New York State Medical Treatment Guidelines for in workers compensation patientsNon-Pharmacological Approaches

The guidelines provided by the New York State Workers Compensation Board offer fundamental principles for employing non-pharmacological approaches. These directives aim to assist healthcare professionals in identifying appropriate non-drug interventions within the context of comprehensive care.

Healthcare professionals with expertise in implementing non-pharmacological approaches can rely on the guidance outlined by the Workers Compensation Board to make well-informed decisions about the most suitable non-drug interventions for their patients.

It is important to stress that these principles are not intended to replace clinical judgment or professional expertise. The use of non-pharmacological approaches should involve collaboration between the healthcare provider and the patient, considering individual needs and preferences.

Non-Pharmacological Approaches

Delayed Recovery

  • The transition from acute to non-acute pain represents a critical period for injured workers. Patients experiencing non-acute pain are inherently considered to be experiencing delayed recovery. When this delayed recovery extends beyond the expected time for tissue healing, physicians should:
    • Review and reconsider the initial diagnosis and treatment plan.
    • Identify, address, and document psychosocial factors that affect functional recovery, including:
      • Demoralization due to work-related losses.
      • Distress experienced in daily life.
      • Maladaptive cognitive and behavioral responses.
      • Catastrophizing, with doctors advised to reinforce appropriate expectations.
      • Fear avoidance, with doctors encouraged to reassure patients regarding pain-triggered activities and re-injury fears, promoting active treatment over passive approaches.
      • Medication-related issues such as addiction and adverse side effects.
      • Persistent frustrations with medical care that hasn’t led to a cure or concerns about payment responsibilities.
    • Identify any underlying primary psychiatric illness or mental condition.
    • Promptly assess, provide appropriate reassurance, and refer to mental health professionals or interdisciplinary/functional restoration pain management programs as necessary.


Note on Referrals to Mental Health Providers

  • Referring a patient to a mental health provider or pain management program should not imply the validity or invalidity of the patient’s claim, nor should it suggest malingering or a related psychiatric diagnosis.
  • Incorrect application of these referrals could exacerbate stigma or demoralization and should be avoided. Such referrals are an essential part of assessing non-acute/delayed recovery and can help identify social, cultural, coping, or other factors that may positively influence the patient’s recovery.
  • While accessing these services might be challenging, referrals to mental health providers for evaluating and managing delayed recovery do not imply the establishment of a psychiatric or psychological condition or claim.
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