Saturday, February 14, 2009

Chiropractic Treatment and Minnesota Workers' Compensation Passive Treatment Parameters

For some injured workers, chiropractic care and treatment can be very helpful in relieving low back or neck pain and stiffness resulting from a work injury, including disc injuries, sprains and strains, and degenerative conditions.

The Minnesota Workers’ Compensation Rules set forth treatment parameters for passive care, including chiropractic treatment. These parameters are essentially guidelines for determining how much chiropractic treatment is reasonable and necessary to cure or relieve the effects of the work injury. Generally, the parameters permit 12 weeks of passive care or treatment to cure or relieve the effects of a work-related injury.

Twelve additional treatments over the course of a year may be permitted if (1) the employee is released to work or is permanently totally disabled and the additional passive treatment results in progressive improvement in, or maintenance of, the functional status achieved during the initial twelve weeks of passive care, (2) the passive treatment cannot be given on a regularly scheduled basis, (3) the doctor must document a plan to encourage the employee’s independence from and decreased reliance on ongoing treatment, (4) the employee must undergo active treatment modalities during this period in addition to the passive care, (5) the additional twelve weeks of passive care must not delay surgical intervention or an evaluation for chronic pain, and (6) the passive care is not to treat chronic pain syndrome.

A departure from the passive treatment parameters for work related neck or back injuries may also be appropriate if (1) there is a documented medical complication of the condition, (2) if the prior treatment did not meet the accepted standards of practice, (3) where the treatment is necessary to assist the employee in the initial return to work where the employee’s work activities place stress on the body part affected by the work injury, or (4) where there is an incapacitating exacerbation of the employee’s condition.

The Rules also permit a departure where the treatment meets two of the following three criteria, which must be documented in the medical records: (1) the employee’s subjective complaints of pain are progressively improving as evidenced by documentation in the medical record of decreased distribution, frequency or intensity of symptoms, (2) the employee’s objective clinical findings are progressively improving, as evidenced by documentation in the medical records of resolution or objectively measured improvement in physical signs of injury, or (3) the employee’s functional status, especially vocational activity, is objectively improving as evidenced by documentation in the medical record, or successive reports of workability, of less restrictive limitations on activity.

Finally, even if the prescribed treatment does not fall into one of these exceptions to the parameters, the Minnesota Workers’ Compensation Court of Appeals, as confirmed by the Minnesota Supreme Court, held that a departure is warranted “in those rare cases in which departure is necessary to attain proper treatment.”

After you undergo an initial twelve weeks of chiropractic treatment, the workers’ compensation insurer may indicate that they will not approve additional treatments. What they don’t tell you, however, is that there are literally dozens of exceptions to the treatment parameters. Your situation may fall within one of these exceptions. We have successfully argued on behalf of many, many of our clients that departure from the treatment parameters was appropriate, and that additional chiropractic care and treatment was compensable.

If you were injured on the job, and chiropractic treatment helps relieve your pain, but the workers’ compensation insurance company is denying payment for your chiropractic treatment, give us a call at 877-746-5680 or click here to email us to schedule a free consultation.

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