| The California Labor Code designates the use of ACOEM Guidelines, which are presumptively correct. ACOEM guidelines address chronic pain in Chapter 6, and advocate the use of interdisciplinary care in some cases. |
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ACOEM Guidelines
ACOEM guidelines 2nd Ed. Chapter 6 pg 114 paragraph 1 states: “Research suggests that multidisciplinary care is beneficial for most persons with chronic pain, and likely should be considered the treatment of choice for persons who are at risk for, or who have developed chronic pain and disability”.
Paragraph 2 states: “Multidisciplinary treatment was found to be superior to conventional physical therapy alone, had benefits that persisted over time, and was beneficial in improving return to work and decreasing the use of health care. While the components and approaches of multidisciplinary care often differ, the hallmarks of such programs include: a thorough, multidisciplinary assessment of the patient, establishment of a time limited treatment plan with clear functional goals, frequent assessment of the patient’s progress toward meeting such goals, and modification of the treatment plan as appropriate, based on the patient’s progress. Typically, such programs involve ongoing medical care or supervision, exercise or specific physical therapy intervention, psychosocial intervention, and occupational therapy or other services related to daily functioning and/or vocational rehabilitation. Specific multidisciplinary approaches, such as functional restoration, report return-to-work rates of more than 80% following treatment, with a high percentage of these persons still working after one year. Because not all chronic pain patients may need intensive multidisciplinary interventions, some program offer comprehensive multidisciplinary evaluations resulting in specific treatment recommendations for the patient.
ACOEM guidelines state that the “treatment of chronic pain requires specialized knowledge, substantial time and access to multidisciplinary care. Judicious involvement of other professionals, including psychologist, exercise and physical therapists and other healthcare professionals who can offer extra physical or mental therapy while the physician continues to orchestrate the whole therapeutic process can be helpful. Close communication between all participating professionals is mandatory”. (Pain, Suffering, and the Restoration of Function, Chapter 6 pg 109, ACOEM Guidelines, 2nd ED).
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