DWD 81.12(3)(e)2.2. In addition to one of the diagnoses in subd. 1., all of the clinical findings in subd. 3. shall be satisfied for a lateral ligament ankle reconstruction. For initial nonsurgical care, the patient shall have received an adequate course of initial nonsurgical care, including one of the following: DWD 81.12(3)(e)2.b.b. A physical rehabilitation program that follows immobilization with support, cast, or ankle brace. DWD 81.12(3)(e)3.3. The patient’s clinical findings shall include all of the following: DWD 81.12(3)(e)3.c.c. There are positive stress X-rays identifying motion at ankle or subtalar joint with at least a 15 degree lateral opening at the ankle joint, or demonstrable subtalar movement, and negative to minimal arthritic joint changes on X-ray, or ligamentous injury is shown on magnetic resonance imaging scan. DWD 81.12(3)(e)4.4. Prosthetic ligaments are not necessary for the treatment of lateral ligament ankle reconstruction. DWD 81.12 HistoryHistory: CR 07-019: cr. Register October 2007 No. 622, eff. 11-1-07. DWD 81.13(1)(1) Scope. This section applies to chronic management of all types of physical injuries, even if the injury is not specifically governed by this chapter. If a patient continues with symptoms and physical findings after all appropriate initial nonsurgical and surgical treatment has been rendered, and if the patient’s condition prevents the resumption of the regular activities of daily life including regular vocational activities, then the patient may be a candidate for chronic management. The purpose of chronic management is twofold: the patient should be made independent of health care providers in the ongoing care of a chronic condition; and the patient shall be returned to the highest functional status reasonably possible. DWD 81.13(1)(a)(a) Personality or psychological evaluation may be necessary for patients who are candidates for chronic management. A treating health care provider may perform this evaluation or may refer the patient for consultation with another health care provider in order to obtain a psychological evaluation. These evaluations may be used to assess the patient for a number of psychological conditions that may interfere with recovery from the injury. Since more than one of these psychological conditions may be present in a given case, a health care provider performing the evaluation shall consider all of the following: DWD 81.13(1)(a)2.2. Does the patient exhibit an emotional reaction to the injury, such as depression, fear, or anger, that is interfering with recovery? DWD 81.13(1)(a)3.3. Are there other personality factors or disorders that are interfering with recovery? DWD 81.13(1)(a)6.6. Does the patient have a chronic pain syndrome or psychogenic pain? DWD 81.13(1)(a)7.7. In cases in which surgery is a possible treatment, are psychological factors likely to interfere with the potential benefit of the surgery? DWD 81.13(1)(b)(b) Any of the chronic management modalities of sub. (2) may be used singly or in combination as part of a program of chronic management. DWD 81.13(1)(d)(d) No further diagnostic evaluation is necessary unless there is the development of symptoms or physical findings that would in themselves warrant diagnostic evaluation. DWD 81.13(1)(e)(e) A program of chronic management shall include appropriate means by which use of scheduled medications can be discontinued or severely limited. DWD 81.13(2)(a)(a) Home-based exercise programs. Home-based exercise programs consist of aerobic conditioning, stretching, and flexibility exercises, and strengthening exercises done by the patient on a regular basis at home without the need for supervision or attendance by a health care provider. Maximum effectiveness may require the use of certain durable medical equipment that may be prescribed within any applicable treatment guidelines in ss. DWD 81.06 to 81.10. DWD 81.13(2)(a)1.1. ‘Indications.’ Exercise is necessary on a long-term basis to maintain function. DWD 81.13(2)(a)2.2. ‘Guidelines.’ The patient shall receive specific instruction and training in the exercise program. Repetitions, durations, and frequencies of exercises shall be specified. DWD 81.13(2)(a)3.3. ‘Treatment.’ Treatment period is one to 3 visits for instruction and monitoring.