Bob is a 53 year old previously serving ADF member, who was referred to an ARPA member for an Initial Rehabilitation Assessment in July 2017.  At the time of referral, Bob lived in Rural Queensland and had limited access to regular health care. Having previously served in the Australian Army for 11 years, Bob presented with numerous complex physical and psychological injuries and conditions including; PTSD; depressive disorder; left leg below knee amputation; lumbar spondylosis; left and right shoulder osteoarthritis; Varicocele, Orchiectomy and androgen deficiency.  Originally sustaining a fracture and partial severing his left lower leg during active service with the ADF, the wound was treated conservatively (unsuccessfully) for a period of five years, ultimately resulting in a below the knee amputation in 1997. 

Bob initially reported constant high levels of pain at multiple sites, including, stump, knee, hips, lumbar spine, upper back and both shoulders, the development of compensatory postures, altered gait patterns and upper limb loading from the prolonged use of crutches due to ongoing stump complications. His treating medical practitioner was unable to alter his medication readily due to the impact of medication interaction, despite experiencing significant side effects from the medication he had been prescribed to treat his ongoing symptoms of infection, inflammation and pain at the surgical site (stump wound), depression, anxiety and androgen deficiency.    

The combined impact of his traumatic military experiences together with a prolonged period of failed rehabilitation, the subsequent amputation of his left lower leg and the corresponding loss of independence, function, capacity and purpose, together with ongoing and prolonged stump difficulties, meant that Bob had been unable to return to work for some period of time and the impact on Bob and his family was profound. 

There were also a number of psychosocial, functional and medical barriers present for Bob who had become increasingly dependent upon his wife’s support who subsequently found herself unable to work because of her own worsening health conditions.

Bob agreed to participate in the rehabilitation program to assist him develop meaningful and realistic goals and was assigned an experienced Occupational Therapist (OT) with relevant skills and experience in supporting veterans on their rehabilitation journey.  The OT was able to utilise her clinical experience and communication skills to gain the trust of Bob and his wife and supported him to reengage with his treatment team, and initially attend all scheduled appointments with him to ensure that his psychological, physical and physiological treatment needs were being addressed.

Bob was engaged in weekly job seeking and support sessions following completion of an RPL assessment and review of his resume and due to the consistent support and intervention provided by the OT, the client obtained paid employment as a security officer/supervisor during the 2018 Commonwealth Games, drawing on his military training and leadership skills.

The OT was able to implement the health benefits of good work by utilising all of her skills as an allied health professional to gain the trust of the client and his wife, engage his treatment providers, develop meaningful rehabilitation goals and systematically implement a graduated rehabilitation plan addressing medical, functional, psychosocial and vocational barriers and ultimately assist Bob return to work in his chosen vocation as a security officer.  Due to his enthusiasm and work ethic, Bob has a been given a promise of ongoing casual employment and his employer has confirmed that he will be offered the next permanent security officer position that becomes available at the power station.