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New Rules for Prescribing Pain Medications to Treat Injured Workers

Washington State’s Department of Labor & Industries has issued new guidelines for prescribing pain medications to treat injured workers. These extensive guidelines went into effect on July 1, 2013, and will impact many people covered by our workers’ compensation system.

According to the Department’s Medical Director, the new guidelines are “based on the best available clinical and scientific evidence following a systematic review of the literature and consensus of expert opinion.” These changes are intended to improve the safety and effectiveness of treatment of pain among injured workers in this state.

The new guidelines address a number of areas including overprescribing pain medication, the impact of the drugs — both clinically and socially, the uses of the drugs at different stages of injury, and how doctors should help injured workers stop using pain medication.

Injured workers should be aware of the follow major rule revisions:

Doctors who prescribe pain medications to injured workers beyond six weeks immediately following an injury must complete the following.

 Monitor whether workers are recovering their ability to perform normal activities.
 Access the state’s
 Prescription Monitoring Program to make sure the worker is not getting pain medications from another doctor.
 Screen the worker for depression.
 Screen the worker for earlier problems with addictions.
 Take a baseline urine drug test.
 Consider discontinuing other medications which could interfere with pain medications.

Doctors who prescribe pain medications beyond 12 weeks for injured workers must complete additional steps before L&I will authorize payment.

These steps include:

 Document that the worker is improving in function and normal activities.
black_bullet Consider any reasonable alternatives to pain medications.

black_bullet Have a pain contract signed by the worker.

 Document a time-limited treatment plan to address whether pain medication will allow an injured worker to return to work.

black_bullet If the worker’s dose is above 120 mg per day, then there must be a consultation with a pain specialist.

This is a major change in the way the Department will authorize pain medications and it will directly impact our clients. Pain medication will be limited to times immediately following the initial injury or following surgery.

You can find the complete guidelines at:

Please call us if you have any questions about your workers’ compensation benefits or the new changes to these pain medication guidelines.

Patrick Cook is an associate attorney at The Walthew Law Firm and practices workers’ compensation and personal injury law.

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