The Division of Workers’ Compensation (DWC) has posted proposed “Chronic Pain Medical Treatment Guidelines” to its online forum. Members of the public may review and comment on the proposal online until Thursday, December 18.
“Chronic pain is a national concern. By issuing these guidelines, California continues to be on the forefront of providing appropriate care and improving outcomes,” said Department of Industrial Relations (DIR) Director Christine Baker. DWC is a division of DIR.
The current Medical Treatment Utilization Schedule (MTUS) Chronic Pain Medical Treatment Guidelines is based on a “frozen” 2009 adaptation of the Official Disability Guidelines (ODG) published by the Work Loss Data Institute.
The proposed guidelines consist of an edited version of the ODG “Treatment in Workers’ Compensation—Chapter on Pain (Chronic),” published April 10, 2014, which DWC has adapted with permission from the publisher. The proposed guidelines were developed in cooperation with the multidisciplinary Medical Evidence Evaluation Advisory Committee (MEEAC) and are based on the best available medical evidence and scientific studies.
“Chronic pain is a public health problem, a significant factor in delayed recovery, and the main reason for medical treatment disputes in the workers’ compensation system,” said DWC Executive Medical Director Dr. Rupali Das. “A key goal of these guidelines is to incentivize a multidisciplinary approach to chronic pain treatment to restore function and reduce pain and ultimately to encourage return to work following injury. The guidelines promote an evidence-based, comprehensive approach to treating pain, emphasizing measures that prevent or reduce chronic pain, suffering, and disability.”
The proposed MTUS “Chronic Pain Medical Treatment Guidelines” provide a set of best practices for considering a multidisciplinary approach to the management of chronic pain issuing from work-related injuries. The guidelines consist of an introduction (Part 1) and specific recommendations on interventions and treatments for chronic pain (Part 2), in addition to extensive bibliography and reference summaries. Specific guidance on opioid use is not contained in the “Chronic Pain Medical Treatment Guidelines” but is provided in a separate MTUS chapter.
The MTUS regulations can be found in Title 8 of the California Code of Regulations, beginning with section 9792.20. The proposed guidelines are in section 9792.24.2.