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Chronic Pain Cover Denied by NY Worker’s Compensation Board

Posted on Nov 24, 2011

The New York Worker’s Compensation Board has released new regulations concerning medical coverage for the treatment of chronic pain. More than 116 million patients have been under the care of doctors for the treatment of medical conditions producing chronic pain but the new regulations means that injured workers may not be able to get the coverage they need for continued treatment.

The Board updated its policies to only cover continued therapy that results in ‘functional improvement’. Due to this new rule, many injured worker facing chronic pain will not be able to get the coverage for the medical treatment they often need on a long-term basis.

In response to criticism of the rule change, the Board insists that the new rules were put in place in order to give patients the best medical care as quickly as possible. It is also meant to prevent fraudulent claims and the mismanagement of the compensation system.

There is an available appeals process for those who have been denied on-going coverage for care. If a treated patient can prove that the ongoing treatment is beneficial for coverage, they may be granted a variance. To date, over 78,000 variances have been filed with two-thirds of those requests being approved by the Board.

Medical professionals have been critical of the rule changes by the Board who feel the policy changes are truing to get rid of coverage for injured workers who can not recover within a two to three month period of time. Those that legitimately require ongoing medical care for chronic pain may not be able to get that opportunity moving forward.