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Sep 02

Quiet Changes To New York Workers Comp Rules Leave Out Those With Chronic Pain

A little-noticed policy change at the state Workers’ Compensation Board is jeopardizing insurance for thousands of workers and retirees with long-term medical problems.

scaffold collapse.jpgOur Glenn Blain reports:

New treatment guidelines quietly enacted by the board late last year limit coverage to therapies that yield “functional improvement” in patients – leaving out people with chronic pain conditions, say labor leaders and caregivers.

“They basically tried to throw out all injured workers with chronic conditions,” said Bruce Silber, president of the New York State Chiropractic Association, which has been lobbying lawmakers to intervene.

“They give them approximately two to three months to get better.”

The board has applied the guidelines to new cases and existing patients in the system, including those who had been receiving treatment for years, Silber added.

“It’s a travesty,” said Jim Beamish, a retired Verizon worker from Massapequa Park, L.I., whose chiropractor dropped him after 13 years of treatment because of the new policy.

“They just make you feel like you are almost a criminal to try and get care,” added Beamish, who still suffers neck pain from a 1998 fall.

Workers’ Compensation Board officials and members of the state Business Council – which supported the changes – defended the new policy as an”evidence-based” system that ensures workers receive care quickly.

“In the past, there was no objective and consistent standard for determining whether the care was effective, which can lead to potential fraud, delay and mismanagement of the system,” said board spokesman Brian Keegan.

Keegan said people denied coverage can appeal for a variance so long as they can show “objective evidence that a treatment medically benefits their patient.”

Keegan said 78,178 variance requests have been filed, and more than two-thirds were approved.

Critics, including the powerful AFL-CIO, said the variance process is cumbersome and difficult to navigate.

“The agency now views itself asthe protector of insurers and employers,” said Robert Grey, a lawyer who specializes in workers’ compensation cases. “Clearly, someone thinks cutting off medical treatment will save money for employers and insurance companies.”

Legislation that would have stopped the board from applying its new guidelines retroactively was approved by the Assembly this spring but stalled in the GOP-controlled Senate.

The bill faced stiff opposition from the Business Council.

“You just don’t do something forever just because you feel like it,” said the Business Council’s Maggie Moree. “You have to have evidence.”

Upstate Republican Sen. George Maziarz, the bill’s sponsor, said he’s pressing to have the Senate take up the measure at a yet-to-be-called session this fall – or in January.

“People are being denied care that is inexpensive and that I think helps them,” Maziarz said.

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