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HAPPY HALLO-WEAN

by | Oct 31, 2016 | MAD News |

HAPPY HALLO-WEAN

Today the Board issued Subject Number 064 – 892 which creates a “hearing process” for addressing opioid weaning issues. In support of this new process the Board recognizes that the Non-Acute Pain Medical Treatment Guidelines clearly indicate that long-term opioid use is recommended in only limited circumstances, involves constant clinical monitoring and reevaluation, and requires best practices for safe weaning of workers from opioid medications. To further effectuate this goal the Board has created a process for hearings addressing opioid medications.

Initially, the process is commenced with the filing of an RFA-2 for which the Board has created a new checkbox, which indicates opioid weaning under Non-Acute Pain Medical Treatment Guidelines.  Attached to the RFA-2 must be either an IME or record review, which addresses weaning goals, a weaning program, or weaning resource.

Claimants are now directed to submit a medical report in response to the carrier’s RFA-2 within 45 days after of the Board’s notice to the claimant.

Transcripts of testimony of both the independent medical examiner and the claimant’s treating provider, if contrary medical evidence is submitted, are due to the Board prior to the opioid hearing.

Once the record has been fully developed, the Judge will issue a decision finding either:

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Finally, once there is a ruling that weaning is required the insurer is to cover the costs of the claimant’s addiction treatment program, weaning protocol, and medications through the duration of the weaning process.

This effectively places whether a claimant’s opioid medication treatment is within the Non-Acute Pain Medical Treatment Guidelines on the expedited hearing calendar.  A link to the subject number is below.

http://www.wcb.ny.gov/content/main/SubjectNos/sn046_892.jsp