The news media is reporting the problems in our region from the heroin epidemic we are facing. Law enforcement, the judicial system and the medical community are trying to tackle the issues this epidemic is causing. It is a problem in urban, rural and suburban communities. It exists in the workers’ compensation arena, too.
Recently the Ohio BWC has adopted drug formularies for the payment of prescriptions in claims. The Ohio BWC periodically reviews claim files to determine if the prescriptions meet the formulary guidelines and whether they are for treatment of the allowed conditions. Opiates and painkillers are often the subject of these reviews.
You may face this scrutiny in your own claim. You can appeal a decision to terminate the payment of prescriptions. An appeal will result in a hearing before the Industrial Commission. The hearing is an opportunity to present medical evidence to support the continuation of the payment of the prescriptions.
The best thing you can do if you are faced with a challenge on the prescriptions is to meet with your doctor. Discuss whether the current prescriptions are necessary. Ask whether there are alternative drugs or treatment for the symptoms you are experiencing. And ask the doctor for a written report or explanation for the drugs that are at issue if the doctor wishes to continue to prescribe them. This can be presented to a hearing officer for consideration in whether prescriptions will be authorized.
You should manage your own medical care, i.e. providers, courses of treatment, procedures and prescriptions. Be cautious of the drugs you are taking. Talk to your doctor if you start to feel dependent on them. Be proactive and understand the side effects and potential for addiction. Be the boss of you.
For more info, read this NY Times article.