Dr. Sonia Paquette, OTD, OTR/L, CPE, D-ABVE

Ergonomics, Occupational and Vocational Rehabilitation

(866) 861-8659


Goal: facilitate maintaining or returning a worker at work.

By helping employees return to work more quickly after an injury while gradually building productivity, I can help lower companies’ health care expenditures while raising worker productivity. Health care expenditures will decrease due to reduced medical insurance premiums, reduced absenteeism, reduced turnover rates, reduced worker’s compensation claims, reduced tardiness, reduced disability rate, etc.

Onsite rehabilitation

There is growing concensus that, while attending to the physical and medical aspects of the work disabled employee is important, much of the variability in return to work outcomes is accounted for by what takes place at the workplace . This is why unlike traditional programs, done in the clinic, every piece of therapy I do is done at the worksite. Indeed, there is increasing evidence or greater effectiveness of workplace-based interventions as opposed to interventions provided outside the workplace

In fact, when the job factors are not accounted for, it has been shown that even the best standardized functional capacity assessment can hardly provide any valuable data . I choose my evaluation tools according to the worker, the workplace and the situation at hand.

In order to answer the question: ”How and when can this person go back to work?”, I not only evaluate the worker’s medical and functional conditions, but also, the work tasks and physical and organizational demands, as well as other psychosocial factors which may influence the worker’s return to work. After years and many hundred worksites evaluated, I understand the realities of both the worker and the employer.

Put together, this information prepares me to write the rehabilitation plan that will allow the worker to progressively reintegrate his work tasks or, at least, tasks that are appropriate.

Because I have a medical background, I can speak to doctors, case managers, therapists and other health professionals in their language. And because I am onsite and work with them, workers and employers know that I care and understand their situations.

Preparedness to work

The longer a person is off work, the less likely this person is to return to work. When there is no work to go back to, a person may become sedentary and suffer from depressive symptoms. Research has shown that it is important to keep the person active after an injury, not only to facilitate healing but also to prevent further disability. Work hardening and conditioning are interesting, but they last only a time period and cannot be reproduced in the client’s home and family environment. The client is not likely to keep his/her lifestyle active unless it is integrated into his/her routine.

Credentialed to use the research-based Progressive Goal Attainment Program (PGAP), I help people get back to a more active lifestyle using their own routine as a canvas. This has been shown to increase their chance of getting back to work.

See a description of the program at http://www.pdp-pgap.com/homepage.html.

This program should be used:

  • When work is not available
  • Along with physical therapy, work conditioning or medical management
  • Anytime after 4 weeks off work and the worker is still in pain
  • Before an IME (independent medical evaluation)
  • Before an FCE (functional capacity evaluation)
  • Before vocational evaluation and retraining
  • Before considering a multidisciplinary pain management program or pain clinic

Return-to-work (RTW) program management

Job stress, coworker support, employer’s attitude toward work disability, type of pay, social support at work, satisfaction at work, autonomy and flexibility at the workplace, knowledge and interest of supervisors regarding rehabilitation, allocated financial and human resources for reintegrating the worker at the workplace etc… Do we need more factors affecting the return-to-work process? The most successful organizations in establishing and using RTW are the ones who allocate money and resources to the process. I can be part of those resources.

Vocational rehabilitation

When the worker has tried, and tried, and tried again, and nothing works…it may be time to think about another employment possibility for him or her. I can help establishing potential for re-entry in the work system and connect to resources that can help the worker find suitable and fulfilling work.