I have come across a couple of instances where a physician or vocational counselor have tried to get authorization for their client to come to our clinic for work hardendening and have been denied.  The only reason that they have been denied is because their claim is over 2 years old and the worker's comp system says that the best chance to get them back to work using work hardening is under 2 years so they are not going to authorize it if it is over 2 years.  The thing is that we have had some clients (up to 10 years out of their injury) go through our work hardening program and do well enough to return to work.

Anyone know of any research that says work hardening is not effective if the injury is over 2 years old? 

Any ideas?  What one of these cases is going to boil down to is this...The person was able to do the physical demands from the position for up to 4 hours per day (FCE results) and we recommended 4 week work hardening program to progress them to full duty.  The system said no (only because the claim has been open over 2 years) and so now we have possible positions for return to work but they are not going to use them.  The vocational counselor is going to get them into retraining (2 years of time loss plus the cost of schooling and supplies which could total up to $30,000 to $40,000) instead of work hardening (4 weeks for $7,000)  I don't get it...

Any thoughts are greatly appreciated.

Jon Harrison, OTR/L, CWCE, CEES