able to perform prior to their injury.

Work-hardening programs are highly structured, simulated work tasks that typically take place in a non-hospital environment. They provide a safe transition from prescribed care after an injury at work to successfully returning to working capacity. Most work hardening programs consist of 3-5 sessions a week for 2-8 weeks. Sessions range from 2-4 hours and are influenced by the patient’s place of employment. Components included in a work hardening program are:

  • Specific Flexibility Program
  • Strengthening Program
  • Cardiovascular Conditioning
  • Therapeutic Activities
  • Functional Job Simulation Activities
  • Education

Who Provides Work-Hardening Programs?

Work-hardening programs can be provided by physical therapists, vocational counselors, or occupational therapists. Occupational therapy practitioners evaluate worker capacities, task performance, and the worker’s environment, to help ensure the proper course of treatment. According to the American Occupational Association, “These specialized evaluation skills allow the occupational therapist to understand and deliver results in the complex psychosocial and physical work environment.” Below is a list of issues most work hardening programs address:

  • Physical Limitations
  • Job Specific Physical Rehabilitation
  • Work Place Safety and Injury Prevention
  • Job Performance

Example: TIRR Memorial Hermann

TIRR Memorial Hermann is an example of a local facility with the ability to provide work hardening programs. TIRR is an internationally recognized rehabilitation and research hospital. Their occupational therapy treatment is patient-centered and deliberately designed to help individuals recover from an injury or accident through participation in everyday activities. They are one of the many treatment centers where patients with catastrophic injuries can receive specialized care.

Do I Need a Work-Hardening Program?

Your medical providers and vocational rehabilitation therapists can help you decide whether this type of program is right for you. When a patient undergoes physical therapy, they may sometimes reach a plateau in a treatment. This plateau is referred to in the worker’s compensation world as Maximum Medical Improvement (MMI). This is the point at which continued care may not be considered curative care by the medical community. Often workers may reach MMI but still continue to struggle with the physical activities they are required to complete in their profession. In many cases, a functional capacity exam (FCE) will be performed to determine whether the worker can return to work. If he does not have the physical capacity to meet the minimum physical requirements of the job, In such cases, a work hardening program can be beneficial in helping the injured worker return to an employable level of physical health.



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