New York State Medical Treatment Guidelines for Orthotics and Prosthetics in workers compensation patients

The guidelines provided by the New York State Workers Compensation Board offer general principles for the use of orthotics and prosthetics. These directives aim to assist healthcare professionals in determining appropriate strategies for incorporating orthotic devices and prosthetic limbs as part of a comprehensive care plan for individuals with specific medical needs.

Healthcare practitioners specializing in orthotics and prosthetics can rely on the guidance from the Workers Compensation Board to make well-informed decisions about the most suitable approaches for utilizing these devices in the treatment and support of patients with various medical conditions.

It is crucial to emphasize that these guidelines are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding the use of orthotics and prosthetics should involve collaboration between the patient and their healthcare provider.

Fabrication / Modification of Orthotics

Recommended – for specific patients as clinically indicated.

Indications: Utilized when there is a necessity to normalize weight-bearing, enhance motion response, stabilize a joint with inadequate muscle or proprioceptive/reflex competencies, protect subacute conditions during movement as needed, and correct biomechanical issues.

Frequency: Typically conducted one to two times per week, requiring one to three sessions to achieve the desired effect, including the assessment of the wearing schedule.

Optimum/Maximum Duration: Comprising four sessions involving evaluation, casting, fitting, and re-evaluation.


Orthotic / Prosthetic Training

Orthotic/Prosthetic Training involves skilled instruction, preferably by qualified providers, in the proper use of orthotic devices and/or prosthetic limbs. This includes stump preparation, donning and doffing limbs, guidance on wearing schedules, and training in orthotic/prosthetic maintenance. Training may cover gait, mobility, transfer, and self-care techniques.

Recommended – for specific patients as clinically indicated.

Frequency: Three times per week, with two to six sessions needed to achieve the desired effect.

Optimum/Maximum Duration: Recommended for a period of two to four months.


Splints or Adaptive Equipment

Recommended – for specific patients as clinically indicated.

Indications: Design, fabrication, and/or modification are indicated when there is a need to control neurological and orthopedic injuries to reduce stress during functional activities. It also involves modifying tasks through instruction in device usage or physical adaptation, aiming to decrease stress on the injury. Equipment should enhance safety and lower the risk of re-injury. This encompasses high and low technology assistive options, such as workplace modifications, computer interfaces, seating adjustments, crutch or walker training, and self-care aids.

Frequency: One to three sessions or as indicated to establish independent use.

Optimum/Maximum Duration: One to three sessions.

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