General Guideline Principles for Rehabilitation

for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Rehabilitation.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Rehabilitation of Complex Regional Pain Syndrome

There are various sorts of recovery programs. To help sort out and introduce a different leveled development, restoration is grouped in this rule as essential, optional, or tertiary.

Primary rehabilitation Essential restoration incorporates the most generally experienced treatment and comprises a moderately negligible quantity(ies) of clinical consideration combined with non-intrusive treatment, word-related treatment, or medical care supplier coordinated works out (i.e., a home activity program).

While there is a lot of variety, ordinary systems regularly incorporate showing explicit stretches, evaluated works out, tending to fear avoidant convictions (“kinesiophobia”), and propelling movement levels, by and large in the intense to subacute stages, until recuperation is finished.

Secondary rehabilitation normally happens after one or the other disappointment of essential restoration as well as an assurance that the mending course won’t bring about overcoming an issue between current capacities also, work actual requests.

Optional recovery incorporates further developed and contact time-serious rehabilitative medicines and is most regularly named Work Molding and Work Solidifying. Work Molding normally underlines practices and incorporates errands to mimic work exercises. Work Solidifying normally incorporates moderate activity yet adds some restricted mental guiding and schooling.

Tertiary recovery includes interdisciplinary restoration. There is a wide range of terms and accentuations of tertiary recovery programs; nonetheless, they can commonly be characterized as torment programs and useful reclamation programs.

These projects by and large utilize different disciplines utilizing biopsychosocial ways to deal with address torment, capability, work, and mental misery. There are a few quality preliminaries of tertiary restoration projects and direction is remembered for this segment.

Commencement of these projects might be viewed as in the subacute stage on the off chance that handicap isn’t satisfactorily made sense of by actual discoveries and essential restoration medicines have neglected to altogether be working on the practical status.

Chronicity without anyone else is a significant indicator of poor results. The more it takes to determine the handicap (deferred recuperation), the almost certain patients are to always avoid typical or close to ordinary capability or to work. Useful rebuilding is both a sort of interdisciplinary torment the board and recovery

The program, as well as a general way to deal with clinical considerations. Crucial components of a utilitarian reclamation approach incorporate evaluation of the patient’s dynamic physical and practical status including customary tests for strength, sensation, and scope of movement.

Psychosocial qualities and stressors should likewise be evaluated (counting a past filled with youth misuse, outrage, NYS WCB MTG – Complex Provincial Agony Condition 55 the feeling of dread toward reinjury, and a background marked by substance abuse), and the patient’s emotionally supportive network, proof of mindset issues, appraisal of training and abilities, medicine use, presence of prosecution, and work inadequacy broke down.

Following this assessment, the accentuation is on the assumption of the executives, coordinating molding and exercise, CBT, practical objective setting, and decline in prescription use. A continuous evaluation of patient cooperation and consistency (With documentation of confounding issues and progress toward explicit objectives, including a decrease in handicap and clinical usage) is required.

In useful reclamation, the treatment group works more as teachers and mentors, no “treaters”. Uninvolved treatments and obtrusive mediations are de-stressed for home activity/self-administration strategies. There ought to be a shift of wellbeing, capability, and prosperity obligation (locus of control) from doctors and specialists to the person.

A utilitarian reclamation approach might incorporate the restricted/adjunctive utilization of drugs and interventional measures (which were explicitly demonstrated); nonetheless, these ought not to be seen as progressing arrangements and used to help the patient’s dynamic cooperation in restoration.

Restoration ought to remember guidance for preventive measures, training for backslide anticipation, legitimate movement and work pacing, ergonomic convenience, and when suitable, prescribe momentary re-visitation of work.

The objective is a relief of a patient’s misery and their re-visitation of a useful life notwithstanding having a persistent aggravation issue. Assuming an individual has risk factors for deferred recuperation or neglects to recuperate inside the fitting organic mending period, the intense consideration of ideal models of explicit conclusion and treatment change to biopsychosocial approaches that address torment, capability, work, and mental elements obstructing progress.

Treatment programs center around the rebuilding of business-related capability. These projects incorporate work molding and work solidifying, interdisciplinary torment restoration programs, and practical recovery. Since practical rebuilding is a methodology, in addition to a particular program, the methodologies taken both cross-over and are on a continuum.

Work conditioning has been characterized by the American Active recuperation Affiliation (APTA) as “an escalated, business-related, objective situated molding program planned explicitly to reestablish foundational neuromusculoskeletal capabilities (e.g., joint respectability and versatility, muscle execution (counting strength, power, and perseverance), engine capability (engine control an engine learning), the scope of movement (counting muscle length), and cardiovascular/pneumonic capabilities (e.g., vigorous limit/perseverance, course, and ventilation and breath/gas trade).

Work solidifying has been characterized by APTA as a “profoundly organized, objective situated, individualized mediation program intended to return the patient/client to work. Work Solidifying programs, which are multidisciplinary in nature, utilize genuinely or recreated work exercises intended to reestablish physical, social, and professional capabilities.

Work Solidifying resolves the issues of efficiency, wellbeing, actual resilience, and laborer ways of behaving.” Subsequently, work molding is named a solitary discipline program, and the work solidifying program is interdisciplinary.

The Commission on Authorization of Restoration Offices (CARF) characterizes word-related recovery as work molding and far-reaching word-related restoration as work solidifying. Albeit not generally acknowledged, a few doctors consider work molding as.

Early distinguishing proof and fitting administration of patients showing indications of deferred recuperation are accepted to diminish the probability that side effects will become persistent.

Patients who are recognized in danger of deferred recuperation might profit from a restricted however extreme program of actual reclamation and instruction, including the executives of obstructions to recuperation and return to work.

These patients might require a curtailed early intercession interdisciplinary recovery program (IPRP given utilitarian reclamation standards, as opposed to a more extended program used for additional mind-boggling cases.

Early intercession programs are an option to work on molding and work solidifying programs for subacute or early patients with ongoing torment who have proof of deferred recuperation with an expanded requirement for schooling and mental evaluation and intercession.

These projects are generally started when a critical hole is distinguished between useful capacities and occupation requests, preferably in the early. subacute time (e.g., 30-60 days). An IPRP may likewise be legitimate before assuming factors for postponed recuperation are distinguished.

The interdisciplinary practical rebuilding program utilized for early intercession contains the highlights of a practical reclamation program, however, includes lower power and length of administration than a program utilized for patients with more noteworthy chronicity or force of incapacity. The sort, force, and span of administration ought to be directed by the patient’s one-of-a-kind restoration needs.

These administrations might be utilized for patients who bomb work molding and work solidifying programs, as a rule in something like a half year of the beginning of handicap post-injury. The period of three to a half years post-injury (or prior if hazard factors for postponed recuperation are distinguished) is indispensable for mediating with the best treatment conceivable to stay away from the negative sequelae that accompany expanding the length of inability.

During this, typical outer muscle mending will for the most part have happened, killing any leftover actual obstructions to escalated recovery. Such projects are fitting for counteraction before the patient is dug into a constant torment condition or before extreme agony and ailment conduct advances.

What our office can do if you have workers compensation injuries

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.

Call Us Now!

Based on 96 reviews
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18


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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.