In December 2010, the New York State Workers' Compensation Board made policy changes that affected a wide range of injured workers in New York state. The changes, referred to as the Medical Treatment Guidelines, apply to New York workers who have suffered injuries to the neck, shoulder, mid- or lower back, or knee.
New York's Medical Treatment Guidelines were an effort to reform and standardize the methods in which workers with neck injuries, back strains, and certain other musculoskeletal injuries got treatment from their physicians. The guidelines also remove the requirement that an injured worker must obtain pre-authorization from an insurance carrier for any procedure over $1,000 for all treatments that comply with the Medical Treatment Guidelines.
While the Medical Treatment Guidelines went into effect on December 1, 2010, the guidelines apply to the treatment for all injured workers with neck, lower back, shoulder and knee injuries, regardless of the date of injury. Experts that led the reform effort chose these injury types because nearly four in 10 worker's comp claims involves one of these injuries. Treatment for these injury types also contributes to 60 percent of the treatment costs in the worker's compensation system.
Injured Workers' Treatment Options Severely Limited by Guidelines
The Medical Treatment Guidelines severely limit the treatments available for injuries that fall within the guidelines. New York doctors and medical professionals treating injured workers are expected to be familiar with the treatments authorized under the Medical Treatment Guidelines and treat workers injured on the job accordingly. In fact, a treating physician must obtain a variance for any procedure that does not comply with the Medical Treatment Guidelines.
Injured worker advocates including the Workers' Compensation Alliance have criticized the restrictions the Medical Treatment Guidelines impose on treatment for injured workers. Advocates argue that the guidelines fail to adequately address treatment needs for all injured workers in favor of reducing worker's compensation treatment costs.
If you were injured on the job and you fear that your medical treatment has been hampered or your recovery delayed because of the Medical Treatment Guidelines, contact an experienced New York worker's compensation attorney to advocate for your right to adequate treatment.
