New York States Adoption of the Medical Treatment Guidelines in Workers Compensation Cases has led to unbelievable confusion and denial of needed medical treatment related to work injuries. Although designed to improve the medical care, level the playing field and quickly getting care where needed, in many cases it has created layers of bureacracy, utter confusion and denial of needed treatment. It has also, in some cases, done its job.
There are some basic rules to remember. As of April 2012 these guidelines apply to injuries to a workers Neck, Back, Shoulder or Knee. There are additional body parts in the works, but if you have an injury to a different body part then the 'old' rules apply.
Some basic principles that need to be followed when requesting medical care that is outside the guidelines or exceeds the guideline recommendaitons is for your doctor to:
- Show or describe that there has been improvement in your condition from a prior exam,
- Describe how additional treatment is expected to improve one's condition, and
- Show that there will be a medical follow up
As I said, this is confusing and overwheliming for many medical practitioners and legal practitioners as well as injured workers