The Ohio Administrative Code has been amended to include a new rule governing lumbar fusion surgeries under Ohio workers’ compensation claims. O.A.C. 4123-6-32 requires numerous criteria to be met prior to a fusion surgery being eligible for approval. To see the complete rule click here. The rule sets out two sets of standards for people who have not undergone previous lumbar surgery and those who have. Under each section, very specific medical findings must be documented to support the requested surgery. In addition to numerous requirements the rule requires a statement included in the appendix to the rule to be signed by both the injured worker and the treating physician. The motivation behind the rule is clearly to prevent lumbar fusion surgeries as many injured workers who undergo these surgeries never return to gainful employment. What is yet to be seen is whether or not these people without the surgery will far any better than those with the surgery or will still end up permanently disabled and possibly worse off without the surgery. Furthermore, the physicians will likely be very hesitant to sign the statement as required in the appendix as it basically says the surgery may not work, you will likely need another surgery, you may not ever return to work and you will likely become dependent on opioids. To view the appendix click here.
Workers Comp News
- Ohio BWC Enacts New Lumbar Fusion Surgery Rule
- Ohio BWC to give $1.5 billion back to employers.
- Ohio Supreme Court denies right to permanent partial disability to injured worker receiving permanent and total disability.
- Statute of Limitations to File Claims Reduced to 1 year
- Governor Kasich signs Michael Louis Palumbo Jr. Act