NYS Worker's Comp Guidelines

[Ducttape]

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Anyone else having trouble with New York State "new" guidelines begun last year?

In particular, i have patients that have had radicular pain after spinal surgery that have been getting TFepidurals and caudals. They all have gotten ">50% pain relief", "improvement in functional ability", yet they are being denied further injections, because the guideline states "Generally, there are not believed to be benefits beyond 3 injections for a given episode of radicular pain. Patients requesting a fourth injection should be counseled for discectomy, or considered to have chronic radicular symptoms for which epidural steroids are not recommended"...


So what to do? stim 'em all after 3 epidurals for chronic radicular pain?

 

[PMR 4 MSK]

Worker's Comp is not compatible with pain management. The system is set up against it. Occ Med guidelines are patently hostile to Pain Medicine.

You declare them at MMI, let them settle their case, then treat them with their private insurance.

 

[Kwijibo]

These guidelines serve as a template for the procedure to be performed without having to request through the WC carrier.
If you want to do more than three epidurals, which are allowed you need to fill out an M2 form and you can request additional epidurals with that.