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New Workers Compensation Rules Could Limit Pain Medications to Injured Workers

In many workers compensation cases, injured workers have broken bones, torn ligaments, open cuts and other serious personal injuries. Some injured workers require surgery to repair their injuries. Some injured workers may even require multiple surgeries to repair their injuries. For still other injured workers, surgeries do not fix the underlying injuries, and the injured worker must simply learn to live with a life of pain.

In order to alleviate pain from serious personal injuries, doctors often prescribe narcotic pain medication to injured workers. However, the recent opioid addiction crisis has raised concerns of doctors overprescribing narcotic medications. In an effort to curtail the number of injured workers who become addicted to their pain medication, the N.C. Industrial Commission has proposed new rules which will limit the prescription of these drugs. These rules will be open for debate for a few months and can be finalized as early as May 1, 2018. These rules will govern all workers compensation cases in North Carolina.

First, the proposed workers compensation rules divide an injured worker's recovery into two (2) phases: the acute phase and the chronic phase. The acute phase is the first 12 weeks after an injury or surgery. There can be multiple acute phases during a worker's recovery. The chronic phase is the period after the acute phase.

In the acute phase, a doctor must consider alternatives to opioid pain medication to treat an injured worker's pain. Only if there are no better alternatives can a doctor prescribe opioids. Further, the prescription must be for the lowest possible dosage and for the fewest possible days to treat the injured worker's pain, not to exceed seven (7) days. Certain drugs, such as fentanyl, valium and Xanax cannot be prescribed to treat pain. If a doctor feels that the injured worker needs the pain medications beyond the seven days, she must document the need. If the prescription is for more than thirty days, the doctor must perform and random drug screen of the injured worker and also assess the injured worker's risk of addiction.

Beyond the first twelve (12) weeks after an injury or surgery, a doctor must document the need for continued opioid pain medication and consider alternative pain relief techniques for the injured worker such as massage, acupuncture, chiropractic care or physical therapy. Random drug tests of the injured worker are required as well as assessments for addiction. The doctor must also consider prescribing opioid antagonists (such as Naloxone and Naltrexone) with any opioids.

If a doctor believes that the injured worker has developed an addiction to pain medications, the doctor can refer the injured worker for an assessment at an addiction treatment facility. If treatment is recommended by the facility, the injured worker is entitled to receive treatment as part of his workers compensation case.

These rules, if adopted, will apply immediately to all workers compensation cases regardless of when the injury occurred. The proposed workers compensation rules can be found at http://www.ic.nc.gov/ proposed10MRules.html. Comments and questions regarding the proposed workers compensation rules can be directed to Kendall Bourdon at [email protected]

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