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Got NY Workers’ Comp Medical Benefits? Here are answers to THREE big questions.

How will the new medical treatment guidelines affect YOUR current New York workers’ comp benefits?

If you already get workers’ comp benefits in New York, or if you’ve just started working with a doctor for your on-the-job injuries, you may be worried about how the new New York WCB medical treatment guidelines will affect your claim.

Here are THREE questions that you may have about your existing workers’ comp benefits:

I’ve been receiving treatment for a while, and it turns out that I have already exceeded the recommended number of treatments allowed under the new guidelines. Does this mean I don’t get any more treatments at all? The new guidelines do apply to your claim – but they only apply for treatment you received ON or AFTER 12/01/2010. Any treatment you receive after this date has to follow the guidelines, and you must be re-evaluated to make sure that the treatments are indeed helping you to get better. If your re-evaluation shows that you are not improving, you will not be able to have further treatments. This could be an issue for some workers – what if you just need more time to improve? In that case your doctor will have to file a variance… and you’ll have to hope it gets approved.
I need a medical procedure because of my workplace accident. It was authorized before 12/01/2010 but I won’t be able to do it until later. Does this procedure now have to comply with the new guidelines? No – since your treatment was authorized before the magical date of 12/01/2010 you can still get it, even after this date.
I was getting treatments once a week before the new medical treatment guidelines took effect. However, according to the guidelines I am eligible for treatment three times a week! I can go more often now – right? Not so fast. Additional treatments have to be medically necessary. You would be evaluated after three weeks of your usual treatment, and if you are getting better and NEED more frequent treatments – you may qualify. However, if you are evaluated and show no “objective functional improvement”, then you may not get any more treatments at all.

As always, if your medical provider thinks that you should be treated differently than what is in the guidelines, they can apply for a variance – and that is a whole different topic.

If this seems confusing to you, then you are not alone. These new medical treatment guidelines were implemented to make sure that workers quickly get the medical care they need, but that is tough when there are so many new rules to follow.

Let our skilled NY workers’ comp lawyers fight on your behalf

Don’t let these new medical treatment guidelines prevent you from getting the care you need and deserve after being hurt on-the-job in New York. Please contact our office today – we work hard to keep up to date with workers’ comp rules and regulations so you don’t have to.

Markhoff & Mittman, P.C.

14 Mamaroneck Avenue

Suite 400

White Plains, NY 10601

Toll Free: (866) 205-2415

Phone: (914) 946-1452

Fax: (914) 946-0810