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NEW YORK WORKERS’ COMPENSATION TREATMENT GUIDELINES APPLY TO CLAIMANTS WHO HAVE MOVED TO AND ARE TREATED IN OTHER STATES (THIRD DEPT).

The Third Department determined the Workers’ Compensation Board properly ruled that the guidelines for back pain treatment applied to claimant in Nevada. Claimant qualified for benefits in New York in 1996 and moved to Nevada in 2005:

… [W]e disagree with claimant that the Board impermissibly departed from its earlier decisions, as the Board acknowledged such a departure in its May 2017 decision and articulated its reasons for doing so … . Moreover, we find that the Board’s decision to depart from its prior decisions and apply the guidelines to the out-of-state treatment received by claimant in this case was rational. “The Board has the authority to promulgate medical treatment guidelines defining the nature and scope of necessary treatment” … .. “An agency’s construction of its statutes and regulations will be upheld if rational and reasonable” … . …

There is no dispute that claimant, who was injured in New York but has since moved to Nevada, is entitled to continue to receive medical treatment from qualified physicians in her new state and that the employer remains liable for the reasonable value of necessary medical treatment from qualified physicians in her new state … . In our view, the plain language of the regulations governing the guidelines do not limit their applicability to such medical treatment provided to claimants in other states, and a “treating medical provider” includes “any physician, podiatrist, chiropractor or psychologist that is providing treatment and care to an injured worker pursuant to the Workers’ Compensation Law” without regard to, or limitation of, geographic location … . Consistent with the regulations, the guidelines also state that “[a]ny medical providerrendering services to a workers’ compensation patient must utilize the . . . [g]uidelines as provided for with respect to all work-related injuries and/or illnesses” … . Matter of Gasparro v Hospice of Dutchess County, 2018 NY Slip Op 07815, Third Dept 11-15-18

WORKERS’ COMPENSATION (NEW YORK WORKERS’ COMPENSATION TREATMENT GUIDELINES APPLY TO CLAIMANTS WHO HAVE MOVED TO AND ARE TREATED IN OTHER STATES (THIRD DEPT))

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