New York State Medical Treatment Guidelines for Therapy: Ongoing Maintenance Care in workers compensation patients

The guidelines provided by the New York State Workers Compensation Board offer general principles for conducting therapy: ongoing maintenance care. These directives aim to assist healthcare professionals in determining appropriate therapeutic approaches as part of a comprehensive assessment.

Healthcare professionals specializing in therapy: ongoing maintenance care can rely on the guidance provided by the Workers Compensation Board to make well-informed decisions about the most suitable therapeutic methods for their patients.

It is important to stress that these guidelines are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding therapy: ongoing maintenance care should involve collaboration between the patient and their healthcare provider.

Therapy: Ongoing Maintenance Care

Recommended for Select Patients as Clinically Indicated

Indications: A maintenance program of physical therapy or occupational therapy may be deemed necessary in certain situations following the determination of Maximum Medical Improvement (MMI). This is particularly relevant when tied to the preservation of functional status, specifically in cases where an objective deterioration of function has been previously observed and documented in the medical record.

  • Specific, measurable objectives should be identified to substantiate the need for ongoing maintenance care.
  • Sequentially longer attempts of therapeutic withdrawal should be undertaken to assess if therapeutic goals can be maintained without clinical interventions.
  • A trial without maintenance treatment should be initiated within a year and annually thereafter.
  • The care for chronic knee symptoms should involve an ongoing patient self-management program regularly performed by the patient and a self-directed pain management program initiated as needed.

Patient Self-Management Program:

  • An ongoing clinically appropriate self-management program, typically independent, home-based, and self-directed, jointly developed by the provider and patient, should be implemented to encourage physical activity and/or work activities despite residual pain, with the aim of preserving function.
  • In addition to the self-management program, a self-directed pain management plan should be devised, initiated by the patient if symptoms worsen and function decreases.

Reinstatement of Ongoing Maintenance: If a documented deterioration in the ability to maintain function is observed, the reinstatement or restitution of ongoing maintenance may be considered.

Frequency: Limited to a maximum of ten visits per year after the determination of MMI, contingent upon objectively documented maintenance of functional status. No deviation from the maximum frequency is allowed.

Ongoing Maintenance Care: A component of the Functional Maintenance Care recommendations outlined in the New York Non-Acute Pain Medical Treatment Guidelines. Refer to the New York Non-Acute Pain Medical Treatment Guidelines for further information.


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