The WA Department of Labor and Industries issued updated guidelines for surgical treatment of foot and ankle injuries in October, 2017. The publication outlines trauma-related conditions and non-work-related conditions that can cause a worker to be predisposed to a foot or ankle injury, and/or can complicate treatment for a work-related condition.

Providers who are in the department’s Medical Provider Network are required to follow this guideline when treating injured workers.a The surgical criteria are used in the department’s utilization review program as the supporting evidence has shown these provide the best chance for injured workers to have a good surgical outcome.

To help ensure that diagnosis and treatment of foot and ankle conditions are of the highest quality, this guideline emphasizes:

• Conducting a thorough assessment and making an accurate diagnosis.
• Appropriately determining work-relatedness.
• Making the best treatment decisions that are curative or rehabilitative.b
• Facilitating the worker’s return to health, productivity, and work.

The guideline was developed in 2016-2017 by a subcommittee of the Industrial Insurance Medical Advisory Committee (IIMAC). The subcommittee was comprised of practicing physicians in rehabilitation medicine, occupational medicine, orthopedic surgery, and podiatry. The guideline recommendations are based on the weight of the best available clinical and scientific evidence from a systematic review of medical literature, and on a consensus of expert opinion when scientific evidence was insufficient or inconclusive.

Peruse the full publication, “Surgical Guideline for Work-related Ankle and Foot Injuries – October 2017” to see every detail of the Department’s position on diagnosis, assessment, return to work and length of disability expected after an ankle injury.

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