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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-519

Chair Seeks Feedback on Proposed Non-Acute Pain Medical Treatment Guideline

Date: April 22, 2013

In October 2011, I appointed a Medical Advisory Committee (MAC) charged with developing additional medical treatment guidelines (MTG) for the treatment of work-related conditions beginning with the management of chronic pain conditions. I am pleased to announce the completion of a draft Non-Acute Pain MTG, as well as changes to the existing neck, back, shoulder, knee and carpal tunnel syndrome MTGs (Proposed Treatment Guidelines). These new guidelines supplement and update current recommendations on chronic pain contained in our existing MTG. Among the highlights, the draft MTG includes state-of-the-art recommendations regarding the long-term use of narcotics for the treatment of pain. This is a particularly important topic in light of the opioid epidemic facing the nation, including New York’s injured workers. I encourage all stakeholders to closely review the draft MTG and to submit any comments or recommendations. After review and consideration of stakeholder feedback, the Board will finalize the Non-Acute Pain MTG and revisions to the existing MTGs, which will be published as part of the formal rulemaking process.

The draft MTG provides for a comprehensive approach to the management of patients with chronic pain, including best practice recommendations for prescribing narcotics. The draft MTG encompasses a continuum of treatment approaches including early identification, the use of the biopsychosocial model, assessment and treatment of delayed recovery, identification of measurable outcomes, non-pharmacological treatments and pharmacological approaches, including both non-opioid and opioid medications.

The draft Non-Acute Pain MTG reflects a consensus of the medical professionals on the MAC regarding the diagnosis and management of chronic pain. The thirteen member MAC consists of eleven physicians, one business representative, and one labor representative. The MAC is co-chaired by the Board’s Medical Directors, Jaime Szeinuk, M.D. and Elain Sobol-Berger, M.D., J.D. The MAC members have given generously of their time and diligently shared their knowledge and experience in this effort.

The Board is working to coordinate its MTG implementation with New York’s recent I-Stop legislation and forthcoming regulations in order to address most effectively the safety and health issues posed by high levels of long-term opioid use.

All stakeholders, including medical providers, are encouraged to review the draft MTG and to submit any comments, with supporting medical literature, to the Board's Medical Director's Office on or before June 10, 2013. Please email your comments to the Board at NAP@wcb.ny.gov.

Thank you for your continued cooperation.

Robert E. Beloten
Chair