I agree with Ardilly in that this will vary greatly on location, setting, facility, styles of COTA and OTR, etc. I've seen this from both sides of the fence in that I was a COTA before I became an OTR. -When I was a COTA (back in the 90's...things have changed a bit since then) I worked on a transitional care unit/SNF based within a level 1 trauma hospital and I essentially carried my own regular caseload of patients. I did everything the OTR did except the evaluation. From that point, the patient was my responsibility. I even did the progress notes and the DC note - this was back when COTAs could do progress and DC notes and back when COTAS were allowed to attend interdisciplinary meetings. The OTR of course had to co-sign the DC notes. I saw the OTR every day but to be honest we never really sat down much to discuss my caseload; she signed my notes and my supervision log and that was usually it. You'll find that OTRs, across the board, have many different styles and degrees of supervision. This OTR in particular was a new grad, and was being asked to be the OT team captain for the newly launched SNF unit and in my humble opinion, she was a little overwhelmed by the responsibilities of leadership. At another place I worked (in an impatient rehabilitation unit within a different Level 1 trauma hospital), the COTAs had a much tighter (and better) level of supervision/working relationship with the OTRs. COTAs would often assist the OTR in completing evaluations; often the COTA would perform the ADL portion of the evaluation and the OTR would complete the sensory motor testing and data collection (I've often wondered if the COTAs can still do that at that hospital). -Nowadays, I'm now an OTR still working in inpatient physical rehabilitation. Our COTAs are utilized more as "overflow coverage" in that they don't carry a regular caseload but instead treat the OTR's patients as needed (particularly when the OTR has a new evaluation). So a COTA can basically get to know many different patients from different OTR caseloads. In my opinion, COTAs don't have the same level of autonomy that they used to; they're not allowed to do progress notes, DC notes and of course, they can't do evaluations, and only the OTR can attend the interdisciplinary patient meetings. Other than that, they do everything the OTR does. And we collaborate and communicate daily with our COTAs; sometimes hourly. All that said, I find the COTAs to be an invaluable resource to our team. They will often know the patient better than I will because they'll get more hands on time with the patient. And even though they don't type up notes, they're always great about letting me know what short and long term goals have been achieved and what did and didn't work so you could say that they contribute greatly to progress notes and DC notes. Just typing all this up makes me realize just how important COTAs are to our department! Hope that helps a bit.