At Maximum Independence Inc., all Functional Abilities Evaluations will be completed by an Occupational Therapist who is a Regulated Health Professional, Certified and Licensed to practice in the province of Ontario and country of Canada as well as specifically trained and Certified in the performance of this assessment utilizing the WorkWell Method.

This method of assessment utilizes the Kinesiophysical approach which looks at the study of physical movement during activity. It has been deemed to be the most reliable and valid system of assessment available today. This system of assessment is reliant on the evaluator being an Occupational Therapist and trained to assess an individual's occupational performance capabilities within the context of his/her environment. Client safety and maximum function are emphasized.

This particular assessment is a comprehensive and objective test of an individual's ability to perform work-related tasks. A Functional Abilities Evaluation has a musculoskeletal basis and performance is rated; physical abilities and limitations are compared to physical and functional findings.

The Functional Abilities Evaluation is performed one-on-one between the Occupational Therapist and the client over one or two days for several hours each day. This assessment will identify the safe maximum abilities of the client related to the performance of specific physical activities which are commonly performed during work. If adequate information is available a specific comparison of the client's abilities can be made to a client's pre-accident position (Job Demands Analysis) or a possible future job goal.

An in-office assessment will be conducted to determine the current status of the client's functional, physical and cognitive limitations. The client's medical file will also be thoroughly reviewed in order to understand the actual impairments and sequelae related to the subject motor vehicle accident. Additionally, communication with the client's family doctor, physiotherapist or health practitioner may be warranted to ensure no physical limitations or restrictions are in place preventing the individual from returning to work.

Once this initial portion of the assessment is completed, a job site visit is required. This portion of the assessment is focused on the environment and observing the actual job duties of the client's pre-accident position. Communication with the employer is essential to fully understand what accommodations and/or modifications can be put in place by the employer, if applicable.

This assessment will recognize the dynamic interdependence of the person, their environment and their actual job duties in order to make recommendations to maximize their independence and safety with respect to their vocational activities and intended return to pre-accident work duties.

The purpose of this assessment is to thoroughly review the client's physical, cognitive and affective accident related injuries, impairments and sequelae for the purpose of assessing the ergonomics within the client's home office or work office to determine the impact they have on the client's accessibility and safety within the home office or work office environment post accident. The assessment will describe the home office or work office environment and provides necessary and reasonable recommendations to ensure optimal safety and independence.

An Occupational Therapist will assess the client within his/her home office or work office environment to determine the client's needs. The Occupational Therapist will complete a full physical, functional and environmental assessment. Following completion of the assessment, recommendations will be made pertaining to accessibility, safety and ergonomics within the home office or work office to maximize independence.

This assessment will include both qualitative and quantitative methods; including completion of a clinical interview, physical assessment, cognitive and affective screening protocols and a functional assessment. A medical chart review will be completed if available.

The purpose of a Job Demands Analysis is to assess the actual job duties required of the client's pre-accident position. This includes a job description (based on available employer documentation, client and employer report) and objective measures of the associated physical, cognitive, social and environmental demands of that particular position. Communication will occur with the employer to review and confirm the availability of work, the demands of the job and any possible modifications or accommodations.

This will include an onsite assessment of a specific job that then involves observation and measurement of physical and cognitive demands of a specific job.

The purpose of such an assessment is to determine vocational options that are available to the client based on their current physical, cognitive, psychoemotional and functional status pertaining to the injuries and impairments caused by the subject motor vehicle accident. The client's employability, inclusive of labour market research and actual job matches will be discussed within the Transferable Skills Analysis. Often a Functional Abilities Evaluation is also required to determine general physical and functional capabilities of the client which may enhance or preclude client access to multiple positions.

The assessment report is based on meetings and functional assessment/observation of the client, an analysis of previous education, work history and current functional limitations. Additionally the information obtained by the available medical documents, clinical notes, standardized testing administration of vocational assessment measures and the client's self report of their pre-accident and post accident level of function and interests have been reviewed to assist with this process.

An in-office assessment will be conducted to determine the current status of the clients functional, physical, cognitive and psychoemotional limitations as they relate to work issues. The clients medical file will also be thoroughly reviewed in order to understand the actual impairments and sequelae related to the subject motor vehicle accident. Additionally, communication with the clients family doctor, physiotherapist or health practitioner may be warranted to ensure no physical limitations or restrictions are in place preventing the individual from returning to work/labour force.

This assessment will provide recommendations to maximize their independence and safety with respect to their vocational activities and facilitate the individuals ability to resume some type of productive vocational activity in the future.

This assessment may determine the need for further assessments such as a:

• Functional Abilities Evaluation
• Situational Assessment
• Neuropsych Assessment
• Psychiatry Assessment
• Psycho Vocational Assessment

and/or for additional treatment services such as:

• Work conditioning/Work hardening
• Chronic pain management education
• Psychological counseling
• Basic skills upgrading

At Maximum Independence Inc., all Situational Assessments will be completed by an Occupational Therapist who is a Regulated Health Professional, Certified and Licensed to practice in the province of Ontario and country of Canada as well as specifically trained and Certified in the performance of the Functional Abilities Evaluation component of the assessment utilizing the WorkWell Method for the Functional Abilities Evaluation component.

This particular assessment is a comprehensive and objective test of an individual's ability to perform work-related tasks from a physical, cognitive and psychoemotional perspective. A Functional Abilities Evaluation will be completed as a component of this assessment for the purpose of determining musculoskeletal performance. The client's physical capabilities are rated; physical abilities and limitations are compared to physical and functional findings. In addition to physical function, the client's ability to perform the cognitive and psychosocial demands of work will also be reviewed. This will include a review of the client's general work behaviors and tolerances, ability to learn work tasks, attend, concentrate and perform job functions at productive levels.

The Functional Abilities Evaluation is performed one-on-one between the Occupational Therapist and the client over two days. The total assessment will be conducted over a period of 5 days dependent on client needs and the purpose of the assessment itself. The remainder of the assessment will include client participation in a variety of simulated work activities that will allow further determination of skills, abilities, and limitations related to physical, cognitive and social/behavioral demands of work. Clients are requested to attend on consecutive days between the hours of 9:30 to 3:30, in order to better simulate the demands of a real job. Supervision and evaluation of simulated work activities will be completed by the Occupational Therapist, Occupational Therapy Assistant and Vocational Specialist as appropriate. A review of the outcome of the assessment and recommendations arising from the assessment will be conducted with the client on their last day of attendance.

This assessment will identify the safe maximum abilities of the client related to the performance of specific physical activities which are commonly performed during work. If adequate information is available a specific comparison of the client's abilities can be made to a client's pre-accident position (Job Demands Analysis) or a possible future job goal. Specific referral questions will be requested.

Further this assessment can determine the client's ability to perform the cognitive demands of work (attend, remember, learn new duties etc.) and be able to demonstrate appropriate social/behavioral skills necessary for working. This assessment can be utilized to determine the client's ability to perform their own occupation, any occupation, a client's ability to work at productive or competitive levels, their ability to work full or part time as well as the impact of the client's work on their ability to function in other life roles (homemaking, house cleaning, care giving etc.).

The Occupational Therapist will work with a client and a pre-accident employer to negotiate an appropriate return to work plan.

Specifically the therapist will gather information regarding the client's pre-accident position (job description, physical and cognitive demands) via an interview with the client, Employer and or a Job Demands Analysis or Worksite Assessment.

Further they will determine/obtain information regarding the client's physical /cognitive/behavioral abilities and limitations via communication with the client's treating health care providers (family doctor, physiotherapist, psychologist or neuropsychologist), a review of medical information and/or the completion of a Functional Abilities Evaluation or Situational Assessment.

Once the above information is obtained, a meeting is established with the employer and client. A plan for return to work will be developed.

This plan will be graduated and goal oriented. Intermittent re-evaluation of progress will occur in the form of telephone communication with the client and employer, onsite visits and formal performance reviews. Job coaching may also be utilized to assist a client in learning new methods of task completion/performance, promote proper body mechanics, use of pain management or cognitive compensatory strategies at work.

Upon effective completion of a return to work program, the Therapist will obtain medical clearance for return to work.

Work trials will be utilized by a Therapist for a number of different purposes, inclusive of but not limited to;

1. Determining a client's ability to perform real work generally
2. Determining a client's ability to function and perform competitively in a specific job
3. To trial various vocational options that have been identified or potential job goals
4. Specialized and job specific work hardening

The need for a work trial can be identified by the client's treating Occupational Therapist or other treatment team members.

The Vocational Specialist will be responsible for finding an appropriate work setting/employer.

The Occupational Therapist will provide direction related to the purpose of the work trial, evaluation/critique etc. The Work Trial Coordinator ensures set up of necessary insurance and monitors client performance through communication with the client and employer. They will also complete one onsite visit once per week throughout the duration of the trial. If determined necessary and appropriate, a job coach may also be utilized to assist the client in learning job duties and or modifying job tasks.