Struggling for care: Impact of workers' compensation reform on injured workers access to medical care in New York state

Background In 2007 New York State legislated a major reform of the Workers' Compensation system. Significant changes to the process of obtaining medical care and assessing permanent impairment were important aspects of the reform. A study was undertaken to evaluate two aspects of access to care: 1) How difficult is it for patients with potentially work related injuries or illnesses to locate a physician who accepts Workers' Compensation? 2) What impact have the newly legislated medical treatment guidelines had on the time it takes for patients to access diagnostic testing and treatment?

Methods A telephone survey of physician practices listed by the Workers' Compensation Board as accepting Workers' Compensation was undertaken to assess how many actually do accept Workers' Compensation insurance. A chart review of patients seen at the OHC was undertaken to compare the length of time required to obtain diagnostic testing and/or treatment post reform to pre reform.

Results For most medical specialties large differences were found between those listed by the WCB and those actually accepting Workers' Compensation. For conditions covered by the Medical Treatment Guidelines (MTGs) time to testing or treatment was significantly reduced post reform.

Conclusions New York's 2007 Workers' Compensation reform has been associated with mixed results for injured workers' access to medical care. The implications and reasons for the serious decline in physician acceptance of Workers' Compensation insurance will be examined. Discussion will also address issues that may negatively impact the identified improvement in the time to testing/treatment.