Occupational Therapy Activities of Daily Living Assessment guidance

Helping people achieve independence

The Occupational Therapy Activities of Daily Living Assessment (OT ADL Assessment) is a functional assessment of a worker’s ability to carry out common household tasks.

It must be completed by an occupational therapist (OT registered with WorkSafe) and returned to the worker’s WorkSafe agent.

The OT ADL Assessment will identify strategies to maximise and maintain a worker’s independence.

WorkSafe expects the assessment to include direct observation of a worker’s functional capacity.

Referral process

Agents will complete a referral stating the reason for OT assessment and any relevant information. This will include identified safety concerns and risks.

They will provide the workers previously completed:

Contact the worker’s agent case manager if you need more information about the referral.

Completing an ADL assessment

Before the assessment

You will need to review the following before beginning an assessment.

• The referral, including the purpose of the OT ADL Assessment.
• Household help workers declaration form. This provides information about the worker’s personal and social circumstances, and their home.
• Request for household help services. This describes any previous capacity assessment and the clinical rational for services.
• WorkSafe household help services guidelines.
• WorkSafe equipment and related services guidelines.
• Clinical framework for the delivery of health services.
• Any additional documentation provided by the agent.

You should contact the worker to arrange a time to complete the assessment.

Remember to conduct your own risk assessment before attending the home.

The assessment

You should complete all sections of the WorkSafe Occupational Therapy Activities of Daily Living Assessment form.

You will be asked to complete the following.

• A comprehensive functional assessment specific to the referral.
• Consider the expected and reasonable contribution of other household members.
• Contact the worker’s treating medical practitioner and/or therapy team. This could include the certifying practitioner, a physiotherapist or a psychologist etc.

You should discuss the Recovery and services plan with the worker and any relevant parties, such as their case manager.

Assessment checklist

Check you have completed the following.

• All sections of the ADL assessment template.
• Include evidence of a comprehensive functional assessment.
• Provide clear clinical justification based on an injury-related need for all recommendations. This includes Personal and household help services and Assistive technology prescriptions.
• Document the outcomes of contact with any treating professionals. Include objective assessment findings and therapeutic strategies discussed.
• Ensure recommendations reflect your professional opinion. You should clearly separate client and/or family subjective views.

You should send the report only to the referrer. You should not include any other people unless confirmed by the referrer or agent.

Services and recovery plan

Early intervention is key to supporting worker’s to maximise their independence. It is an important part of recovery and return to work.

WorkSafe values the expertise of OTs in facilitating this transition following injury or illness.

Household help services should be considered an interim or short-term arrangement. They are expected to reduce as the worker recovers.

You should plan to support the worker’s gradual return to managing home-based activities independently.

The focus should be on:

• building capacity
• promoting recovery
• using temporary supports to enable sustainable independence.

Adaptive household equipment

Adaptive household equipment can be used to support people in their independence in activities of daily life.

It is expected that the equipment prescription will lead to a cessation and reduction of Household help services. If not, then a recovery plan must be in place to support a reduction and cessation of services.

This can be outlined in the Recovery and services plan of the ADL assessment template.

Review of services and recovery plan

OT Providers can seek approval to deliver further goal-oriented assessments to support workers.

These assessments may include the following.

• Goal-related educative input. This can include adaptive strategies and functional retraining. For example, self-pacing, energy conservation, biomechanical techniques and graded activity programs.
• Trials and prescription of adapted equipment.
• Phased reduction in support services. This should occur as participation levels increase through implementation of a graded activity program.

Clinical justification process

Pre-approval is required for WorkSafe to pay for the reasonable costs of referred occupational therapy treatment or assessment.

Requests should demonstrate the use of valid, reliable, and objective tools at regular intervals. This is to:

• assess changes in functional status
• guide decisions by measuring progress toward and/or achieving functional goals
• clinically justify ongoing intervention.

Support is available for detailing your clinical assessment, justification and requests. See the WorkSafe ADL Assessment template.