Because not all injuries incurred at a New York workplace are the same, the way they are treated will be different. With workers' compensation benefits, it is important for the injured worker to understand when a variance from typical treatment will be necessary and how to get approved for it. The law for medical treatment guidelines in workers' compensation cases addresses variances. When there is a dispute over this or any other workers' compensation issue, legal help is critical.
The Medical Treatment Guidelines are used to determine what treatment is necessary. The medical provider treating the injured worker might decide that the patient needs care which varies from what is customary. To receive coverage for this treatment, the patient must request a variance. The carrier, the Special Fund or the Workers' Compensation Board must approve the variance. If treatment has already been provided and it deviated from the guidelines, the variance request will not be considered.
The burden of proof is on the medical provider to show that the variance is necessary. The medical opinion and its basis must be part of the request. The request must state that the claimant has agreed to the care and must include an explanation of why alternative forms of treatment are not sufficient. The frequency and length of time the treatment is given and, based on the date of the request, the outcomes that show the person has improved must also be given.
Not all injuries can be classified and treated the same way. When there is a medical issue that requires a different form of treatment than that which is listed in the guidelines, it is important to request a variance. When doing so, it is wise to have legal advice from a workers' compensation attorney to make certain that the requirements are adhered to and there is a good chance of an approval.