What if the claim is several years old and the injured worker has already received more than the recommended amount of physical therapy treatment? Do the Guidelines apply?
Yes, however the Guidelines apply prospectively. Therefore, the Guidelines’ recommended limits apply to treatments on, or after, December 1, 2010. For example, if the doctor prescribes six weeks of physical therapy two times per week in mid-November, the portion of that therapy that occurs before December 1, 2010 is not subject to the Medical Treatment Guidelines. Beginning December 1, 2010, physical therapy may continue for up to 3 weeks and then, as required in the general principles of the Guidelines, the injured worker must be re-evaluated to determine if there is continuing objective functional improvement. Subsequent physical therapy must be consistent with the Guidelines or be approved through the variance process.
Related Questions
- What if the claim is several years old and the injured worker has already received more than the recommended amount of chiropractic treatment? Do the Guidelines apply?
- Can an injured worker voluntarily pay a medical provider for medical treatment that is not recommended in the Medical Treatment Guidelines?
- If the Medical Treatment Guidelines clearly indicate that a certain procedure is not recommended, is a request for a variance appropriate?
