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Medical Treatment Guidelines (MTG) Post-Traumatic Stress Disorder and Acute Stress Disorder Effective: November 1, 2021 Adapted by NYS Workers’ Compensation Board (“WCB”) from MDGuidelines® with permission of Reed Group, Ltd. (“ReedGroup”), which is not responsible for WCB’s modifications. MDGuidelines® are Copyright 2019 Reed Group, Ltd. All Rights Reserved. No part of this publication may be reproduced, displayed, disseminated, modified, or incorporated in any form without prior written permission from ReedGroup and WCB. Notwithstanding the foregoing, this publication may be viewed and printed solely for internal use as a reference, including to assist in compliance with WCL Sec. 13-0 and 12 NYCRR Part 44[0], provided that (i) users shall not sell or distribute, display, or otherwise provide such copies to others or otherwise commercially exploit the material. Commercial licenses, which provide access to the online text-searchable version of MDGuidelines®, are available from ReedGroup at www.mdguidelines.com. Contributors The NYS Workers’ Compensation Board would like to thank the members of the New York Workers’ Compensation Board Medical Advisory Committee (MAC). The MAC served as the Board’s advisory body to adapt the American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines to a New York version of the Medical Treatment Guidelines (MTG). In this capacity, the MAC provided valuable input and made recommendations to help guide the final version of these Guidelines. With full consensus reached on many topics, and a careful review of any dissenting opinions on others, the Board established the final product. New York State Workers’ Compensation Board Medical Advisory Committee Christopher A. Burke, MD , FAPM Attending Physician, Long Island Jewish Medical Center, Northwell Health Assistant Clinical Professor, Hofstra Medical School Joseph Canovas, Esq. Special Counsel New York State AFL-CIO Kenneth B. Chapman, MD Director Pain Medicine, SIUH Northwell Health Systems Assistant Clinical Professor, NYU Langone Medical Center Adjunct Assistant Professor, Hofstra Medical School Robert Goldberg, DO Attending Physician,Department of Rehabilitation, Beth Israel Hospital and Medical Center of NYC Professor of Physical Medicine and Rehabilitation and Health Policy Clinical Associate Professor of Rehabilitation Medicine, New York Medical College Clinical Professor of Rehabilitation Medicine, Philadelphia College of Osteopathic Medicine Member Council on Medical Education of the American Medical Association Craig L. Katz, MD Clinical Professor, Departments of Psychiatry, Medical Education, and Health System Design & Global Health Icahn School of Medicine at Mount Sinai Vice Chair of Committee on Emergency Preparedness, Medical Society of the State of New York Distinguished Fellow, American Psychiatric Association Frank Kerbein, SPHR Director, Center for Human Resources The Business Council of New York State, Inc. Joseph Pachman, MD, PhD, MBA, MPH Licensed Psychologist and Physician Board Certified in Occupational Medicine NYS WCB MTG – Post-Traumatic Stress Disorder and Acute Stress Disorder 2 Fellow in ACOEM Vice President and National Medical Director, Liberty Mutual R. P. Singh, M.D. Clinical Professor of Psychiatry Associate Director, Psychiatry and Law Program Department of Psychiatry, University of Rochester Board Certified in Psychiatry and Forensic Psychiatry Distinguished Fellow, American Psychiatric Association Elain Sobol Berger, MD, Esq. Medical Director and Senior Policy Advisor NYS Workers’ Compensation Board James A. Tacci, MD, JD, MPH (FACOEM, FACPM) University of Rochester Medical Center Attending Physician, Strong Occupational & Environmental Medicine, Strong Memorial Hospital Associate Professor of Clinical Environmental Medicine: Department of Environmental Medicine Associate Professor and Preventive Medicine Residency Director, Department of Public Health Sciences Medical Director, URMC Travel Medicine / Passport Health of Upstate New York Zebulon Taintor, MD, DLFAPA, FACPsy Adjunct Professor of Psychiatry, NYUSOM Edward C. Tanner, MD Chair, Department of Orthopaedics at Rochester General Hospital Past President, New York State Society of Orthopaedic Surgeons (NYSSOS) Member, American Academy of Orthopaedic Surgeons (AAOS) Member, American Association of Hip and Knee Surgeons (AAHKS) ACOEM Post-Traumatic Stress Disorder and Acute Stress Disorder Contributors Editor-in-Chief: Kurt T. Hegmann, MD, MPH, FACOEM, FACP Evidence-based Practice Workplace Mental Health Panel Co-Chairs: Daniel Bruns, PsyD, FAPA Pam Warren, PhD Evidence-based Practice Workplace Mental Health Panel Members: Tony Alleman, MD, MS, MPH Molly M. Brady, PsyD Garson M. Caruso, MD, MPH, FACOEM, FIAIME Gregory P. Couser, MD, MPH Brad K. Grunert, Ph.D. Harold E. Hoffman, MD, CCFP, FCRP, FRCPC Mark H. Hyman, MD, FACP, FIAIME Les Kertay, PhD, ABPP Steven Mandel, MD, FACOEM, FAAN, FAADEP NYS WCB MTG – Post-Traumatic Stress Disorder and Acute Stress Disorder 3 Yusef Sayeed, MD, MPH, Meng, CPH, CMRO, CME, COHC, EIT, DABPM Joel S. Steinberg, MD Methodology Committee Consultant: Nelson S. Haas, MD, MPH, MA, FACOEM Research Conducted By: Kurt T. Hegmann, MD, MPH, FACOEM, FACP Kristine Hegmann, MSPH, CIC Matthew S. Thiese, PhD, MSPH Emilee Eden, BS, MPH Harkomal Kaur, BS Jenna K. Lindsey, BS Michael L. Northrup, BS Skyler D. Walker, BS Chapman B. Cox Jenny Dang Melissa Gonzalez Weijun Yu, BM, BA, MS Vivian Nguyen Matthew Houston, BS Helena Tremblay Specialty Society and Society Representative Listing: Academy of Organizational & Occupational Psychiatry Paul S. Hammer, MD American Academy of Neurology Rawan Tarawneh, MD American Association of Occupational Health Nurses Jennylynn Balmer, RN, MPA, COHN-S, CSP, FAAOHN American Physical Therapy Association American Psychological Association Lynn Bufka, PhD International Academy of Independent Medical Evaluators Robert J. Barth, PhD Society of Behavioral Medicine Charlene Niemi, PhD, MSN, RN, CNE The American Occupational Therapy Association, Inc. Donna Costa, DHS, OTR/L, FAOTA Other Reviewers: Gaurava Agarwal, MD Mason Harrell, MD, MPH NYS WCB MTG – Post-Traumatic Stress Disorder and Acute Stress Disorder 4 Table of Contents A. General Guideline Principles ............................................................................................................. 8 A.1 Medical Care ............................................................................................................................. 8 A.2 Rendering Of Medical Services ................................................................................................. 8 A.3 Positive Patient Response ......................................................................................................... 8 A.4 Re-Evaluate Treatment ............................................................................................................. 8 A.5 Education .................................................................................................................................. 8 A.6 Acuity ........................................................................................................................................ 9 A.7 Initial Evaluation........................................................................................................................ 9 A.8 Diagnostic Time Frames ............................................................................................................ 9 A.9 Treatment Time Frames ............................................................................................................ 9 A.10 Delayed Recovery ...................................................................................................................... 9 A.11 Active Interventions ................................................................................................................ 10 A.12 Active Therapeutic Exercise Program ..................................................................................... 10 A.13 Diagnostic Imaging And Testing Procedures ........................................................................... 10 A.14 Surgical Interventions ............................................................................................................. 11 A.15 Pre-Authorization .................................................................................................................... 11 A.16 Psychological/Psychiatric Evaluations ..................................................................................... 11 A.17 Personality/Psychological/Psychosocial Intervention ............................................................ 12 A.18 Functional Capacity Evaluation (FCE) ...................................................................................... 13 A.19 Return To Work ....................................................................................................................... 13 A.20 Job Site Evaluation .................................................................................................................. 13 A.21 Guideline Recommendations And Medical Evidence ............................................................. 14 A.22 Experimental/Investigational Treatment ................................................................................ 14 A.23 Injured Workers As Patients ................................................................................................... 14 A.24 Scope Of Practice ...................................................................................................................
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