CHIROPRACTIC CARE PAYMENT
Sometimes when a worker is injured in Minnesota, he or she would prefer to go to a chiropractor to treat their injuries. Minnesota workers’ compensation, however, limits the amount of chiropractic care that insurance companies are required to pay for. These “limitations” are called the treatment parameters. The treatment parameters apply to all dates of injury and health care providers. They only apply however to treatment that was provided after January 4, 1995.
The treatment parameters only apply to treatment initiated after liability has been established. If the insurer has denied liability, the treatment parameters are not applied to the treatment for that injury.
AS A GENERAL PARAMETER, ANY TREATMENT MUST BE MEDICALLY NECESSARY.
Regarding chiropractic care, the courts have held that chiropractic treatment that provided relief of symptoms was not in and of itself sufficient to support a determination that the treatment was reasonable and necessary. There are several factors that the compensation judges look at to determine whether the chiropractic care is reasonable and necessary to cure and relieve the effects of the injury. These factors include:
- The employee’s opinion as to the relief obtained in terms of the extent, frequency, and duration of treatment.
- The possibility of other conditions not discovered by the chiropractor causing the employee’s problem.
- The setting up of a weekly schedule with no reduction to an “as needed” status.
- The period of relief from pain, in particular whether persistent pain returns.
- The use of alternative medical providers in the event of the employee’s ability to continue to work.
- The recommendation of long-term chiropractic care into the future which results in a maintenance rather than injury treatment.
- The possibility of psychological dependency of the employee on chiropractic care.
THE DURATION OF TIME THAT AN INJURED EMPLOYEE IS ALLOWED TO OBTAIN CHIROPRACTIC TREATMENT IS ALSO LIMITED UNDER MINNESOTA WORKERS’ COMPENSATION LAW.
Under the treatment parameters, an injured employee is allowed up to 12 weeks of treatment, including adjustments and adjunctive therapies. There is a maximum treatment frequency of five times a week for the first one to two weeks and then decreasing frequency thereafter. After the initial 12 weeks of treatment, an additional 12 visits over the next 12 months are allowable if all of the following requirements are met:
- The treatment must progressively improve or at least maintain the functional status gained during the initial 12 weeks of treatment.
- The treatment is not regularly scheduled.
- The chiropractor’s records include a documented plan to “encourage the employee’s independence and decreased reliance on health care providers”; and
- The chiropractor uses active modalities (i.e., education, posture and work method training, worksite analysis, modification, and exercise).
If you are an injured worker and would like to seek the help of a chiropractor it is important to seek the advice of a work comp attorney. We can help find a chiropractor that is familiar with Minnesota workers’ compensation laws to ensure that the treatment is covered, and/or advise the employee’s chiropractor regarding those laws. If you have been injured at work and would like to treat with a chiropractor, contact our Minneapolis/St. Paul workers’ compensation attorneys today for a free consultation.