California Division of Workers Compensation Proposes Guidelines for Opioid Prescription Coverage
The California Division of Workers Compensation has posted proposed changes to the guidelines concerning workers comp coverage of opioid prescriptions used to treat worker injuries.
“Opioid misuse is a national concern. California is on the forefront of providing appropriate care and improving outcomes by issuing these guidelines,” said Department of Industrial Relations Director Christine Baker. The guidelines were posted on the DWC’s online forum for commenting until April 21st.
The current Medical Treatment Utilization Schedule (MTUS) addresses the use of opioid prescriptions to treat chronic pain from injury according to the Chronic Pain Treatment Guidelines. The new workers comp proposal would use the new painkiller guidelines in place of the original MTUS guidelines for workers comp applications.
“We created separate guidance for the use of opioids in the California workers’ compensation system to highlight the importance of appropriately treating workers in pain while also ensuring safety when using these medications,” said DWC Executive Medical Director Dr. Rupali Das. “A key goal of this guideline is to ensure restoration of function and early return to work following an injury.”
The workers comp guidelines will set new “best practices” regarding acute, subacute, post-operative, and chronic pain related to work-related injuries. Recommendations include whether or not it would be appropriate to add opioid prescriptions to a treatment regimen; medications to avoid when taking opioid prescriptions; methods and tools to monitor patients on opioids to help prevent addiction; patient education regarding opioid use and its dangers; and responsible storage and disposal of opioid painkiller prescriptions. The guideline is divided into four parts: Part A, a summary, abbreviated treatment protocols, and introduction; Part B, complete recommendations, and appendices containing useful tools; Part C, findings to support the recommendations; and Part D, a compilation of recommendations from a review of existing guidelines.
The Ohio Bureau of Workers Compensation recently created a system to monitor opioid prescriptions as well as other addictive drugs like anti-anxiety medications, starting in January 2014. According to that state’s new rules, the state-run workers comp insurance provider said it will no longer cover prescriptions for injured workers unless the provider enrolls in an automated reporting system, so the workers comp company can monitor potential abuse of opiate medications.
According to workers comp statistics, the bureau paid $38.2 million for 357,970 prescriptions for opiate pain killers to 39,028 claimants. While the workers comp bureau has not said specifically that they believe workers comp claimants are lying, growing national concern over prescription drug abuse has led the bureau to enact this monitoring system and try to stop drug abuse.
The workers comp bureau did little to track opiate drugs until 2011, and since monitoring policies have been put into place, prescriptions for opiate drugs have dropped 28%, and muscle relaxant prescriptions dropped 73%, in 2013 compared to 2010.
The Strom Law Firm Can Help with Workers Comp Claims in South Carolina
You are entitled to all necessary medical treatment that is likely to lessen your disability. Workers’ compensation generally pays for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. Keep in mind that in order to receive these benefits you must go to the doctor chosen by your employer or its insurance representative.
The workers comp lawyers at The Strom Law Firm, LLC proudly seek justice on behalf of employees injured or killed on the job who work for private companies, as well as employees working for local county, city, and state government. We are licensed to practice throughout South Carolina, as well as Georgia and New York. If you are confused about worker’s comp laws, or have had your worker’s comp claim denied, contact us. We offer free consultations to discuss the facts of your case.803.252.4800.