Claude CoWork for Occupational Therapists

What is Claude CoWork?

Claude CoWork is the practice of using Claude as a dedicated, context-aware assistant that plugs directly into your occupational therapy workflow. Instead of starting from scratch every time you open a chat window, you configure Claude with your practice context, documentation preferences, and clinical style so it consistently produces output that is useful from the first draft.

Claude-native prompts. The prompts in this guide use Claude's native XML tag structure (<context>, <instructions>, <format>, <avoid>) for more precise, consistent output. These tags help Claude parse your intent with less ambiguity. They work in ChatGPT too, but are optimized for Claude.

Occupational therapists manage one of the heaviest documentation loads in rehabilitation. SOAP notes that must capture intervention rationale and functional outcomes for every session. Treatment plans that tie occupation-based goals to measurable criteria. Home programs that patients and caregivers need to follow independently. Progress reports that demonstrate skilled intervention. Insurance appeals that argue medical necessity when authorizations are denied. These tasks are essential but repetitive, and they are exactly where Claude adds the most value.

This guide shows you how to configure Claude for OT-specific work, the five workflows that will reclaim the most time in your day, and the privacy guardrails that are non-negotiable in a clinical setting.

Install the Occupational Therapist Plugin

This guide works on three Claude surfaces. The plugin is the fastest path on two of them. Pick whichever you use:

If you're on Cowork (desktop or mobile app)

Claude Cowork is Anthropic's agentic workspace — Claude completes work autonomously and returns finished deliverables. The Occupational Therapist plugin packages the workflows below as native skills and slash commands.

Open the Cowork plugin directory in your desktop app.
Filter by Cowork, search for "Occupational Therapist", and click Install.
The plugin's slash commands and ambient skills are now available in any Cowork task.

If you don't see the plugin in the directory yet, install via custom marketplace: paste https://github.com/alexclowe/awesome-claude-cowork-plugins in your Cowork plugin settings.

If you're on Claude Code (CLI)

Install from your terminal:

claude plugin add alexclowe/awesome-claude-cowork-plugins/occupational-therapist

The plugin's slash commands and skills load on next session.

If you're on Claude.ai (web chat only)

Plugins aren't directly installable on the web chat surface. You have two options:

Use the prompts in this guide directly in a Claude Project (covered in the next section). Same outputs, more typing.
Upload the plugin's skills as a zip via Settings → Features → Custom Skills (Pro/Max/Team/Enterprise plans). Higher friction; only worth it if you want the auto-activating skills, not the slash commands.

What the plugin gives you (any surface)

Slash command	What it does
`/soap-note`	Generate structured SOAP notes from session observations with all four documentation sections
`/treatment-plan`	Draft individualized treatment plans with measurable goals and evidence-based interventions
`/progress-report`	Create progress reports documenting functional improvements and continued medical necessity
`/home-program`	Build patient-friendly home exercise programs with instructions, precautions, and progressions

Auto-activating skills (no command needed — Claude applies them when relevant):

Occupational Therapy — Clinical reasoning, functional assessment, evidence-based interventions, and OT-specific documentation standards
Patient Education — Clear home program instructions, activity modification guidance, and patient-friendly clinical language

The plugin works standalone for one-off tasks. Pair it with the surface-specific setup below for persistent context across every task — that combination is the full Claude CoWork setup.

Setting Up Claude for Occupational Therapy Work

Surface note: The Project setup below is for claude.ai web users. Cowork users have their own task-context mechanism (set context once when starting a Cowork task). Claude Code users get the plugin's ambient skills automatically — no Project setup needed. The workflows themselves are surface-agnostic — paste the prompts wherever you're working. Step 1: Create an OT Project. In Claude, go to Projects and create one called "OT Practice" or similar. This is your persistent workspace with context that carries across conversations.

Step 2: Set your custom instructions. In the Project settings, add:

You are my occupational therapy documentation assistant. Here is my context:

<practice-profile>
- Role: [Staff OT / OTR/L / Travel OT / OT clinic owner / COTA supervisor]
- Setting: [Outpatient / Inpatient rehab / Acute care / Home health / Pediatric / SNF / School-based]
- State: [Your State]
- EMR system: [NetHealth, WebPT, Clinicient, Meditech, Epic, etc.]
- Common payers: [List your top 3-5 insurance companies]
- Documentation style: [Occupation-focused, functional outcomes, SOAP format]
- Specialty: [Hand therapy / Neuro rehab / Pediatric / Geriatric / Mental health / Ergonomics]
</practice-profile>

<rules>
- Documentation should follow AOTA documentation guidelines and emphasize occupation-based outcomes
- Goals must be functional, measurable, and tied to meaningful occupations (ADLs, IADLs, work, leisure)
- Always document skilled intervention rationale — why OT services specifically are required
- Home programs should use plain language with clear instructions for patients and caregivers
- Never generate content for a specific identifiable patient — all scenarios must use de-identified information
- Remind me to verify all clinical details before finalizing documentation
</rules>

Step 3: Upload your templates. Add your preferred SOAP note template, treatment plan format, home program layout, any payer-specific documentation criteria, and your progress report template.

Step 4: Always work inside this Project. Every new conversation inherits your context automatically.

Your Top 5 Workflows with Claude

1. SOAP Notes

OT documentation requires demonstrating skilled intervention and functional progress at every visit. Claude drafts SOAP notes from your session shorthand.

<task>Draft an OT SOAP note from these session details (de-identified patient).</task>

<context>
- 74-year-old female, 5 days post R total hip replacement, inpatient rehab
- Prior level of function: Independent in all ADLs, lived alone in two-story home
- Session focus: Lower body dressing, toilet transfers, hip precaution education
</context>

<instructions>
Use this session data:

Subjective: Patient reports R hip pain 4/10 at rest, 6/10 with movement. States she is "worried about going home alone." Motivated to participate.

Objective:
- Lower body dressing (donning pants/socks/shoes): Mod A with adaptive equipment (reacher, sock aid, long-handled shoehorn). Required 3 verbal cues for hip precaution compliance during pants donning. Completed task in 12 minutes.
- Toilet transfer: Min A using raised toilet seat and grab bar. Required 1 tactile cue for posterior hip precaution during sit-to-stand.
- Hip precaution education: Reviewed posterior precautions using visual handout. Patient able to verbally recall 3/4 precautions independently.

Assessment: Patient demonstrating progress from Max A to Mod A for lower body dressing in 3 sessions. Skilled OT intervention required for adaptive equipment training, task modification, and safety education. Patient would benefit from continued repetition to achieve independence prior to discharge home alone.

Plan: Continue daily OT. Progress to Min A for dressing. Initiate kitchen and meal prep assessment tomorrow. Target discharge in 5-7 days.

Format as a standard SOAP note. Emphasize functional outcomes and skilled OT rationale.
</instructions>

<avoid>Patient identifiers, vague language that does not demonstrate skilled intervention need.</avoid>

Before Claude: 12-20 minutes per SOAP note, often completed after hours. After Claude: 3 minutes to input session data, 3 minutes to review and finalize.

2. Treatment Plans

Treatment plans must connect assessment findings to occupation-based goals with clear, measurable criteria. Claude structures plans that satisfy both clinical and payer requirements.

<task>Draft an OT treatment plan for a de-identified patient.</task>

<context>
- 48-year-old male, carpenter, 6 weeks post R distal radius ORIF
- Referred for: R wrist/hand rehab, return to work
- Current status:
  - R wrist AROM: Flexion 35 degrees, extension 25 degrees, supination 40 degrees, pronation 55 degrees
  - Grip strength: R 18 lbs (L dominant 95 lbs)
  - Edema: Mild dorsal hand, circumferential measurements 0.5 cm > L
  - Sensation: Intact
  - Function: Unable to grip tools, cannot turn doorknobs, difficulty with buttons and zippers, cannot lift > 5 lbs
- Patient goal: "Get back to work full duty"
- Job demands: Repetitive gripping, overhead reaching, lifting up to 50 lbs, fine motor tool use
</context>

<instructions>
Write a treatment plan that includes:
- 4 short-term goals (4 weeks) and 3 long-term goals (12 weeks) in SMART format
- All goals tied to functional activities or occupational demands
- Proposed interventions with frequency and duration
- Skilled OT rationale for each intervention category
- Discharge criteria

Follow AOTA documentation best practices. Goals should progress from ADL independence to work-specific functional demands.
</instructions>

<avoid>Unrealistic timelines, goals not tied to meaningful occupations, patient identifiers.</avoid>

Before Claude: 20-30 minutes building a comprehensive treatment plan. After Claude: 5 minutes to input data, 5 minutes to review and customize.

3. Home Programs

Patients and caregivers need home programs they can follow without a therapist present. Claude generates clear, illustrated-ready instructions.

<task>Create a home program for a de-identified patient post-stroke.</task>

<context>
- 67-year-old male, 4 weeks post L CVA with R hemiparesis
- Transitioning from inpatient rehab to home with wife as primary caregiver
- Current UE status: R shoulder AROM flexion 75 degrees, minimal active hand movement, emerging finger extension
- Current ADL status: Mod I for feeding with setup and adapted utensils, Min A for upper body dressing
- Equipment at home: Raised toilet seat, grab bars (installed), tub bench, adapted utensils
- Caregiver: Wife, willing and physically able to assist
</context>

<instructions>
Create a home program that includes:
- 5 exercises for R upper extremity (ROM, strengthening, and task practice)
- 3 functional activity recommendations to practice daily (incorporated into routine)
- Clear instructions for each exercise (sets, reps, positioning)
- Caregiver instructions for assistance and safety
- What to watch for (red flags: increased pain, swelling, new weakness)
- A weekly schedule (which exercises/activities on which days)

Write at a level both the patient and caregiver can follow. No clinical jargon.
</instructions>

<avoid>Exercises beyond current ability level, assuming equipment not listed, clinical terminology without explanation.</avoid>

Before Claude: 25-35 minutes creating a comprehensive home program. After Claude: 5 minutes to generate, 5 minutes to customize and add illustrations.

4. Progress Reports

Progress reports summarize treatment outcomes and justify continued services. Claude structures these to withstand payer scrutiny.

<task>Draft a progress report for a de-identified patient at the 30-day mark.</task>

<context>
- 48-year-old male, R distal radius ORIF, outpatient hand therapy
- Treatment dates: 12 visits over 4 weeks
- Baseline vs. current:
  - R wrist flexion: 35 to 52 degrees
  - R wrist extension: 25 to 38 degrees
  - Grip strength: 18 lbs to 34 lbs (L 95 lbs)
  - Edema: Resolved
  - Function: Can now turn doorknobs, button shirts independently, lift up to 15 lbs. Still unable to grip tools for sustained use or lift > 25 lbs.
- Goals met: 2 of 4 short-term goals met (edema resolution, independent ADLs)
- Goals in progress: Grip strength 60 lbs, return to modified duty
- Requesting: 12 additional visits over 6 weeks
</context>

<instructions>
Format as a progress report suitable for payer review. Include:
- Summary of initial findings and treatment provided
- Objective progress with baseline comparisons
- Goals met and goals in progress with projected timelines
- Justification for continued skilled OT services
- Updated plan of care

Emphasize measurable functional gains and remaining occupational deficits.
</instructions>

<avoid>Vague progress language, patient identifiers, suggesting patient has plateaued.</avoid>

Before Claude: 15-25 minutes drafting a detailed progress report. After Claude: 4 minutes to input outcomes, 4 minutes to review and finalize.

5. Insurance Appeals

When authorizations are denied, a well-structured appeal that emphasizes functional necessity can reverse the decision. Claude builds the clinical argument from your data.

<task>Draft an insurance appeal for continued OT services.</task>

<context>
- 74-year-old female, R total hip replacement, transitioned to home health OT
- Insurance: [Payer], denied after 6 home health visits, stating "patient can continue with home exercise program independently"
- Current status: Mod I for lower body dressing with adaptive equipment (requires setup assist from neighbor), unable to prepare meals standing > 10 minutes, cannot safely enter/exit bathtub even with tub bench
- Safety concerns: Lives alone, nearest family 2 hours away, fall risk (Tinetti score 18/28)
- Progress: Advanced from Mod A to Mod I for dressing in 6 visits, but has not yet achieved safe independence in bathing or meal prep
- Requesting: 8 additional visits over 4 weeks to achieve safe independent living
</context>

<instructions>
- Emphasize functional deficits that directly impact safe independent living
- Address the denial rationale specifically — explain why a home exercise program alone is insufficient for these occupational performance deficits
- Document fall risk and safety concerns related to living alone
- Reference the need for skilled OT intervention (task modification, adaptive equipment training, environmental assessment) vs. exercise alone
- Format as a formal appeal letter
</instructions>

<avoid>Emotional language, patient identifiers, exaggerating deficits beyond documented findings.</avoid>

Before Claude: 20-30 minutes crafting a clinical appeal letter. After Claude: 5 minutes to input clinical data, 5 minutes to review and customize.

Prompt Engineering Tips for Occupational Therapists

1. Always include assist levels and functional context. Claude writes significantly better OT documentation when you specify assist levels (Max A, Mod A, Min A, Mod I, I) and tie them to specific occupations. "Mod A for lower body dressing" is far more useful than "needs help getting dressed."

2. Emphasize occupation, not just impairment. Add "Frame everything in terms of occupational performance and participation" to your Project instructions. Payers and reviewers want to see how deficits impact meaningful daily activities, not just ROM numbers.

3. Include baseline measurements for every progress document. Claude produces stronger progress reports and appeals when you provide both current and initial values. "Grip 34 lbs (was 18 at eval)" makes the progress undeniable.

4. Specify the setting for home programs. "Patient lives alone in a second-floor apartment with no elevator" versus "patient lives with spouse in a single-story home" drastically changes what a home program should include.

5. Ask Claude to audit your skilled intervention rationale. Paste a note and ask: "Does this note clearly demonstrate why skilled OT is required versus a home exercise program or aide services?" This is the question payers ask, and it should be the question you ask too.

6. Use Claude to generate multiple goal options. Say "Give me 3 versions of this goal with different functional activities and timeframes" when writing treatment plans. Select the version that best matches the patient's priorities and trajectory.

Privacy & Compliance

HIPAA compliance is mandatory. Never enter real patient names, dates of birth, medical record numbers, or any identifying information into Claude. This is a hard rule, no exceptions.

De-identify all clinical scenarios. When using Claude for documentation support, change or omit identifying details. Use "74-year-old female, 5 days post total hip replacement" instead of any real patient information. Adjust ages by a few years, omit exact dates, and never include facility-specific chart numbers.

Claude drafts, you finalize. Every note, treatment plan, and home program that Claude produces is a draft. Your clinical review, verification, and signature are what make it a valid medical document. You are the clinician of record, not Claude.

Verify treatment protocols. Claude does not have access to your patient's chart, imaging, or the clinical observations you make during hands-on treatment. Always verify that generated documentation accurately reflects your clinical findings and that recommended interventions align with current evidence-based practice.

Document functional outcomes accurately. Payers audit OT documentation for evidence of skilled intervention and measurable functional progress. Ensure that Claude-generated content accurately represents the patient's actual functional status and your clinical reasoning.

Check your employer's AI policy. Many health systems, rehab facilities, and home health agencies have specific policies about using AI tools with clinical information. Review these before integrating Claude into your workflow, even with de-identified data.

Going Further

Ready to take your OT practice further with AI? Explore these resources:

Browse our full library of rehabilitation AI resources and prompt packs for additional templates
Run the AI readiness audit for occupational therapists to see where AI fits in your practice
Check out AI tools designed for rehab professionals to streamline documentation and client engagement