A Descriptive Study of the Implementation of Remote Occupational Rehabilitation Services Due to the COVID-19 Pandemic Within a Workers' Compensation Context.
Douglas P Gross, Alexander Asante, Joanne Pawluk and 1 others
PMID 33118130WHAT IT FOUND
Remote occupational rehabilitation proceeded with no reported adverse events, but clinicians made more cautious recommendations.
Fewer workers were cleared for full pre-accident duties, and more received permanent restrictions. Service volumes dropped, and complex cases were largely excluded from remote assessment.
Key findings
01Remote work assessments resulted in significantly fewer workers being judged ready for full pre-accident duties and significantly more receiving permanent work restrictions compared to in-person assessments.
02No formal complaints or adverse events were reported during the first two months of remote service delivery, although case managers expressed concern that remote assessments yielded lower functional levels than previous in-person tests.
03The transition to remote services saw a substantial reduction in overall volume, with weekly work assessments dropping from a mean of 244.6 to 135.9 and weekly rehabilitation completions falling from 125.6 to 45.1.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was descriptive and did not follow workers up over time, so long-term return-to-work outcomes and the sustainability of remote assessments are unknown. There was a large amount of missing data for self-reported outcome measures, limiting the ability to fully compare clinical characteristics between groups. The groups were not comparable at baseline; workers assessed remotely had different demographic and employment characteristics (e.g., higher salary, less likely to be employed or working) than those assessed in person. Raw data from functional tests was not available to explore why remote assessments resulted in lower functional determinations. The study period coincided with the onset of the pandemic, meaning broader socioeconomic factors like increased unemployment likely influenced referral patterns and outcomes.
The easy way to misread this
Do not interpret the lack of adverse events as proof that remote assessment is equivalent to in-person testing. The study shows that remote assessment led to significantly more conservative work recommendations and permanent restrictions, which may reflect the limitations of interview-based assessment rather than true changes in worker capacity.