Hamberger & Weiss LLP


H&W Obtains Favorable Decision on Drug Weaning from Board Panel, Reversing WCLJ

Earlier this month in Toys R Us, N.Y.W.C.B. 80801667 (5/11/17), the Board directed the claimant's treating physician to develop a program to wean the claimant from Fentora, Kadian, Parafon, and Rozerem in accordance with recommendations set forth in the carrier's IME report and the Non-Acute Pain Medical Treatment Guidelines (NAP-MTGs). This decision modified the finding of the WCLJ, who refused to make any changes to the claimant's treating physician's prescription regimen due to the claimant's extreme pain. This case was litigated and argued by our partner, Melanie Wojcik.

This case serves as a reminder that the Board will enforce its Medical Treatment Guidelines, especially with respect to opioid weaning. The claimant in this case showed no functional improvement by following the treating physician's opioid-based treatment plan, which had a morphine equivalent dose (MED) of approximately 150 mg. The carrier's IME opined that the claimant's "current medical regimen is not consistent with the medical treatment guidelines." The IME set forth his recommendations for weaning of the opioid medications.

Despite a factual inaccuracy in the IME report, the Board found that the IME's report was "most consistent" with the NAP-MTGs and that the claimant should be weaned from his medication regimen based on the recommendations in the IME report.

Opioid weaning decisions such as this one can help employers and carriers in reducing long-term liability in their cases and reduce the medical costs of claims in anticipation of settlement.

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