Cancer survivors often ask their physician whether they will be able to work or when is
the best time to return. Also, employers and insurance companies often count on the physician to provide information about a survivor’s limitations, restrictions and ability to work. This information may inform an insurance claim, help with creating a return to work plan or determine the limitations and restrictions to be accommodated.
Answering questions about a survivor’s work ability, limitations and restrictions, especially if the survivor has been off work for some time, may be challenging. The answers may require the survivor to partner with you, the healthcare provider, in deciding when they are ready to work through formal and informal assessments.
For an understanding of these factors and research that can guide the assessment process, see our webinar “Vocational Rehabilitation for Cancer Patients Part 2″:
For healthcare providers, assessing a cancer survivor’s work ability involves understanding all of the factors that might influence return to work including the survivor’s abilities in 3 key domains: physical, cognitive and emotional functioning capability. There are many ways to assess an individual’s work ability, including:
- patient self-assessment
- clinical examination of symptoms
- specialized medical assessments (i.e. neurological, ophthalmology, physiatry) and diagnostic tests
- professional assessments by specialists such as neuropsychologists, psychiatrists, occupational therapists, physical therapists and vocational rehabilitation counsellors
- medical or psychosocial interviews
- standardized tools that measure physical, cognitive and emotional functioning
- observations by family or friends of how a survivor is performing activities at home or work
- worksite assessments, such as functional capacity on the job, ergonomic assessment or observation at the worksite
- assessments of job demands and supports at the workplace
Worksite assessments may not be available within the healthcare system. In some cases, such assessments are available through private short-term or long-term disability plans. If your patient has such a plan, you can help by recommending that the insurance company fund and refer the patient to such assessments if indicated.
You can also ask the survivor to use self-assessment tools to track their energy levels, fatigue and pain throughout the day as well as their sleep quality to help with return to work planning. These tools will help the survivor identify which work activities may present challenges. There are a few other work-focused assessments available for cancer patients such as screening tools but these are not specifically designed for vocational rehabilitation. Family or friends can also be asked to observe and comment on the survivors’ performance of daily tasks.
These various assessments can inform return to work planning and guide supports and accommodations needed at the worksite. Assessments can also help in deciding whether work-related rehabilitation would be helpful, whether more time off is needed for recovery, or whether working in the future is unlikely.
Once you have gathered information about your patient’s functioning and the demands of the job, the next step is to pull this information together to provide an opinion on work readiness and make recommendations for further assessment, treatment and supports.