After an employee has been injured at work, they often seek treatment from a trusted chiropractor. The practice of chiropractic is often an essential element in an injured person’s ability to regain their enjoyment of life and their ability to work. It’s important care that helps many thousands of people each year.
Nobody deserves to live with chronic pain, and nobody should feel like they can’t get the treatment they need because they can’t afford it. If an employee is injured at work, they may be eligible for workers’ compensation benefits, and they can select a chiropractor as their “primary health care provider.” Why is that important? Because it means a chiropractor can be paid from an employee’s workers’ compensation claim, and can refer the employee to other professionals.
What Chiropractic Treatments Are Allowed Under Workers’ Compensation?
Because workers’ compensation patients are (thankfully) not often a chiropractor’s typical cases, we often hear questions on what treatments work comp law covers. In general, all treatments must be medically necessary, as defined in Minnesota’s Administrative Rules, part 5221.6040, subpart 10. Employees most often seek treatment for low back pain, neck pain, or thoracic back pain.
If the primary healthcare provider deems treatment is medically necessary, workers’ compensation benefits cover 12 weeks of:
- Adjustment or manipulation of the joints
- Thermal treatment including superficial and deep heating and cooling modalities
- Electrical muscle stimulation
- Mechanical traction
- Manual therapy, including manual traction and massage
- Phoresis including iontophoresis and phonophoresis
At each visit, the health care provider must evaluate whether the treatment results in progressive improvement, based on 1). The employee’s subjective evaluation of pain or disability, 2). the objective clinical finding, or 3). the employee’s functional status. If the employee’s status has not shown progressive improvement in two of the three areas listed above, the treatment should be modified, or the provider must reconsider the diagnosis. If the patient isn’t getting better, then the treatment must change.
The purpose of workers’ compensation is to ensure employees can regain functionality after being injured in the workplace. Unfortunately, a full recovery can’t always happen in 12 weeks. If the healthcare provider determines that the employee needs further care at the end of the initial treatment period, workers’ compensation can be extended.
The patient may be eligible for an additional 12 visits over an additional 12 months if all of the following requirements are met:
- The treatment progressively improves or maintains the functional status that was gained in the initial 12 weeks of treatment;
- The treatment is not regularly scheduled;
- The treatment records contain a plan to encourage independence and decreased reliance on health care providers;
- Management of the condition includes active treatment modalities;
- The additional visits do not delay surgical or chronic pain evaluations; and
- The employee does not have chronic pain syndrome.
What If an Employee Needs Care Outside “Normal” Treatment Parameters?
Every case and every patient is different, so treatment parameters will often need to be adjusted. Under rule 5221.6050, subpart 8, a departure from a parameter that limits the duration or type of treatment may be appropriate in certain situations. Should you wish to depart from treatment procedures, you will need to submit a notification to the insurer at least seven working days before treatment is initiated (see 5221.6050, Subpart 9A(4). The notice can be oral or written and must contain:
- Your diagnosis
- The basis for the departure under subpart 8
- The treatment plan – must include the nature and anticipated length of the proposed treatment and the anticipated effect of treatment on the employee’s condition.
If an Insurer Cuts Off Payment
Chiropractors and other medical providers who are not paid or are underpaid can file a Motion to Intervene to become formally involved in their patient’s workers’ compensation case.
When a Claim Petition has been filed with the Office of Administrative Hearings, the Motion to Intervene must be filed via eFiling or by mail to:
Minnesota Office of Administrative Hearings
Workers’ Compensation Division
PO Box 64620
Saint Paul, MN 55164-0620
In the alternative, when a Medical Request has been filed with the Minnesota Department of Labor and Industry, the Motion to Intervene should be filed there via Campus or by mail to:
Minnesota Department of Labor and Industry
Workers’ Compensation Division
443 Lafayette Road
Saint Paul, MN
The Motion to Intervene must be served on all parties, with the exception of other intervenors. An Affidavit of Service must be served and filed with the Motion to Intervene.View Sample Affidavit of Service
Schroeder & Mandel is Here to Help
We represent injured workers on a contingency fee basis. They pay no fees out of pocket, and we don’t collect unless we are successful with their claim.
While representing an injured worker, we often help chiropractors and other small medical providers file a Motion to Intervene. If a provider contacts us for help, we fill out the case caption (top) and the signature block (bottom). The provider fills in the dates of treatment and the amount owed (middle), then must sign, date, and send it back to us. We then complete the Affidavit of Service and e-file it with the Office of Administrative Hearings. It’s that simple.
Contact us for a FREE consultation to get started.