GLA Newsletter  | Fall Issue  |  October 2021
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Hello to our readers!
I hope you are enjoying the fall weather and the beautiful changes in colours as the leaves turn all different shades of reds and oranges.
In this edition of our newsletter, we are discussing a new assessment that will be offered by GLA Rehab, called the Cognitive Functional Capacity Evaluation (Cog-FCE.)
This is in addition to Functional Capacity Evaluation (FCE) and Vocational Assessment which we have been doing so far.
The FCE mostly addresses the physical capacity and physical limitations, as they affect work capacity and employability. The FCE is not designed to accommodate for the cognitive and/or behavioural challenges, faced by individuals with traumatic brain injury or mental health conditions.
The Cognitive Functional Capacity Evaluation (Cog-FCE) accounts for the functional cognitive barriers, and psycho-emotional and behavioural barriers to return to work, faced by this diagnostic group. It compliments the FCE that addresses the physical barriers.
This assessment will be completed by our occupational therapists in collaboration with our trained FCE+Cog-FCE assessor, Farhana Jaffar, PT.
So, what is the Cognitive Functional Capacity Evaluation?
The Cognitive Functional Capacity Evaluation (Cog-FCE) is designed to evaluate the ability to work for individuals with cognitive disabilities.
This assessment helps to explain how clients’ cognitive challenges may affect their ability to work. This evaluation will be used to assist with a client’s return-to-work plan and goals, as it combines a cognitive analysis with a focus on how the client is able to perform functionally and vocationally.
The first step involves an analysis of the cognitive job demands of the client’s pre accident job.
The second step is when the OT will be using a variety of different assessment methods, including a combination of subjective and objective measures. The OT will use high-level cognitive screens and questionnaires that will provide a baseline of the client’s cognitive status.
Some of the work-related cognitive tasks that the OT will look for are the client’s ability to follow instructions, remember procedures, sustain attention on a task, problem solve, plan and organize, reason, self-regulate, self-correct decisions, meet deadlines, work under pressure, be flexible and shift thoughts and plan when needed, multi-task, use adequate judgement and more.
We will address the client’s ability to communicate with others, be clear, understand instructions and self-advocate in a work environment.
The third step, work simulation, is when the OT will be asking the client to complete tasks that mirror the demands they would be responsible for if they were to return to work. This is through simulated situational assessments and analysis of the client’s ability to meet job demands. The OT will create situational tasks that model real-life work demands to see how these cognitive disabilities may manifest during work tasks.
Why is this evaluation helpful?
The Cognitive Functional Capacity Evaluation can be a very helpful tool to assess a client’s occupational performance and cognitive disabilities, in relation to their ability to perform their pre-accident job or any job that is “reasonably suited by education, training or experience.”  
By taking a comprehensive and holistic approach to assessment, the client is observed through several different avenues of obtaining information.  The assessor can develop further insight into how the client’s cognitive disability is apparent in a variety of tasks and situations.
The assessment findings and the identified gaps in ability to perform the cognitive job demands will be of assistance for Income Replacement Benefits claims and disputes
The team at GLA Rehab is excited to start using the Cognitive Functional Capacity Evaluation as this will allow us to collect data related the client’s ability to work, while he/she/they are coping with cognitive-behavioural impairments, following a motor vehicle accident.
Sources: Hartmen-Maeir, A., Katz, N., & Baum, C. (2009). Cognitive Functional Evaluation (CFE) Process for Individuals with Suspected Cognitive Disabilities. Occupational Therapy in Healthcare. 23:1,1 — 23

Structured Work Activity Group Test (SWAG) 

Written by Lian Yaffe, Occupational Therapist OT Reg. (Ont.)

As noted in our fall newsletter, several types of assessments are used to complete the Cognitive Functional Capacity Evaluation. Specific cognitive measures are used to assess for how cognitive difficulties are presented through occupation.
Assessments conducted in this step of the evaluation seek to use situational tasks that model real-world demands to assess a client’s ability to perform functionally.
One of the assessments commonly used to address this step is called the Structured Work Activity Group Test (SWAG).

Read full article

Workplace Safety and Insurance Appeals Tribunal: An Appeal that Recognized the Evolution of Cognitive Disability Symptoms

Written by Lian Yaffe, Occupational Therapist, OT Reg. (Ont.)
Individuals who have experienced traumatic brain injuries experience cognitive-behavioural symptoms that can affect them in their daily lives. Many individuals report impairments including fatigue, inability to concentrate, lack of attention, low frustration tolerance, memory difficulties, problem with organization and sequencing, impaired judgement and difficulty with emotional regulation.
It is important to collect proper data on client’s cognitive-behavioural abilities from observation and standardized testing.
In a recent appeal decision made by the WSIB board in 2020, Decision No. 657/20, 2020 ONWSIAT 1423 (CanLII), the arbitrator revised the benefits awarded to an individual after further information was provided, suggesting a change in the individual’s symptomology and ability to function.

Read full article
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