Workers Compensation

The Law That Helps Patients & Employers - If Followed

Department's Services

Injured at work? Are you in pain?

Want to get back to the life you had before getting hurt?

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California law ensures that you get whatever it takes to get better and compensate you for disability. Its the law! California Code of Regulations 9792.2-.27. The problem is that Insurance Companies don’t want to lose any of their money in payments to treat you fairly. The Doctors make more money if you keep coming back for treatment, on and on and on. Lawyers, whom represent you, make more money the longer you suffer and the more disabled you become.

The California Division of Workers Compensation doesn’t even enforce the laws they wrote to protect you from all of this abuse. The only losers feeding the system are the Employers and You, the injured patient! Employers financially lose as they are the ultimate payers’. The patient loses because they are rewarded for suffering, for putting up with the pain and system. Basically exchanging their health and safety for the system in hopes of maximizing the money they make in settlement. The progression of injury to Chronic Pain is common as is Addiction to Narcotics.

If you are injured and want to get better, as soon as possible, while maximizing your settlement then we are for you. We follow the Workers Compensation medical treatment guidelines (MTUS), which is the law. Below is a direct link to the WC guidelines and a short summary of the law. In addition, if you continue to be abused by the system we can help you with legal and medical assistance that supports your best interests not theirs.

We may not be accepted into the network of those who take advantage of you and the system. We don’t really fit in. Instead we are the real deal, we provide the care our Government feels you are entitled to, for your benefit. An Integrated Multidisciplinary Approach.

First, don’t get caught in the system, it will take advantage of you. Second, if you are already caught, give us a call and we’ll help you get out of the abuse.

 

MTUS Treatment Approach – Its The Law

Title 8 of The California Code of Regulations §§9792.20 et al MTUS and Appendix D as described online here:

http://www.dir.ca.gov/dwc/DWCPropRegs/MTUS/MTUS_Regulations.htm

Summary of The Law:

Providers are required to follow the MTUS (Medical Treatment Utilization Schedule), which contains a set of multidisciplinary treatment guidelines effective for certain injuries, as well as how often the treatment should be given, the extent of the treatment, and for how long, among other things.

Early care is paramount. It should be approached in an integrated multidisciplinary manner that includes treatment modalities such as medications, physical therapy, injections, and behavioral modification with the goal of functional restoration rather than merely the elimination of pain. www.dir.ca.gov/dwc/DWCPropRegs/MTUS_Regulations/MTUS_Regulations.htm, Part 1 Introduction, MTUS pg 1

History and Physical: This should rule out any major “red flags” that would endanger the patient. When red flags are ruled out then Conservative Treatment directed at Myofascial components is indicated.

Initial Conservative Treatment For Acute Injuries

Pharmacologic Treatment:

  • To include analgesics, NSAID’s, muscle relaxants.

Behavioral Modification:

  • Psychotherapy to rule out dual diagnosis, malingering, and prevent chronicity.

Physical Therapy:

  • 3 times per week for 2 weeks to address myofascial components. After this the patients’ functionality should have greatly improved unless there is underlying pathology. The intent here is to eliminate or, at least, control any myofascial component to the patients’ pain complaints so that underlying pathology may be identified if present.

Re-Evaluation 3rdWeek:

  • Responding: If the patients’ myofascial component is responding as expected there is probably no other underlying pathology so continue the physical therapy for 2 weeks and re-evaluate for rehabilitation or discharge.

Total physical therapy =  3 per week for 4 weeks = 12 therapies

  • Not Responding: If the patient continues to have pain that persists beyond the anticipated time of healing the chronic pain medical treatment guidelines apply.

If self sustaining Trigger Points are found they should be injected while continuing physical therapy and re-evaluate after 1 week.

  • Responding: If the patients’ myofascial component is responding as expected no other underlying pathology is anticipated so continue the physical therapy for 2 more weeks and re-evaluate for rehabilitation or discharge.

Total physical therapy =  3 per week for 6 weeks = 18 therapie

  • Not Responding: If the patients’ myofascial component is still not responding as expected search for underlying pathology through imaging, EMG/NCV, psychological evaluation, consultations, and labs followed by treatment modalities such as injections, surgery, etc. While this workup is being done it is important to continue Physical Therapy 2 times per week to not lose the gains that have already been made.

Total physical therapy = 3 per week for 4 weeks plus 2 per week for 6 weeks = 24 therapies.

Results With This MTUS Approach:

Within 3 months a Diagnosis, Prognosis, and Treatment Plan will be established.

At that time the patient would be faced with the decision to live with their chronic condition and its treatment, or if that is unacceptable, progress to more invasive treatment modalities like surgery, infusion pumps, dorsal column stimulation, neurolysis, narcotics, etc…

References:

http://www.dir.ca.gov/dwc/DWCPropRegs/MTUS/MTUS_Regulations.htm

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