General Guideline Principles for Initial Assessment
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 Initial Assessment.

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.

Initial Assessment of Complex Regional Pain Syndrome

When compared to most evaluations of patients with chronic pain, the initial assessment calls for a complete physical exam and history with a slightly different emphasis. This covers a history of ailments, trauma, the alleged origin of the diagnoses, treatments that have been tried, and exercises that have been done according to NYS WCB MTG – Complex Local Pain Syndrome.

Particular attention must be paid to variations in limb usage, strength, colour, and temperature during the history and physical exam. To validate the clinical impression, selective testing can be required. The emphasis should be placed most heavily on ruling out alternative explanations.

Finding alternative curable, explanatory conditions in patients with chronic pain is a particularly challenging assignment for the practitioner conducting an initial evaluation. However, it is also important to prevent oversetting, which could increase morbidity (such as iatrogenic damage) either directly as a result of the tests themselves or, more likely, by encouraging an unending quest for a potential lesion that can be “fixed.”

The results of the physical examination and medical history may inform the doctor about further pathology that can manifest as pain or any of the other subjective symptoms that a patient with consistent pain may have.

Red flags are certain results that suggest dangerous underlying medical issues Infections, malignancies, and systemic rheumatological conditions are examples of potentially dangerous diseases.

A meticulous, in-depth history is necessary. The strategy must be thorough and examine every facet of the physical symptoms. A pertinent review of the symptoms is required. Analyzing psychological and social aspects is essential.

Evaluation of occupational and social functions is also crucial, with a focus on social, physical, and psychological barriers that might be removed to lessen the effects of the illness.

Without warning signs, the majority of people who experience typical types of chronic semi-pain can be categorised as having one or several of the following conditions:

• Type I or Type II of the Complex Regional Pain Syndrome (CRPS).

   

• Radicular, peripheral, or central neuropathic pain.

   

• Myofascial pain and trigger points.

   

• Fibromyalgia and tender points.

   

• Osteoarthritis and other degenerative joint diseases, such as osteoarthrosis.

   

• Persistent back discomfort.

   

• Syndrome of ongoing discomfort.

   

• Chronic lower back pain, non-specific.

   

• Chronic lower back pain, non-specific.

  If applicable, please also refer to Medical Treatment Regimens for Non-Acute Pain.

  It is important to remember that people with chronic pain conditions may also have one or more psychological illnesses. The presence of depressive disorders is particularly significant. Please refer to the Medical Treatment Guidelines for Depression and Depressive Disorders Related to the Workplace.

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.