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Levels for Vocational Restoration in Worker with Pain

Purpose: To evaluate a patient requiring vocational restoration using the grading scheme of Gottlieb et al.

Description

Gottlieb et al identified levels for grading outcome from vocational restoration in a worker affected by ongoing pain. This can be tracked over time to determine the progress of the rehabilitation process. The authors are from the Casa Colina Hospital for Rehabilitative Medicine in Pomona, California.


Description

Level

patient unable to consider vocational restoration due to physical disability and/or incapacitation by pain

1.0

patient considering vocational restoration, including assessment of capacity to procure and sustain employment

1.5

vocational assessment has identified goals consistent with the patient's capacities and reflecting a reasonable chance for successful outcome to employment

2.0

• patient begins vocational training

• recurrence of pain prevents participation

2.5

vocational training, schooling or employment opportunities identified; the patient has been accepted; opportunity consistent with patient's interests, aptitudes and overall physical capabilities

3.0

• patient placed in gainful employment

• employment maintained >= 30 days

• pain is a limiting factor and patient ceases employment

3.5

• patient placed in gainful employment

• employment maintained for >= 30 days

• pain is not a limiting factor

4.0

 

where:

• Matching the patient with the appropriate opportunity is the trick. If the job is too much for the patient to do, or if it is something the patient hates, then failure will be more likely.

 


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Specialty

Objective

ICD-10