As of 12/01/10, use of the Medical Treatment Guidelines became mandatory for injuries to the mid and low back, knee, shoulder, and neck.
The Guidelines are retroactive meaning that they apply to all cases regardless of when the accident actually occurred.
The Medical Treatment Guidelines radically alter the process for an injured worker to secure medical care.
If your doctor has requested approval for a certain type of treatment or medication, the starting point in determining how to get that treatment is to review the Medical Treatment Guidelines. The link below brings you to the Workers’ Compensation Board frequently asked questions page and also an online version of the actual Guidelines:
NY Medical Treatment Guidelines
Certain procedures still need pre-authorization and they are listed in the Guidelines. If your doctor has requested one of those procedures he must file a C-4AUTH. Most treatment will be approved without prior authorization. However, it is incumbent upon the attending physician or chiropractor to provide the treatment if he or she feels it is within the Guidelines.