New York: Comp board urges physicians to become familiar with treatment guidelines

The New York State Workers' Compensation Board is urging physicians to become familiar with the state's proposed medical treatment guidelines.

As a result of New York's comprehensive workers' comp reforms enacted in 2007, the medical treatment guidelines were developed under the guidance of the state Insurance Department's Workers' Compensation Reform Task Force. The group, which consisted of physicians and other medical professionals, worked with representatives of labor, business, and other state agencies to create the guidelines. Officials said the guidelines will help eliminate variations in treatment, reduce disputes about appropriate medical care, and will promote quality care by basing decisions on sound, evidence-based medicine.

Zachary S. Weiss, chairman of the Workers' Compensation Board, said that the board is beginning the process of adopting the treatment guidelines released to date through the regulation process. In addition, the board is following the recommendations of the Insurance Department's education plan to develop a comprehensive training program for all stakeholder groups.

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The use of the guidelines by attending physicians and carriers' consultants is not mandatory. However, Weiss strongly recommended that doctors become familiar with the guidelines and, when deemed appropriate, use them in the delivery of medical care to injured workers.

"All parties are strongly encouraged to begin this process in preparation of submitting comments during the public comment period as part of the regulation adoption process," he said.

The guidelines focus on the treatment of injuries of the lower back, cervical spine, knee and shoulder. According to the Workers Compensation Research Institute, these injuries account for nearly 60 percent of total medical costs in New York's system. Recent data indicate medical costs are consuming an increasingly larger share of the total cost of New York's workers' comp system. Medical costs in the state increased to 38 percent of workers' comp benefit costs in 2003 from 34 percent in 1994. In addition, the medical cost of claims by workers off the job more than seven days grew substantially faster than the rate of medical inflation each year from 1997 to 2002.

February 23, 2009

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