ProviderPulse
Revised Treatment Guidelines: Rule 17
Workers' Comp Coordination
January 2012
Chronic Pain Disorder and Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy
On Dec. 27, 2011, the Division of Workers’ Compensation (DOWC) revised two Exhibits of Rule 17: the Chronic Pain Disorder, Exhibit 9, and the Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy, Exhibit 7. Both contain a considerable number of updates, along with the corresponding analysis of medical literature regarding the topics. These revised Exhibits become effective Feb. 14, 2012.
Early in 2011, the DOWC established a medical advisory panel of expert individuals from within the workers’ compensation business community to develop a preliminary draft released in the fall of 2011 for review and feedback from the public. The result of the panel and public feedback is current clinical guidance that is enforceable under the Workers’ Compensation Rules of Procedure, 7 CCR 1101-3.
Both Exhibits contain the same updates for the Interdisciplinary Rehabilitation Programs and Medications section and the Medical Management section. Opioid/Chemical Treatment Programs was added to the Rehabilitation Program section, and the medication sections on opioid management and topical drug delivery were expanded to address the growing concerns surrounding these treatment protocols. It is important to note the following reference regarding Fentanyl in particular:
“Fentanyl is not generally recommended for use with musculoskeletal chronic pain patients. It has been associated with a number of deaths and has high addiction potential. Fentanyl should never be used transbuccally in this population.”
Each Exhibit has a number of changes relevant to that treatment disorder. You can review Exhibit 7 here and Exhibit 9 here.
We encourage you to download these new Exhibits and review each document thoroughly in order to be familiar with the new treatment recommendations. Pinnacol’s staff will be using these new standards in their prospective and concurrent reviews of all treatment plans.
Both Exhibits contain the same updates for the Interdisciplinary Rehabilitation Programs and Medications section and the Medical Management section. Opioid/Chemical Treatment Programs was added to the Rehabilitation Program section, and the medication sections on opioid management and topical drug delivery were expanded to address the growing concerns surrounding these treatment protocols. It is important to note the following reference regarding Fentanyl in particular:
“Fentanyl is not generally recommended for use with musculoskeletal chronic pain patients. It has been associated with a number of deaths and has high addiction potential. Fentanyl should never be used transbuccally in this population.”
Each Exhibit has a number of changes relevant to that treatment disorder. You can review Exhibit 7 here and Exhibit 9 here.
We encourage you to download these new Exhibits and review each document thoroughly in order to be familiar with the new treatment recommendations. Pinnacol’s staff will be using these new standards in their prospective and concurrent reviews of all treatment plans.
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