Emergency Room Opioids?

Christian Sison
Christian Sison, Esq.

Opioids is one of the hottest topics in the workers’ compensation arena. As a result of the epidemic across the country, the New York Workers’ Compensation Board has implemented new procedures to address opioids. You can locate our recent articles about opioid abuse, requesting a weaning program with the assistance of the Non-Acute Pain Medical Treatment Guidelines, and the recent Board Bulletin released by the Workers’ Compensation Board that reiterates a growing need to stop the proliferation of long-term opioid use.

A recent New York Times article was penned by an emergency room physician alluding to the practical effects of weaning and ultimately discontinuing severe opioid use.  Dr. Helen Ouyang fights the good fight, as a judicious practitioner that regularly tracks her opioid prescriptions.  Dr. Ouyang refers to studies that reveal the lack of any beneficial effect of opioids in “controlling pain that’s not acute, like persistent low back pain.”

Despite her adherence to recommending eventual discontinued use of opioids, Dr. Ouyang notes that some of her patients “seek out the emergency room.”  Veteran opioid users can learn to rotate the hospitals and facilities that can prescribe medication for what the user will deem an “emergent” need.  But even if the patient doesn’t receive the relief he or she desires, the facility will turn them away and label them a “drug seeker.”

In summation arguments to a Law Judge, we consistently stress that the desired objective is one that benefits all parties.  Long-term, severe opioid use is dangerous for the patient, and it drives up unnecessary costs for the compensation carrier.  Dr. Ouyang’s article lauds the city of Boston in opening urgent care centers that target opioid treatment.  And to its credit, the Workers’ Compensation Board has cited, in Board Panel Decisions, an Office of Alcoholism and Substance Abuse Services (OASAS).

We are determined to defend your rights pursuant to the Non-Acute Pain Guidelines.  If you receive bills for opioids prescribed by emergency room physicians, they should be denied with Form C-8.1B.  Employers can note that such treatment deviates from the Non-Acute Pain Guidelines without seeking a Variance, or that the medication was not within the predetermined network provider.  Ultimately, we seek the end result that is in your best interests:  MSA totals are lowered, and weaning programs foster a better return-to-work scenario.

I will speak about opioids in the debut episode of Third Fridays, a legal podcast that aims to discuss high-level issues in Workers’ Compensation defense.  Follow the Third Fridays Twitter account and submit a question for me to answer directly on the first show, scheduled for December 16, 2016.  If your question is used, then you will be eligible for a free iPad mini!

Christian Sison is a Partner at Lois Law Firm LLC where he defends employers and carriers in New York workers’ compensation claims. He can be reached directly at csison@loisllc.com or 201-880-7213.