Not all claimants will qualify for participation in Restart-FX. The evaluation process usually begins with a referral from a carrier, TPA or employer. The Nurse Case Manager who directs intake will request any additional records that would be helpful in evaluating suitability, particularly in identifying significant barriers to treatment that may exist.
The Nurse Case Manager then convenes a roundtable from a panel of physicians, mental health specialists and physical therapists where the case complexities are reviewed and a plan of action is prepared. Each action plan is specifically tailored to the unique issues of each claimant and will typically involve a 3-step coordinated effort to “restart” the injured worker’s life and improve functionality. These include:
This may involve cutting edge medications to specifically address opioid dependence/addiction.
CBT identifies and treats the psychosocial issues that present barriers to functionality.
Physical therapists with specialty training to address complex pain issues will prepare and oversee a program to recondition an injured worker. The program can include evidence-based treatments such as Graded Motor Imagery, Therapeutic Neuroscience Education, Graded Activity, and Mindfulness Training. This is not normal PT or work hardening; rather it is an intensive daily program to improve functional tolerance and problem solving skills to retrain workers to get back into life successfully.
The evaluation results are then presented to the payor with a proposed plan of action and budget. Upon receiving approval, the plan is presented to the claimant. Only after arriving at agreement amongst all parties -- the claimant, payor, and Restart-FX -- can the program commence.
Every injured worker is different, and each program length and cost is different. The standard is five days a week, four hours per day, for six weeks, or 120 hours of supervised treatment. In addition, claimants are given self-directed activities to improve their outcomes. All services are performed in an outpatient setting.
At two, four and six week intervals, the Nurse Case Manager, in collaboration with the Team, reports to the payor/adjuster on progress and goal attainment.
Each case has a one-time cost that covers ALL professional services during the agreed upon project term.
Restart-FX does not solve all problems or cure all issues. It focuses on removing or reducing the obstacles that for many years have stood in the way of the claimant’s progress. Nothing can change until we confront and address these issues.