NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
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Every so often DWC gets around to looking into medical treatments which may or may not be effective. That is to see if Texas injured workers can benefit or could be harmed, and to evaluate the economic benefits to certain physicians. Case in point is DWC’s recently announced intent to audit the use of spinal cord stimulators to determine the appropriateness of a physician’s decision to install one into the body of an injured worker, and the effectiveness of the device once installed. The review will be part of and conducted under the auspices of the DWC’s Medical Quality Review Process. We mention here that these devices require preauthorization under Rule 134.600 so that medical necessity is evaluated by qualified Utilization Review Agent (URA) physicians. It is unclear whether the audit will scrutinize URAs, the information requesting doctors send to the URA to justify medical necessity, the treatment guidelines criteria for stimulators, or all of the above. Apparently even our friends “down under” are taking a look at this issue: To hell and back: Devices meant to ease pain are causing trauma.
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