Insurance Rehabilitation Programs

Hi I’ve been reading the helpful tips for the last year but this is my first post. I have 3 months left before my COD 2 year mark and have been told I need to do behavioural activation & work hardening programs. My doctor told insurance I can try even though I’m not stabilized and I don’t get it.

What is the difference between the different rehab programs the insurance recommends?
1)behaviour activation
2)work conditioning
3)work hardening
5)vocational rehabilitation

Are they all the same thing to get you back to work right after any program or used in difference stages of recovery together in steps?
Is anyone willing to share their experiences? I am freaking that they will try to set unrealistic goals and activities and say I’m not trying. I’m not able easily do things around the house or go outside freely with my mental health and paranoia.

And, when you fill out activity sheets how do you know if it’ meant to be past, present of future?

Just do what you can handle. If you can’t at least you tried. You have no choice if medical approves it. You need to have the discussion with your MD.

Will try my best, is my plan. Just really stressful. I want to get better but they sure make it hard to have any breathing room to heal.

I was an occupational therapist before becoming a lawyer, so I have a lot of experience with this.

Behaviour Activation and PGAP are usually done by an occupational therapist outside of a “Gym” setting. They are focused on people who have disability related to mental or psychological issues. But can be pain or fatigue as well. The goal is getting you to slowly increase your activity over time though goal directed activities that you enjoy. The idea is that there is a vicious cycle – the less you do activity wise – the less you will want to do. The more you do, the more you will want to do. So, the will design programs to ease you back into being more active.

Work hardening is seen when there is a physical limitation and part of the problem is deconditioning. So the “hardening” part means you are attending a physical rehabilitation “gym” setting and they are building up your physical fitness, conditioning and tolerances.

Vocational Rehabilitation is more of a general term that covers a range of assessments and interventions aimed at returning a person to work. So, behavior activation, work hardening, etc would fall under it. It can include other things like transferrable skills assessments or identifying gaps in education and training, etc

This is a very basic explanation, but I hope this helps.


David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.

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Thank you David for the response.

I won’t ask you this question directly if uncomfortable thus directed at the forum generally overall, but please feel free to answer if you are willing to.

Looking for advice. Should you make notes of your OT rehab sessions like discussion with insurance claim manager or a IME? I want to believe all OTs will be doing their job to their professional code, but I am worried and paranoid with everything I read about IME and claims manager.

100% yes keep your own notes. I recommend keeping a treatment journal where you can track this type of stuff. Just know that if your case ever goes to a lawsuit you would have to show these notes to the insurance company. That is not a problem, just keep that in mind.