MRoA/MMRC Munich Re Group Life Seminar 2008 The value of the occupational therapist Yolanda Skei 21 February 2008

2 A MRoA/MMRC Munich Re Group What this talk will be about…  Core competencies of the occupational therapist  Disability claims assessment – why an OT?  Models of OT utilisation in disability insurance  Pointers for when to utilise the services of an independent occupational therapist  Last words

3 A MRoA/MMRC Munich Re Group Core competencies of the occupational therapist  Human occupation  Components of function  Knowledge of medical conditions  Holistic view of individuals  Rehabilitation focused on functional ability  Vocational rehabilitation  Interviewing - Observation - Reporting

4 A MRoA/MMRC Munich Re Group Domain of Occupational Therapy Practice Center on Human Development and Disability, Clinical Training Unit, University of Washington, Box , Seattle, WA

5 A MRoA/MMRC Munich Re Group Domain of Occupational Therapy Practice (2) Occupational therapists are skilled in both physical and psychiatric disorders

6 A MRoA/MMRC Munich Re Group Disability claim assessments Why should you even contemplate using an OT?  A disability claim seeks to determine the impact of an impairment on a claimant’s ability to perform work tasks.  A disability claim is about vocational competence.  Depending on the definition of disability, an opinion on rehabilitation / recovery / likelihood of return to work is required.  Depending on the definition of disability, an opinion on the transferability of vocational and other skills is required.

7 A MRoA/MMRC Munich Re Group Models of occupational therapy involvement / employment in disability insurance  Employed by a Life Office as Claims Assessors / Consultants  Employed by a Life Office as Case Managers  Performance of independent assessments  Performance of case management by an independent occupational therapist

8 A MRoA/MMRC Munich Re Group Pointers for when it would be beneficial to utilise the services of an independent occupational therapist  Functional capacity evaluations  Medical evidence lacks sufficient information to determine the impact of the impairment on functional ability and vocational capacity.  Lack of objective reasons for stated limitations  Observations do not support the degree of disability reported / claimed  History / background to the claim is unclear  Complex cases with a multitude of diagnoses  Determining the potential duration of disability  Rehabilitation within the original occupation is unlikely

9 A MRoA/MMRC Munich Re Group Pointers for when it would be beneficial to utilise the services of an independent occupational therapist (2)  Home visit / Field visit  Better understanding of limitations / symptoms  Activities of daily living  Work site visit  Insight into actual work task requirements  Reasonable accommodations  Explore / identify suitable alternative occupations  Observation of workplace dynamics  Review assessments  Brief evaluation comparative to a historical view of claimant

10 A MRoA/MMRC Munich Re Group Work site visit – assessment of accessibility for persons with physical disability

11 A MRoA/MMRC Munich Re Group Pointers for when it would be beneficial to utilise the services of an independent occupational therapist (3)  Case management  Feasibility of candidate selection  Source appropriate medical service providers  Obtain quotations  Case management programme planning  Facilitate appointments and source reports  Ongoing contact with claimant  Liaison with the employer

12 A MRoA/MMRC Munich Re Group Last words  Referral brief has to be clear and comprehensive  Standardised tests - ?interpretation and analysis  Quality of reports  Suitably skilled independent occupational therapists

13 A MRoA/MMRC Munich Re Group The value of the occupational therapist THE END