Return to work with upper limb impairments: combined effort to recognize negative outcomes in advance Moshe S.1, Izhaki R.2, Chodick G.3, Yagev Y.4, Slodownik D.5, Juven Y.6 Maccabi Healthcare Services - Occupational Medicine Clinics: 1Jerusalem & HaShfela District, 2Occupational Therapy Clinic, Jerusalem & HaShfela District; 3Medical Informatics Dept. 4HaNegev District; 5Department of Dermatology, Hadassah University Medical Center, Jerusalem, Israel6Central District … Background: Return to work (RTW) is a key goal in proper management of Upper limb disorders (ULD). Impairments stem from diverse medical etiologies, and numerous variables have some impact on RTW. The abundance of factors, their complex interactions and the diversity in human behavior has made it difficult to pinpoint those at risk, and to efficiently intervene. Objective: To weigh various clinical, functional and occupational parameters and identify RTW predictors. Methods: Retrospective study analyzing data of 52 workers referred to an occupational clinic to assess their fitness to work due to ULD. Participants were further examined by an occupational therapist. Functional assessment included objective parameter (e.g. grip & pinch strength, FDT) as well as subjective ones (DASH scores). Quantifying work requirements was based on a match between job title and an “on line” data base scale – Dictionary of titles (DOT). RTW status was based on a follow up telephone questionnaire. Results: There were no differences between the groups in distribution of socio demographic or vocational parameters. As opposed to all other clinical variables, only the DASH score was different (p<0.001). Patients who did not RTW valued their disability as substantially greater (55%) than those who did (26%). Conclusions: Physicians and Rehabilitation staff should regard a high Dash Score as a warning sign when assessing RTW prospects. It is advisable to focus on workers with large discrepancy between a high DASH score and low objective disability and concentrate efforts to guide RTW.