New Workers Comp Medical Treatment Guidelines
Take Effect Dec. 1
New medical treatment guidelines take effect this week on December 1, 2017. In this article our experienced Orange County workers comp attorneys explain why this is good news for injured workers and their health care providers.
What are Workers Comp Medical Treatment Guidelines?
The “Medical Treatment Guidelines” are the accepted standards of care for treating injured workers. In other words, the Medical Treatment Guidelines set forth which treatments or procedures are considered to be appropriate for any given injury, illness, disease, or condition.
These Guidelines become very important for an injured worker when he or she is attempting to obtain treatment for their condition that workers comp is covering. If the treatment, medication or procedure that your doctor prescribes is listed within the Guidelines for your specific condition, workers comp will likely cover the cost.
If, however, the treatment, medication or procedure that your doctor prescribes is not listed in the Guidelines for your medical condition, workers comp will typically not cover it’s cost. And then the disabled worker is stuck either paying for the treatment or engaging in a long battle with the workers comp insurer for coverage.
California’s Workers Comp “Medical Treatment Guidelines”
Some of California’s medical treatment guidelines are more than thirteen years old. This is problematic because they do not incorporate new and approved treatments. So a better treatment may be denied by the workers comp insurer simply because the guidelines are outdated.
The good news is that on December 1st the California’s medical treatment guidelines will get a long-awaited update. The California Division of Workers’ issued an order incorporating 13 sections from the American College of Occupational and Environmental Medicine’s guidelines into the Medical Treatment Guideline (Utilization Schedule).
The director’s order will make many new and better treatments “presumptively” correct for determining the type and scope of medical treatment provided to injured workers on or after Dec. 1. These new guidelines are based on the best available medical evidence and the consensus of experienced medical professionals.
Our experienced Orange County workers comp attorneys are hopeful that these new guidelines will lead to better workers comp approval for newer and more innovative medical treatments.
Conditions New Workers Comp Medical Treatment Guidelines Affect
The order will adopt new guidelines for many types of injuries and illness. These new guidelines specifically update medical treatments guidelines for:
- Cervical and Thoracic Spine Disorders
- Shoulder Disorders
- Elbow Disorders
- Hand, Wrist & Forearm Disorders
- Low Back Disorders
- Knee Disorders
- Ankle and Foot Disorders
- Eye Disorders
- Hip and Groin
- Work-Related Asthma
- Interstitial Lung Disease
- Chronic Pain
- Opioids Guideline
This update is generally considered to be good news for workers comp applicants. But, of course, how workers comp Utilization Review Physicians will actually use and apply the guidelines will remain to be seen.
The best way to ensure that you receive all of the medical treatment benefits which you need is to have an experienced Orange County Workers Comp attorney handle your case. Our attorneys have decades of experience working with (and fighting with) workers comp Insurers to obtain millions of dollars in benefits for our clients.
Best Orange County Workers Comp Attorneys
Our skilled and caring Orange County Workers Comp attorneys have helped thousands of injured men and women obtain the workers compensation benefits they need and deserve. Call our Orange County workers comp attorneys today for a free consultation.