A chiropractic variance request based on alleged functional improvements and expected continued improvements may not be granted if the chiropractor continues to find that the claimant is totally disabled despite the alleged improvements.
In Hudson Valley DDSO, 2013 NY Wrk. Comp. LEXIS 2315, decided on 3/5/13, a three-member panel of commissioners found that a chiropractic variance request should not be approved despite the chiropractor’s submission which alleged that the claimant’s range of motion, endurance, numbness and tingling had all improved by 30%, and the claimant had an improved quality of life, needed less medication and was getting better sleep. The variance was denied in part because the chiropractor continued to certify to a total disability.
The carrier, the State Insurance Fund, successfully argued that the chiropractor’s report was internally inconsistent given that he asserted that the claimant had various degrees of improvement in her functional abilities as a result of the treatment, and yet remained 100% disabled. As a result, the board panel found the chiropractor failed to meet the burden of proof under the Medical Treatment Guidelines and denied the requested treatment.
A link to copy of the decision can be found below.