NY WCB makes up the law, again?

NY Workers Compensation Board has the legal right to resolve conflicting medical evidence in the record, but 1) cannot make it up and 2) must rely on accurate legal standards and 3) must rely on correct factual assertions (you cannot misread the record!)

NY Workers Compensation Medical Treatment Guidelines - Final Comment Time!

CRUNCH TIME!

It has been almost two and a half years since the passage of the 2007 Spitzer New York Workers Compensation Reform legislation. Finally, I think, the Workers Compensation Board is about to adopt a limited set of Medical TREATMENT guidelines.

What's the importance of this? Under the Reform legislation the WCB, through the State Insurance Department Task Forces, was tasked with creating medical guidelines to help injured workers, employers, insurance companies, attorneys and all others figure out how to best apply the new law in a level, consistent and meaningful way.

The WCB is finally seeking to adopt, as a final regulation, medical TREATMENT guidelines for the lower back, cervical spine, shoulder and knee. Four parts out of the whole body, but its better than nothing.

During a conversation I had with former Chair Weiss he expresed to me the belief that the TREATMENT guidelines would help clean up a rather messy and inconsistent system where everytime a doctor requests treatment it was more likely to result in an Independent Medical Exam instead of a quick review and approval of the needed treatment for the injured worker.

I applaud this attempt since at least you can figure out if the course of treatment that a particular injured worker is receiving is appropriate. However, the delay and confusion over the guidelines doesnt help answer whether they are reasonable, appropriate and so forth.

However, it must be remembered that these TREATMENT guides only address treatment for limited aspects of the injured worker. These are NOT the guidelines for helping figure out how disabled  a person is or what that persons impairment is as a result of the medical condition caused by a work related injury.

Nevertheless, if you have an interest you should review the TREATMENT guidelines and make any final comments before September 9, 2009. You can send comments to regulations@wcb.state.ny.us. (For details see Subject No. 046-346)