NEW YORK WORKERS’ COMP AND THE OPIOID CRISIS

Opioid addiction is a major public health concern affecting workers’ compensation nationally.

Pain management—and the use of prominent drugs such as hydrocodone, oxycodone and fentanyl—is often an important component of healing from workplace injuries. While opiates are effective at controlling pain, are relatively inexpensive and easy to access, they are also highly addictive. For injured workers facing managing their pain, long-term opioid use can also lead to dangerous respiratory depression and failure, liver damage and brain damage. For employees returning back to work after recovering from their injuries, drug misuse can contribute to workplace accidents and even death from impaired judgement and motor function.

Facing this epidemic of opioid addiction and high costs of treatment, the New York State Workers’ Compensation Board adopted the Non-Acute Pain Medical Treatment Guidelines in 2010. These guidelines were intended to be a new mandatory standard of care for treating New York’s injured workers.

A carrier may file an RFA-2 requesting a hearing for opioid weaning issues. During the hearing, the Judge will consider whether or not the claimant’s opioid use adheres to New York’s Non-Acute Pain Medical Treatment Guidelines. The claimant can present medical reports and depositions from his/her treating physician(s) outlining their treatment and opioid usage. A Workers’ Compensation Judge will then weigh evidence and decide generally if 1) the opioid use is effective at the time of the hearing and can continue under the guidelines, or 2) the claimant should be weaned from opioids. If the Judge decides that the claimant requires enrollment in an addiction treatment program, the insurer would be required to cover the expenses of this treatment.