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NEW RULES WOULD ALLOW INSURERS TO DENY OPIOID COVERAGE

by Kelly A. Hemple on Jul. 17, 2017

Employment Workers' Compensation 

Summary: NEW RULES WOULD ALLOW INSURERS TO DENY OPIOID COVERAGE

Several states are considering new rules for combating opioid use that place injured workers in a difficult position when it comes to recovery. The rule changes, if instituted, will give state regulatory bureaus that oversee workers' compensation claims the power to demand that injured employees be incrementally denied coverage for painkillers after an injury.

The motivation for these rule changes is complex. On the one hand, it is becoming widely accepted that opioid painkillers are abused regularly and often lead to life-altering addiction. In Pennsylvania, about one out of every 10 people prescribed some form of opioid after an injury develops a dependency on the drugs. The hard truth of the matter is that opioid addiction regularly leads to destructive life choices or dependency on other, more dangerous and available drugs, such as black tar heroin and methamphetamine.

However, the rule changes also greatly benefit the insurance providers, who can avoid paying out millions of dollars in reimbursements when fewer painkillers are prescribed or denied to those who may still need them. This could create a difficult dilemma for many recovering workers if the rules gain too much power — namely that some regulatory third party has the power to decide when a worker no longer should receive help managing pain from an injury. While the rule change may seem reasonable on the front end, and may legitimately save many lives from the thrall of opioids, it all creates a dangerous precedent giving third parties the power to deny coverage to protect a business's bottom line.

Like many matters in workers' compensation, there is no simple answer to this issue. Of course, no one would wish an opioid addiction on someone else. At the same time, a worker's recovery should not be micromanaged by his or her employer to protect the employer's bottom line.

If you have suffered an injury on the job, it is crucial to get the help you need to recover fully. With guidance from an experienced attorney, you can ensure that your rights remain secure as you do the hard work of getting back to the life and work that you love.

Source: The Oklahoman, "Workers comp programs fight addiction among injured workers," Bob Salsberg, April 10, 2017


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