top of page
G&G logo - NEW - RGB - shaded - REVERSED.png
AdobeStock_141023550.jpeg

GETTING MEDICAL TREATMENT IN THE WORKERS’ COMP SYSTEM

  • Jul 29, 2021
  • 1 min read

Many injured workers report that they have trouble getting medical treatment in the workers’ comp system because of the Board’s “Medical Treatment Guidelines.” Until now, those guidelines have only covered the neck, back, knee, shoulder, carpal tunnel syndrome and chronic pain. However, the Board plans to expand them to include the hip, foot and ankle, elbow, hand, pulmonary treatment, and mental health care for depression and post-traumatic stress disorder. With that in mind, it’s important to understand how the Guidelines work.

The Guidelines “preauthorize” a variety of treatment, which can include diagnostic tests, a course of therapy, and even some types of surgery. Doctors are not required (and should not) submit requests for approval for treatment that is preauthorized – they can go forward and provide that treatment.

However, if the doctor recommends a type of treatment that is not preauthorized, then the Guidelines assume the treatment is not necessary and should be denied. In that case, the doctor is required to ask for a “variance” from the guidelines in order to get the treatment approved. A variance request can be denied for a number of technical reasons, but the most common problem is that the doctor did not provide a thorough explanation of why the proposed treatment is needed and what the doctor expects the patient to gain from it. The more specific information the doctor provides (test results, range of motion measurements, medical journal articles), the more likely it is that a variance will be approved.

Recent Posts

See All

BLOG POST

Grey & Grey, PLLC

Contact Us

Thanks for submitting!

Grey & Grey, PLLC is a law firm dedicated to the representation of workers who are injured on or off the job. We specialize in handling claims for Workers’ compensation, Social Security Disability, Disability Retirement, and Personal Injury.

Farmingdale Office

360 Main Street

Farmingdale, NY 11735

(516) 249-1342
Directions

Manhattan Office

111 Broadway Suite 809

New York, NY 10006

(212) 964-1342
Directions

Queens Office

118-35 Queens Boulevard Suite 1505

Forest Hills, NY 11375

(718) 268-5300
Directions

Suffolk Office

646 Main Street

Port Jefferson, NY 11777

(631) 249-1342
Directions

Westchester Office

203 East Post Road

White Plains, NY 10601

(914) 984-2292
Directions

Bronx Office

2932 Wilkinson Avenue, Room 503, Bronx, NY 10461

(718) 268-5300
Directions

Thanks for subscribing!

Terms & Conditions

Privacy Policy

Accessibility Statement

G&G logo - NEW - RGB - shaded.png

Disclaimer: Attorney Advertising.  The legal information presented on this site is not intended to offer any medical or legal advice. The content presented on this website is intended for educational purposes only. Visitors to this website should not substitute its content for the professional services of a legal or healthcare professional.  Reasonable attempts have been made to ensure the information presented on this website is accurate, and Grey & Grey cannot make express or implied representations or warranties about the completeness or accuracy of the contents of this website.  You should consult an attorney for advice regarding your individual situation.  Contacting us does not create an attorney-client relationship.  Please do not send any confidential information to us until such time as an attorney-client relationship has been established. 

© 2025 by Grey & Grey, PLLC. All Rights Reserved. 

bottom of page