December 29, 2017 • Workers' Compensation
Employees who get hurt on the job must rely on workers’ compensation to provide benefits. Injured workers should get help from New York City workers’ compensation lawyers in order to take action in getting the benefits they need.
Workers’ compensation is typically an exclusive remedy for workers who cannot sue employers after most on-the-job injuries. This important program ensures that medical bills are paid and that workers receive disability income if they need it. However, the American Council of Science and Health indicates that some changes have been proposed to workers’ compensation in New York that could be damaging to workers.
According to the American Council on Science and Health, the chair of the Workers’ Compensation Board in New York released a letter inviting public comment on proposed legislation that would change certain workers’ comp provisions in New York. Public comment was invited until February 26, 2018 and the proposed changes center around the prescription of drugs by providers.
The proposed draft regulation indicates that if a physician treating a workers’ compensation patient determines that the patient needs a non-preferred drug, an unlisted drug, or a brand name drug even though there is a generic equivalent, the medical care provider must seek prior authorization before prescribing or dispensing the drug.
In other words, the government will need to become involved in approval of the drug treatment protocol that a workers’ compensation doctor believes is appropriate for an injured employee.
A pain management specialist and friend of American Council responded to the request for comment, warning of the problems that this change could create. The pain management specialist indicated that the requirement physicians seek prior authorization before prescribing medications could hurt workers in several different ways. The delay in obtaining the proper medication while approval is pending could leave the worker suffering in pain for longer, could delay recovery, and could thus extend the amount of time that the employee is absent from work.
The change to the law would also require that an insurance company would need to approve the non-preferred drug or, in cases where the company self-insures, the company would need to approve the medication. Since there is a continual back-and-forth between insurers and doctors, this raises concerns that insurers will slow down the approval process or even deny legitimate claims.
The process for what happens when a request for a non-preferred drug is denied is described as the most troubling part of the proposed changes to New York’s workers compensation law. If the insurer or self-insured employer denies the requested drug, the medical provider would need to seek review of the denial by the Workers’ Compensation Board through the office of the medical director or through the conciliation process. This would add another layer of bureaucracy to a low process and potentially leave workers without needed medication for a long time.
Comments are being accepted on proposed changes to the law through February 26, 2019 so it remains unclear if the changes will be implemented.
Workers deserve the best care when they are being treated for work injuries, and employees who are not provided with appropriate help in their recovery should contact New York City workers’ compensation lawyers to discuss their legal rights.