Provider Manual TEMPLATE
Condition Severity Surgical Procedure Sedentary Work: < 10 lbs Clerical/Light Work: < 20 lbs Manual . Work:< 50 lbs Mild None 0 Days 14 days Moderate None 5 Days 25 days Severe (Tear) ACL Repair 35 days 180 days Mild: Sprain/strain or partial tear of one of the two cruciate ligaments. Symptoms with normal or near normal ambulation. ................
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