Key Responsibilities and Required Skills for Occupational Therapist

🎯 Role Definition

An Occupational Therapist (OT) evaluates, plans, and delivers individualized, evidence-based interventions that enable people of all ages to perform meaningful daily activities (ADLs/IADLs), regain independence after injury or illness, and maximize functional outcomes across home, school, work, and community settings. OTs work across inpatient, outpatient, home health, pediatric, geriatric, and community-based settings, collaborating closely with multidisciplinary teams, patients, and caregivers to design goal-driven rehabilitation plans, document outcomes, and ensure safe, compliant care.

📈 Career Progression

Typical Career Path

Entry Point From:

Entry-level Occupational Therapist (new graduate with Level II fieldwork experience)
Occupational Therapy Assistant (OTA) progressing with additional education/certification
Allied health professional transitioning from Physical Therapy Assistant, nursing, or rehabilitation technician roles

Advancement To:

Senior Occupational Therapist / Clinical Specialist (e.g., neurological or hand therapy specialist)
Lead Therapist / Team Lead of Rehabilitation Services
Manager or Director of Rehabilitation / Therapy Services
Certified Hand Therapist (CHT), Pediatric Specialist, or Clinical Educator
Private practice owner or advanced clinician (OTD/PhD, research lead)

Lateral Moves:

Case Manager or Utilization Review Specialist
Rehabilitation Coordinator or Discharge Planner
Clinical Educator / Fieldwork Supervisor
Assistive Technology or Seating & Mobility Specialist

Core Responsibilities

Primary Functions

Conduct comprehensive, evidence-based initial evaluations and re-evaluations that assess physical, cognitive, sensory, emotional, and environmental factors affecting a patient’s ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs), using standardized outcome measures (e.g., COPM, FIM, DASH, Berg Balance Scale).
Develop individualized, measurable, and time‑bound treatment plans (goals and interventions) based on evaluation findings, patient priorities, functional needs, and best-practice guidelines, ensuring plans are documented clearly in the electronic health record (EHR).
Deliver skilled occupational therapy interventions across settings (inpatient acute, subacute, outpatient clinic, home health, school-based, pediatric, geriatric), including therapeutic exercises, ADL retraining, cognitive remediation, sensory integration, and adaptive equipment training.
Provide hands-on treatment and skilled instruction for upper-extremity rehabilitation, including splinting, scar management, desensitization, fine-motor retraining, and graded functional tasks for patients post-stroke, TBI, fracture, or hand surgery.
Design, fabricate, fit, and educate patients and caregivers on static and dynamic splints and orthoses to support function, protect healing tissue, and improve joint alignment and ROM.
Perform home and workplace safety assessments and make practical environmental modifications and home program recommendations to reduce fall risk and enable safe community reintegration.
Assess, prescribe, and train patients and caregivers in the use of assistive technology, adaptive equipment, durable medical equipment (e.g., shower chairs, reachers, walkers, wheelchairs), and energy conservation techniques to maximize independence.
Implement cognitive-behavioral and compensatory strategies for patients with cognitive deficits (attention, memory, executive function) to improve task sequencing, safety awareness, and community participation.
Deliver pediatric occupational therapy services including sensory processing interventions, play-based therapy, fine motor and handwriting programs, school-based consultation, and collaboration with teachers and families to support educational goals.
Lead and participate in interdisciplinary rounds and team meetings to coordinate patient-centered care plans with physicians, nursing, PT/SLP, social work, and case management to optimize discharge planning and post-acute needs.
Educate patients, families, and caregivers on prognosis, home exercise programs, fall prevention, skin integrity, safe transfers, toileting strategies, and medication or equipment-related considerations to support continuity of care.
Complete timely, accurate, and defensible documentation (evaluations, progress notes, discharge summaries) that meet facility, payer, Medicare/Medicaid, and accreditation requirements and support medical necessity for ongoing therapy.
Use outcome measures and standardized assessments to track progress, support clinical decision-making, and provide data for quality improvement and utilization review processes.
Coordinate referrals to community resources, outpatient therapy, specialty clinics, vocational rehab, and adaptive recreation programs to ensure successful transitions and continuity of services.
Provide clinical supervision, mentoring, and fieldwork education to OT students, occupational therapy assistants (OTAs), and support staff, maintaining compliant supervision ratios and student training objectives.
Participate in discharge planning, including skilled recommendations for continued therapy, outpatient scheduling, equipment prescription, and patient/caregiver education to support safe transitions home, to skilled nursing, or to community programs.
Apply evidence-based practice and clinical reasoning to modify treatment techniques based on progress, tolerance, and changing medical status; escalate care concerns to the interdisciplinary team when appropriate.
Maintain competency in infection control, universal precautions, and safe handling and lifting procedures to protect patients and staff in acute and non-acute settings.
Collaborate with physicians and rehabilitation specialists to request and interpret diagnostic tests, support medical necessity appeals, and provide clinical rationale for continued therapeutic services.
Lead or contribute to clinical quality improvement initiatives, outcome monitoring programs, and service-line development projects to enhance patient outcomes, efficiency, and patient satisfaction.
Manage caseload effectively, prioritizing therapy needs, scheduling evaluations and treatments, and balancing productivity requirements while maintaining high-quality patient-centered care.
Provide culturally competent, trauma-informed care and adapt communication and treatment approaches for diverse populations, disabilities, pediatric and geriatric cohorts, and neurodiverse patients.

Secondary Functions

Support program development including new service lines (e.g., hand therapy, driving rehabilitation, neurological day programs) and participate in market outreach to grow referral sources.
Maintain equipment inventory, recommend purchases for adaptive devices or clinic materials, and ensure safe maintenance and calibration of therapeutic tools and modalities.
Assist with payer authorization processes, documentation for Medicare/Medicaid compliance, and preparation of clinical documentation for audits or utilization review.
Develop patient education materials, training modules, and caregiver guides that reflect current evidence and facility protocols.
Participate in staff education, in‑services, and competency training to keep the therapy team current on best practices, safety protocols, and new interventions.
Collect and analyze clinical outcome data for reporting, reimbursement justification, and continuous improvement; present findings to leadership or clinical teams when requested.
Represent occupational therapy in community outreach, school consultations, health fairs, and interdisciplinary panels to educate referral sources and community partners about OT services.
Support telehealth delivery by conducting virtual evaluations and interventions where appropriate, ensuring HIPAA-compliant platforms and effective remote coaching.
Contribute to policy and protocol reviews to align clinical practice with accreditation standards (Joint Commission, CARF) and organizational quality goals.
Participate in scheduling, coverage planning, and on-call rotations as needed to ensure continuity of patient care across shifts and settings.

Required Skills & Competencies

Hard Skills (Technical)

Skilled in performing standardized and non‑standardized assessments (e.g., COPM, FIM, AM-PAC, Berg Balance, VFSS consult collaboration) and translating results into functional treatment plans.
Proficient in therapeutic splinting and fabricating custom orthoses for hand, wrist, and upper-extremity conditions, including post-operative protocols.
Strong competence delivering ADL/IADL retraining, transfer training, wheelchair seating and mobility assessments, and durable medical equipment (DME) recommendations.
Experience with cognitive rehabilitation techniques, compensatory strategy training, and use of cognitive assessment tools for TBI, stroke, and dementia populations.
Knowledgeable in sensory integration and pediatric feeding/feeding therapy approaches when working with infants and children.
Competent in vocational evaluation, work hardening, workstation ergonomic assessment, and return-to-work planning for working-age adults.
Skilled in home safety evaluations and environmental modification recommendations, including fall prevention program design and implementation.
Ability to deliver and document evidence-based interventions across multiple settings (acute, inpatient rehab, outpatient, home health, schools).
Strong documentation skills including SOAP/IER formats, progress notes, treatment plans, discharge summaries, and familiarity with EHR systems (e.g., Epic, Cerner, TherapyTrack).
Understanding of payer rules, Medicare Part A/B documentation requirements, CPT coding for therapy services, and experience supporting authorization and appeals.
Familiarity with outcome measurement, data collection, and using metrics to drive clinical decision-making and quality improvement (e.g., functional gains, patient satisfaction scores).
Proficiency with assistive technology prescription, wheelchair seating assessments, and collaboration with ATPs/Vendors as needed.
Experience providing telehealth OT services, remote patient coaching, and virtual care platform documentation.

Soft Skills

Exceptional clinical reasoning and problem-solving skills to design individualized interventions that address complex biopsychosocial needs.
Strong verbal and written communication skills for patient education, interdisciplinary collaboration, and clear clinical documentation.
High levels of empathy, patience, and cultural humility to build therapeutic rapport with diverse patients and caregivers.
Time management and organizational skills to manage a caseload, prioritize tasks, and meet productivity and documentation expectations.
Leadership and mentorship capabilities to supervise OTAs, students, and entry-level clinicians while fostering a supportive learning environment.
Flexibility and adaptability to work across variable caseloads, changing patient acuity, and multiple practice settings.
Conflict resolution and negotiation skills for coordinating care plans with families, providers, and payers.
Attention to detail and compliance orientation to maintain accurate records, adhere to clinical protocols, and support audit readiness.
Coaching and motivational interviewing skills to engage patients in behavior change, adherence to home programs, and long-term functional goals.
Collaborative mindset and team-oriented approach for effective interdisciplinary care planning and execution.

Education & Experience

Educational Background

Minimum Education:

Master of Occupational Therapy (MOT) or Master’s-equivalent in Occupational Therapy; or entry-level Doctor of Occupational Therapy (OTD) where required by employer/state licensure.

Preferred Education:

Doctor of Occupational Therapy (OTD) or advanced clinical certifications (e.g., Certified Hand Therapist - CHT, Pediatric Certification, Driving Rehabilitation Specialist).
Additional certifications in specialty areas (e.g., LSVT for Parkinson’s, NDT, Sensory Integration, Certified Aging-in-Place Specialist).

Relevant Fields of Study:

Occupational Therapy
Rehabilitation Science
Kinesiology / Human Movement Science
Neuroscience or Neurorehabilitation
Psychology (clinical or developmental)
Special Education (for school-based OT roles)

Experience Requirements

Typical Experience Range:

New graduate to 7+ years depending on setting; typical range listed in postings: 0–5 years for generalist roles, 3–7+ years for specialty or senior roles.

Preferred:

1–3 years of clinical experience for outpatient/acute settings; 3+ years for specialty clinics (hand therapy, neurological rehab, pediatrics).
Experience with EHR documentation, working knowledge of Medicare and third‑party payer requirements, and demonstrated outcomes tracking.
Supervisory or mentoring experience preferred for lead, clinical specialist, or managerial roles.