General Guideline Principles for Therapy – Ongoing
Maintenance Care 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 Therapy – Ongoing Maintenance Care.

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.

Therapy – Ongoing Maintenance Care of Therapeutic Procedures

Following the diagnosis of MMI, a maintenance programme of physical therapy, occupational therapy, or spinal manipulation (by a doctor (MD/DO), chiropractor, or physical or occupational therapist) may be recommended when linked to the maintenance of functional status.

The use of maintenance therapy modalities may be appropriate in some circumstances, even though the reviewed body of scientific evidence does not support its habitual usage.

Therapy – Ongoing Maintenance Care of Therapeutic Procedures

Therapy – Ongoing Maintenance Care of Therapeutic Procedures is recommended to only a small number of patients to preserve functional status, in the absence of which an objective decline in function has already been seen and noted in the medical file.

Frequency: Following the assessment of MMI, the maximum number of visits per year is 10, provided that the preservation of functional status is objectively documented. There can be no deviation from the maximum frequency.

Rationale:

  • To prove the need for continuing maintenance treatment, specific target goals should be set and measured.
  • To determine whether treatment goals can be upheld in the absence of clinical interventions, therapeutic withdrawal trials that are gradually longer will be tried.
  • A trial without manner prescribed should be started within a year and then every year after that.
  • A patient’s ongoing self-management plan should be carried out regularly, and as necessary, a self-directed chronic pain program should be started.
  • To encourage aerobic exercise and/or work activities despite persistent pain, to preserve function, an ongoing direct clinical self-management plan should be implemented. Typically independent, home-based, and self-directed, this plan is created jointly by that the provider and patient.
  • In addition to the self-management strategy, a patient-initiated self-directed chronic pain plan should be created in case symptoms intensify and function deteriorates.
  • Resuming ongoing maintenance may be appropriate if a decline in ability to maintain function is proven.

Note: The New York Non-Acute Pain Medical Treatment Guidelines provide guidelines for Functional Maintenance Care, which include Ongoing Maintenance Care as one of their components. For more information, please refer to the New York Non-Acute Pain Medical Treatment Guidelines.

What our office can do if you have workers compensation Therapy – Ongoing Maintenance Care

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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Dr. Nakul Karkare

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.