General Guideline Principles for Work Activities of

Management of CRPS 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 Work Activities of Management of CRPS.

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.

Work Activities of Management of CRPS

Modifying work activities is a crucial component of many treatment plans. Reviewing job responsibilities to see if modifications may be made without notifying the employer and to see if changed duties are appropriate and available are among the suggestions for avoiding significantly aggravating activities that at least for a time increase pain.

It is strongly advised to make every effort to keep patients engaged in their highest levels of activity, including work activities, as this is in their best clinical and psychological interests.

The evaluation of “risk,” “capacity,” and “tolerance” are necessary for the examination of workability. The term “risk” describes what a patient can accomplish but must not do because of the high likelihood of suffering serious consequences. Depending on their assessments of risk, providers set job limits.

What a patient is physically able of accomplishing is referred to as their capacity. This is determined by notions like the range of motion, exercise capacity in metabolic equivalents (METs), etc. A patient (not a clinician) determines whether the benefits of labor outweigh the expense of the symptoms based on their tolerance for persistent symptoms.

A discussion with both patients about whether and not they have control over their job duties is typically the first step in deciding whether work activity changes are necessary.

Even if the discomfort may be incapacitating in certain situations, there may not be a need to write some restrictions if the worker can, for instance, receive assistance from another person.

A workplace inspection and analysis by a healthcare professional with the requisite expertise can also facilitate the assessment of work duties and the possibility for adjustments, according to NYS WCB MTG-Complex Regional Pain Syndrome 34.

The physical demands of the job and the job’s safety, in the scope of case-specific circumstances, should be taken into account while designing work adjustments. When the patient knows that total rest or other forms of inactivity are advised.

It may be necessary to impose restrictions or prescribed activity levels that are higher than what the patient feels they can handle. In such circumstances, information on CRPS and the necessity of continuing to be active should be given.

Common restrictions include adjusting the weight of the objects being lifted, the amount of physical activity permitted (low, medium, or high), the number of lifts, and posture while taconsidconsideringient’s skillsAsskillsewere mentioned, prescriptions for physical activities must be tailored to each individual because there are so many aspects that must be considered.

These are medical conclusions. In the early stages of severe cases of CRPS affecting the upper extremity, common initial restrictions for both occupational and extracurricular activities may potentially include:

  • Two hours of work per day. 

  • Limiting lifting to five pounds or less. 

  • Avoid using the affected hand in activities that require a lot of repetition or force, including pushing or pulling.

When the lower extremities or the spine are involved in severe CRPS, common initial restrictions for work and extracurricular activities could potentially include:

  • Two hours of work per day. 

  • Do not lift more than 10 pounds. 

  • Change between standing and sitting as necessary.

In the early stages of therapy, it is typical to reevaluate these home and work activity requirements every week. Gradual increases in activity are advised so that CRPS patients can retain or regain their optimum level of function.

It is preferable to explain early during treatment that restrictions will be gradually eased as the patient improves. To lessen the element of surprise and actively support the patient’s most crucial aspects of an active, functional restoration program, experienced healthcare providers communicate the intended changes in restrictions for the upcoming week at the current visit (like forecasting increases in exercise program components).

Due to the too ran with symptoms and functionality, practically all CRPS patients require customizing of limitations. The employer should be consulted as well when formulating plans to hasten and aid the patient’s integration into the workplace.

The healthcare professional can help clients and employers by highlighting that:

  • Even when performing “light” duty during the early stages of rehabilitation, patients typically experience greater pain.Increases in sensations should indeed be heard with a helping hand, and the causes of major rises in pain should be addressed. For people with CRPS, rises in pain do not always indicate injury.

  • Any limitations are meant to give time for exercise to increase activity tolerance; and NYS WCB MTG – Complex Regional Chronic Syndrome 35It could be beneficial to remind the patient, if necessary, that this rehabilitation program will also assist him, or she regain their normal non-occupational life functions.

  • In the patient’s best short- and long-term interests, every effort should be made to keep them engaged in their highest levels of activity, including work activities. Regardless of whether the operator is thought to have restricted duty available, work activity restrictions should still be documented.

Written activity limitation guidance conveys the patient’s condition and instructs the patient on what to do and what not to do at home. Recommendations for activity adjustment and time away from the workplace due to CRPS are shown in Table 3.

These recommendations are made for patients who lack comorbid conditions or other complicating issues, such as severe past injuries. From the standpoint of physiologic recovery, they are targets to serve as a reference. Each case will be unique.

Table 3. Guidelines for Modification of Work Activities and Duration of Restrictions

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.

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15:02 02 Mar 23
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21:23 25 Feb 23
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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
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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 .
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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.
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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.
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21:28 23 May 22
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23:31 19 May 22
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17:39 18 May 22
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19:54 16 May 22
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00:48 13 May 22
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23:17 12 May 22
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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.
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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.
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00:46 03 May 22
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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❤️🙏🏼
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19:01 22 Apr 22
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03:25 09 Apr 22
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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
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14:53 03 Mar 22
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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.
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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!
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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.
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19:31 18 Nov 20
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18:17 17 Nov 20
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16:45 17 Nov 20
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04:44 17 Nov 20
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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!
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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.

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