title: Preparing difficult clients to return to work.
abstract: OBJECTIVE
  Investigate the effect of the symptom magnification syndrome (SMS) behavior pattern on industrial rehabilitation on return to work and maintenance at work.
  
  
  METHODS
  A sample of 99 clients with active workers' compensation claims was studied; 25 identified as having SMS.
  
  
  METHODS
  A protocol-driven functional capacity evaluation (FCE) was administered and the presence of SMS was determined from a standard protocol that considered 13 factors.
  
  
  RESULTS
  Upon conclusion of intervention, 80 of the 99 clients were classified as ready to return to full-time usual and customary employment. The readiness for full-time return to work among those who did not have SMS (84%) was not statistically different from those with the syndrome (72%). Six months after discharge, follow-up work status data were obtained for 63 clients. Among those that did not display SMS, 76% continued to work full time, while 39% of those initially identified as SMS were working, a statistically significant difference.
  
  
  CONCLUSIONS
  SMS had no significant bearing on work readiness, but appears to impact maintenance of employment. The value of return to work on a modified basis may need to be reconsidered, because none of the clients who had been discharged ready for modified work were employed at the six-month follow-up.
authors: PRORehab. kellymday@hotmail.com
authors: Kelly M
authors: KM
authors: Chapman-Day
authors: Leonard N
authors: LN
authors: Matheson
authors: Dean
authors: D
authors: Schimanski
authors: Janet
authors: J
authors: Leicht
authors: Luke
authors: L
authors: DeVries
mesh_terms: D000328:Adult; D019567:Back Injuries / Q000503:physiopathology / Q000523:psychology; D004651:Employment; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000293:injuries / Q000503:physiopathology; D008297:Male; D008306:Malingering; D008875:Middle Aged; D060051:Occupational Injuries / Q000503:physiopathology* / Q000523:psychology*; D010146:Pain / Q000523:psychology; D034941:Upper Extremity / Q000293:injuries / Q000503:physiopathology; D014938:Work Capacity Evaluation; D014942:Workers' Compensation; D055815:Young Adult