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Effects of the New York State Workers Compensation Board Medical Treatment Guidelines on Return to Work

Demian, Cristina, MD, MPH, FACOEM; Barron, Bruce, MD, MSc; Almudevar, Anthony, PhD

Journal of Occupational and Environmental Medicine: July 2018 - Volume 60 - Issue 7 - p 617–621
doi: 10.1097/JOM.0000000000001265

Objective: Examine the association between New York State Workers’ Compensation Medical Treatment Guidelines (Guidelines) adherence and return-to-work after occupational low back injuries. Assess adherence to Guidelines by examining diagnostic and treatment utilization.

Method: Retrospective chart review of cases. Outcomes of interest were lost time duration and diagnostic/treatment utilization rates. Time to event analyses performed using Kaplan–Meier plots and Cox proportional hazard model.

Results: Care received after implementation of Guidelines resulted in decreased lost time. Treatment rates were consistent, while diagnostic imaging use was inconsistent with Guidelines recommendations.

Conclusions: Guidelines use positively influenced return-to-work after acute occupational low back injuries. Inconsistencies in following Guidelines were observed for diagnostic tests, having a potential paradoxical effect on lost time. Further studies are necessary to test for additional hypotheses.

Department of Environmental Medicine, University of Rochester Medical Center (Dr Demian, Dr Barron); Department of Biostatistics and Computational Biology, University of Rochester (Dr Almudevar), Rochester, New York.

Address correspondence to: Cristina Demian, MD, MPH, FACOEM, 2180 S. Clinton Ave., Suite D, Rochester, NY 14618 (

No funding was received for the work discussed in the manuscript.

Conflict of Interest: None declared.

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Copyright © 2018 by the American College of Occupational and Environmental Medicine