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When a Local 3 member has an accepted Worker’s Compensation Claim they are entitled to various benefits. New York State Worker’s Compensation Law provides the right for injured or ill workers to attain medical and prescription benefits to treat their work-related injury or illness. When a member has a Worker’s Compensation claim, the prescription benefits that are requested by the members treating doctor are paid for by the employer’s Workers Compensation insurance. Prescription benefits are meant to help the worker treat their injury or illness, but sometimes treatment with prescription pain medication ends up hurting them more. How can that be?åÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊåÊ
Opioid prescriptions are a common way for doctors to treat patients dealing with pain and should be taken with caution and only as prescribed due to their highly addictive nature. Long-term opioid treatment raises concerns regarding the safety and well-being of our members and their families. Before considering opioid treatment, you should have a conversation with your treating doctor asking them to explain exactly what risks are involved with taking the opioids they are prescribing you and what plan you and the doctor will follow while you are being treated with opioids to keep you safe. Some of the common opioids being prescribed are Oxycodone (OxyContin), Hydrocodone (Vicodin), Fentanyl (Fentora, Duragesic, Actiq), Hydromorphone (Dilaudid, Exalgo) and Methadone. These are only a few names of opioids and the pharmaceutical industry is constantly coming out with more.
According to the Centers of Disease Control and Prevention (CDC) the sales of prescription opioids and deaths due to prescription opioids has quadrupled since 1999. This epidemic of drug use has grown to crisis levels in the U.S. and is resulting in overdose deaths at alarming rates. Overdose is not the only risk involved with opioid use. When our members are being treated with opioids under a doctor’s care, they don’t usually anticipate abuse or addiction as potential dangers which could lead to heroin use. The CDC reports that 3 out of 4 new heroin users had abused prescription opioids before beginning using heroin. So it is extremely important to know what medication it is you are taking and its potential dangers or side effects. Opioids are being prescribed too freely by treating doctors and are fueling the opioid epidemic in our country, our state and in our Union. We probably all know someone who has been affected in some way by this drug epidemic.
The New York State Worker’s Compensation Board (NYSWCB) has recognized that opioid addiction is a major health care crisis affecting injured or ill workers in New York and in 2014 adopted the Non-Acute Pain Medical Treatment Guidelines. These guidelines have clear-cut recommendations that have been put in place to help providers manage opioid treatment. Long-term opioid treatment is only recommended in certain cases and must be monitored and evaluated periodically as per the 2014 guidelines.
On October 31, 2016, the NYSWCB implemented a hearing process to assess cases with long-term opioid treatment. This process has now also been implemented in our collectively-bargained ADR Program. This hearing process will enable a Worker’s Compensation Law Judge (at the WCB) or a Mediator/Arbitrator (in our Local 3 ADR Program) to rule at a hearing on the need for long term opioid treatment. The ruling will be based on the facts of each individual case (claimant doctor reports, record reviews or IME’s) and the Non-Acute Pain Medical Treatment Guidelines.
If the ruling issued at the hearing finds that the claimant needs continued long-term opioid treatment, it will continue as per the guidelines. If the ruling finds that long-term opioid treatment is no longer necessary, then there will be a weaning protocol implemented at the hearing as per the guidelines. This process will also make sure that a member’s treating doctor is also following the correct protocol laid out in the Non-Acute Pain Medical Treatment Guidelines while treating them with opioids long-term. This process will hopefully start to address the many concerns we all have relating to long term opioid treatment. By reviewing the Non-Acute Pain Guidelines that are already in place, the hearing process can enforce them to help protect and ensure injured workers get the treatment they are entitled to.
If you have any questions about your opioid treatment on your Worker’s Compensation claim or feel you may need help with weaning from opioids you can call the Local 3 Compensation Department at (718) 591-4000, or check the NYSWCB website and see the Board’s brochure that is named: Is My Pain Medication Making Me Worse?