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Lawyers Grapple with New York Workers' Compensation Medical Treatment Guidelines Effective December 1, 2010

Friday, December 10, 2010

The impact of the New Medical Treatment Guidelines put in place by the New York Workers’ Compensation Board  effective December 1, 2010 is devastating to injured workers. See our law firm’s presentation on the new Workers’ Compensation Medical Treatment Guidelines for Medical Provider’s here ( call us if you would like us to come to your Medical Facility for a free presentation ).

While the general goals of the guidelines are laudable, those claimants with chronic injuries or illness’ will see an almost immediate cut in their ongoing medical treatment.  The prime motive of the new strict limitations on medical treatment is strictly cost driven, and aimed at allowing insurance companies to earn more profit.  A year after these guidelines are in place, let’s see how many employers across New York State get an actual reduction in their workers comp premiums…

The current new Workers’ Compensation Board Medical Treatment Guidelines apply only to neck, back, shoulder and knee injuries for the time being. More body parts are expected to be added later. 

 In an absolutely unfair and cruel policy decision, the New York Workers’ Compensation Board has made these new guidelines applicable to even old cases going back many years despite a prior Judge’s order awarding lifetime medical care. Therefore, if you have been seeing your chiropractor on a "symptomatic" basis to keep you working for years, you can expect such care to be denied soon.  

The new Workers’ Compensation Board Medical Treatment Guidelines  cap physical therapy and chiropractic care at 40 visits for the life of the case, absent a "variance" which the treating medical provider must apply for. Narcotic prescriptions are capped at just two weeks!

Without being overly dramatic, I predict that some workers’ compensation claimants who live in daily chronic pain and take narcotic pain killers due to a back or neck injury will have their prescriptions cut off without adequate time or medical supervision.  Some claimants with serious conditions simply cannot get by on Advil (or the amount they would have to take would burn a hole in their stomach or ruin their liver). When this happens, and it will, the potential results to the claimant (and possibly others) will be  catastrophic. 

The New York Workers’ Compensation Board  really needs to re-look at this particular issue and issue detailed emergency guidelines.  They should get guidance from pain management specialists on how to safely ween claimants  taking narcotic pain killers off their medications. We are talking about real people and real lives here.    

The New York Injured Workers Bar Association and the New York Injured Workers’ Alliance have pleaded with Workers’ Compensation Board not to apply the new Medical Treatment Guidelines retrospectively.  So far, our efforts have fallen on deaf (or purposely covered ) ears. With such a non-response, the Bar Association may have no choice but to sue the Workers’ Compensation Board and seek a permanent injunction stopping the Board from applying the guidelines to old cases where the claimant had a prior "deal" that had been approved by a Workers’ Compensation Law Judge. See the Workers’ Compensation Board’s presentation on the Medical Treatment Guidelines to the Business Council (not to injured workers) here.

I will be lecturing at a  Workers Compensation Law Continuing Legal Education ( CLE) seminar in White Plains, NY for all New York Workers’ Compensation Lawyers next week where I will go into greater detail on these issues.  Feel free to attend so we can all brainstorm on how to best fight these unfair retrospective medical treatment guidelines.

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