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Last Visited: 11/3/2009
As outlined by Art Wilcox, workers compensation spokesperson for the NYS AFL-CIO, these include starting the durational time clock not at the date of injury, but when the injured worker is classified as PPD; any payments made to the worker prior to that date are not factored into the total number of weeks.
At present, Wilcox said, the average time it takes for classification is four years, though many expect this will be one of several targets of streamlining.
Delays and roadblocks, long a feature of the states workers compensation system, are explicitly addressed in Spitzers March 13 letter to the departments of labor and insurance and the Workers Compensation Board.
Specifically, the letter calls for a set of draft streamlined workers compensation regulations, with the objective of creating a system in which the claimants case will be adjudicated within 90 days of a dispute.
If 90 days may seem long to an injured worker, Wilcox is a realist: I think thats probably the best we can expect, he said.
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Wilcox pointed to the success of such measures.
Some of our affiliates, specifically the UAW, have saved a lot of money on workers compensation by utilizing imaging and radiology networks, he said, noting that they have reduced costs by as much as 50 percent, as compared with whats in the fee schedule right now for the same tests.
Much the same provision has been made for pharmaceuticals, requiring the substitution of generics where available and permitting mail-order purchase of medications.
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If networks and best practices might seem to constrain the injured workers options, those measures are also linked to a change in authorization requirements, something Wilcox said labor is really happy about.
Under the previous law, he explained, any medical procedure costing more than $500 required prior authorization from the carrier.
What happened often, he said, [is that] you couldnt get the authorization without going to a hearing.
So people would wait six months to have the MRI to get the arthroscopic knee surgery that ball players come back from in six weeks.
At the same time the legislation raises the authorization threshold to $1,000, it also provides that no prior authorization is needed if the doctor is following best medical practices.
What the entire group tried to do here, Wilcox said, referring to the negotiating team, is to do things that would maybe spend a bit more money on medical costs, but at the same time reduce the lost wage portion.