If they have clearance and I understand their issues and situation, it is not a problem. I have had many clients come to me with issues that I wasn’t ready to work with and I used those as opportunities to learn and grow. I contacted their physician/surgeon/therapist/etc. and got educated for free on how to work with them. I spent hours of my free time studying and researching to be more prepared and able to handle the situation comforatbly. There were a few times when the issues were clearly beyond our scope of practice and I referred them back to their physician for a more appropriate referral. Usually to a physical therapist. A few of those eventually got cleared to work with me and came back. If their physician feels I can conservatively work with a client, I will do what I need to in order to do the best job I can. The few times that I didn’t, the client didn’t come to me with a referral or clearance and needed to be educated about the seriousness of their issues.