Medical treatment

Eliminating Pain from the NY Workers’ Compensation Board Complex Regional Pain Syndrome Medical Treatment Guidelines | Goldberg Segalla

Key points to remember:

  • The New York Workers’ Compensation Board announced that new medical treatment guidelines, including new guidelines covering complex regional pain syndrome, will take effect on May 2, 2022.

  • The detailed guidelines for complex regional pain syndrome are noted as being primarily associated with recent trauma or injury and are divided into two categories: CRPS-I and CRPS-II.

  • These guidelines will be particularly helpful in avoiding misdiagnosis of the condition, as well as specific management and treatment protocol recommendations for injured workers who have been diagnosed.

The New York State Workers’ Compensation Board announced new medical treatment guidelines effective May 2, 2022. Today’s alert includes a breakdown of the Complex Regional Pain Syndrome section (also called SDRC or RSD).

The Council has worked with physicians to produce a series of guidelines that define the medical standard of care for certain published conditions and allow certain treatments to be covered without requiring approval if defined in these guidelines, leading to rapid processing and better defined responsibility. for the carrier.

About the new guidelines

The Complex Regional Pain Syndrome guidelines, found here, include 320 pages of instructions, with the first section devoted to diagnosing the two categories of the disease through the use of motor, sensory, vascular, psychological and neuropathic. Both categories include CRPS-I, also known as reflex sympathetic disorder [RSD]—and CRPS-II—Causalgia, which involves a specific nerve and distribution. There is guidance for specific signs and categories that take this condition out of the diagnosis of exclusion category, which should help to require specialist physicians in the best position to make the diagnosis.

Most guidelines are devoted to the appendix, which provides questions to ask patients in order to reach a diagnosis. Additionally, there are management algorithms to guide functional improvement as part of the diagnosis. Finally, it should be noted that the diagnosis is usually reached by medical professions specializing in pain management, neurology or physical medicine and rehabilitation.

Recommendations for New York Workers’ Compensation Self-Insureds, Third-Party Administrators, and Carriers

It is recommended that insurers review the new guidelines for Complex Regional Pain Syndrome to ensure that they are prepared when the diagnosis is being considered or has already been established, to confirm the appropriate use of treatment and modalities. drugs used in the case. The New York State Workers’ Compensation Board will provide training for all sections of the Medical Treatment Guidelines; Further information is available here.