General Guideline Principles for Medical versus Self-
Management Model 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 the Medical versus Self-Management Model.

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.

Medical versus Self-Management Model of Non-Acute Pain

Patients understandably desire their non-acute pain “cured” or gone. Non-acute pain, however, must be managed rather than treated. The self-management method lays the primary duty on the individual experiencing the non-acute pain, in contrast to the medical paradigm, where the physician bears most of the obligation.

To prevent continuous and illusory hopes for an evasive cure when none exists, it is crucial to educate patients about this distinction and promote self-management.

Unrealistic curative views, which are frequently unintentionally promoted by healthcare professionals or others, can result in costly failures, long recovery times, and avoidable impairment.

The wounded worker is kept from recovering because of the never-ending examinations and treatments they get. A prominence on the injury rather than the healing might impede the patient’s ability to receive effective pain relief.

Appointment cancellations or difficulty to reach the doctor might also be factors. Delays might make the situation appear “hopeless” and aggravate the suffering of the injured worker.

Overinterpreting or focusing on imaging or electrodiagnostic data that may or may not have clinical value can lead to a clinical trap. For instance, the patient could be told, “Your back is a wreck and there’s nothing I can do about it,” rather than being informed that the MRI shows typical injury, and that surgery is not necessary at this time.

The MRI revealed a significant, irreversible back issue, the patient recalls. The patient declares that they suffer from non-acute, incurable agony.

The Medical Therapy Guidelines mandate diagnostic time periods for the execution of imaging studies as a result. It has been shown that MRIs performed too soon or without the proper criteria frequently cause patients’ anxiety to rise instead of diminish.

Other phrases that might intensify the discomfort a patient is feeling include:

  • “I’m certain we can solve this.”

  • “More testing need to be conducted,”

  • “I am aware of a physician in another state; perhaps she might help you.”

An alternative strategy would be to explain to the patient that while explosive growth may help with pain management, it does not always mean that options available, such as returning to work, will cause more damage. Instead, there are ways to successfully manage pain rather than completely getting rid of it.

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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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.