A series of articles emphasizing practical
knowledge you can't find in practice guides
and interviews with experts who share
their techniques for effective and efficient
case management

 
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• Marjory Harris

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HARRIS: What do you see as the value and
purpose of physical therapy as a treatment
modality for work injuries?

LING: Physical therapy has been the “alternative
medicine” for the western medicine model. It is the
most effective method of intervention, and can even
be used as a diagnostic tool to separate serious
from minor injuries, identify potential surgical
candidates quickly, and return workers back to
work safely.

 
Physical therapy (PT) is the treatment of physical dysfunction or injury by the use of therapeutic exercise and the application of modalities, intended to restore or facilitate normal function or development.

HARRIS: From your perspective as a physical
therapist, have changes in the workers’
compensation law been harmful to injured
workers?

LING: The delays in treatment and the 24-session limit
on physical and occupational therapy for injuries on
or after January 1, 2004 can have a severe impact on an injured worker's ability to return to work quickly or
avoid being permanently crippled. The start and stop
of authorizations of PT visits (sometimes only giving
6 at a time) damage the continuity of treatment for
both the patient and therapist and interrupts the flow
of progress during the course of rehab.
 


Labor Code §4604.5(d) (1) limits physical therapy sessions to 24 per injury unless post surgery

As we go to press, the DWC is drafting Postsurgical Treatment Guidelines (§ 9792.24. 3)


HARRIS: Are home exercise programs an
adequate substitute for physical therapy?

LING: A sheet of exercises is no substitute for proper
education. Like any learned activity, repeated review
of the patient performing the exercises with proper
biomechanics with feedback by the therapist is
essential for carryover.
 


HARRIS: How can evidence from a physical
therapist be of value to medical evaluators or
vocational experts?

LING: FCEs, or even focused abbreviated FCEs
which are more task specific oriented and less
expensive, provide more objective data for the
managing MD and insurers re: the patient’s ability
to return to work safely, if at all.
 
“The purpose of a Functional Capacity Evaluation (FCE) is to provide an objective measure of a patient's/client's safe functional abilities compared to the physical demands of work.”

To learn more about FCEs, click here.

HARRIS: What do you think of the way utilization
review is handled in the workers’ compensation
system, as compared to private medical
insurance? Do you have any suggestions
for change?

LING: UR in the workers’ compensation system
seems only to be an administrative delay, not a
necessary one. A change would be to separate
surgical cases or complex cases from simple
cases, and for no UR until 18-24 visits for cases
that require intense rehabilitation.
 
 

HARRIS: If you could change the current landscape
of workers’ compensation medical treatment and
create the ideal physical therapy treatment
environment, what would it look like?

LING: We would make the worker financially
accountable for missed appointments (to pay failed
appointment fees), no delays for workers to get
access to care, a network of reputable physical
therapy providers, and clear guidelines for
discharging a patient with a poor attendance record.
 
 


Allen L. Ling, MPT, OCS, is the Founder and
Executive Director of Physical Therapy
Innovations (PTI)

CLINIC LOCATIONS

EL CERRITO Clinic
425 Kearney Street
El Cerrito, CA 94530

ORINDA Clinic
122 Camino Pablo
Orinda, CA 94563

OAKLAND Clinic
1940 Webster Street
Suite 202
Oakland, CA 94612

Call 510-524-2177 for all locations

www.ptinnovations.com

For a detailed CV,
click here.

The Physical Therapist:
Interview with Allen L. Ling, MPT, OCS

In a continuing series featuring medical professionals in the workers’ compensation system, Marjory Harris interviews Allen Ling, MPT, OCS, Founder & Executive Director of Physical Therapy Innovations (PTI).
> Big Case How-To-Guide
> Computer Corner: Med Manager
> Surviving SB 899
> Getting Best Treatment & Evidence
> Structured Settlement Tips
> New Role for Voc Rehab Eval
> The Nurse Case Manager
> The Physical Therapist
> The Metamorphosis of WC