The New York State Insurance Department has proposed
medical treatment guidelines for those injured on the job, which
regulators say are designed to hold down workers' compensation costs
and ensure better care.
But the unit developing the evaluation scheme has yet
to decide whether the proposals will have any teeth behind them.
The guidelines, the department said, focus on the
treatment of injuries to the lower back, cervical spine, knee and
shoulder -- which account for nearly 60 percent of total medical
costs in New York's workers' comp system, according to data reported
by the Workers Compensation Research Institute.
"Putting medical treatment guidelines in place will
mean injured workers get faster and more effective medical care at a
lower cost to employers," New York Insurance Superintendent Eric
Dinallo said in a statement.
"These guidelines will standardize treatments so
injured workers get quality and appropriate care for their
condition. Without guidelines, disputes and inappropriate
treatments can lead to higher cost, but not better care," he added.
The department's Workers' Compensation Reform Task
Force -- headed by Executive Director Bruce Topman and Project
Manager Dr. Elain Sobol Berger -- worked with representatives of
labor, business and other state agencies to develop the guidelines.
Physicians and other professionals also shared their expertise and
advice, the department said.
Mr. Topman, speaking to National Underwriter, said
the plan for establishing treatment guidelines grew out of the
workers' comp reform legislation passed in March.
In a letter to the department, Mr. Topman noted, Gov.
Eliot Spitzer, as required by the legislation, had designated the
members of the advisory committee and asked the department to
develop the guidelines.
Asked if these guidelines will be enforced in some
way, or if they are intended to be only a reference point for
involved parties, Mr. Topman said: "That is a topic for discussion
that is on the immediate upcoming agenda of the advisory committee
and the task force."
The department has sent the guidelines to the
Workers' Compensation Board for its consideration in promulgating
regulations.
A WCB representative, Jim Smith, said the board has
no comment on the actual guidelines, but he noted WCB is confident
it will work quickly with the task force to implement them.
While the WCB has no specific deadline, Mr. Smith
said, "the timetable around here, when it comes to workers' comp
reform initiatives, is always 'as soon as possible.'"
Responding to the guidelines announcement, David
Dickson, past president of the Professional Insurance Agents of New
York, highlighted the need for consensus with respect to treating
injured workers.
"There were 120,000-plus [dispute] hearings last year
in New York for workers' compensation," noted Mr. Dickson -- a lot
of which, he said, involved injuries covered under the guidelines.
Establishing guidelines, Mr. Dickson added, could
reduce the number of hearings, but he cautioned that much will
depend on how the guidelines are implemented.
Michael Barrett, legislative representative for the
Independent Insurance Agents and Brokers of New York, said he
expects the guidelines will have the "force of law" behind them as
they are implemented through the WCB.
"Everyone will
be on the same page with the same rules," he said.
--By
Phil
Gusman