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New York Workers’ Comp Board Denies Coverage for Those With Chronic Pain

Chronic pain affects many Americans - according to the Institute of Medicine, there are 116 million patients being treated for chronic pain, which costs over $600 billion per year in lost productivity and medical treatment - so it's not surprising that it is a part of many New York workers compensation claims.

In New York, however, many workers may not be able to receive necessary medical coverage for their workplace-related injuries thanks to new regulations adopted by the New York Workers' Compensation Board.

In late 2010, the Board updated its policies to only cover therapy that results in "functional improvement" for patients. As a result of this new rule, many patients with chronic pain will not be covered for their injuries.

"They basically tried to throw out all injured workers with chronic conditions," Bruce Silber, President of the New York State Chiropractic Association, told the NY Daily News. "They give them approximately two to three months to get better."

Despite this criticism, the Board says that its new rule is actually in place to ensure that patients quickly receive the best care possible.

"In the past, there was no objective and consistent standard for determining whether the care was effective, which can lead to potential fraud, delay and mismanagement of the system," Board spokesman Brian Keegan told the Daily News.

In addition, Keegan says that there is an appeal process in place for those who are initially denied coverage. If a patient can show that the treatment is beneficial, they may be eligible for a variance. According to Keegan, so far there have been over 78,000 variance requests filed by patients, and over two-thirds of them have been approved.

With constantly changing rules and regulations, filing for workers compensation benefits in New York can be difficult. To ensure your claim has the best chance of success possible consult with an experienced workers' compensation attorney.

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