California Proposal Reaffirms ACOEM Practice Guidelines

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The 15-day notice of modification was distributed to interested

parties with the revised regulations posted on the DWC web site. The

public has until 5 pm (PT) on December 22, 2006, to comment.

California Proposal Reaffirms ACOEM Practice Guidelines

http://www.acoem.org/news.aspx?id=2502

(Chicago, IL – December 20, 2006) On December 7, the State of

California's Division of Workers' Compensation (DWC) published its

intended modifications to the state's medical treatment utilization

schedule (MTUS) regulations. The proposed revisions reaffirm that the

American College of Occupational and Environmental Medicine's

(ACOEM's) Occupational Medicine Practice Guidelines: Evaluation and

Management of Common Health Problems and Functional Recovery in

Workers, 2nd Edition , are the foundation for the State's Medical

Treatment Utilization Schedule.

The draft regulation also proposes to adopt ACOEM's new rigorous

strength-of-evidence rating methodology. This enhanced methodology,

which ACOEM has adopted for updates to the second edition of its

Guidelines, is designed to produce the most rigorous, reproducible,

and transparent occupational health guidelines available. According to

Tee L. Guidotti, MD, President of ACOEM, " The new methodology ensures

that ACOEM's Guidelines are maintained at the highest achievable

scientific standards for evidence-based literature. "

The 15-day notice of modification was distributed to interested

parties with the revised regulations posted on the DWC web site. The

public has until 5 pm (PT) on December 22, 2006, to comment.

" We are pleased that California has proposed reaffirming that the

ACOEM Guidelines are the foundation for the State's treatment

utilization schedule and are confident that the Guidelines will

continue to serve as a national model for the best standards of

medical diagnosis, evaluation, and medical management in the

workplace, " said ACOEM Executive Director Barry S. Eisenberg.

Other revisions in this draft of the regulations include the following:

* A definition for the term " functional improvement " has been

added to the regulations. The definition is adapted from the medical

treatment philosophy that is incorporated in the ACOEM Guidelines.

* Acupuncture treatment guidelines have been adopted based on the

medical treatment guidelines from the state of Colorado, Division of

Workers' Compensation. The Division notes in the proposal, " ACOEM

remains the foundation for the MTUS, and any supplemental guidelines

including the Acupuncture Medical Treatment Guidelines, must be fitted

to ACOEM as it provides the framework for the MTUS… "

* Increased the size of the medical evidence evaluation advisory

committee to better represent all treatment procedures and modalities

commonly performed in workers' compensation cases. The proposal

requires the committee to use the ACOEM methodology to evaluate

evidence when making recommendations to the DWC.

ACOEM created the Guidelines to improve the efficiency and specificity

of medical diagnosis of workplace-related injuries and diseases,

enhance the effectiveness of treatment, and help occupational and

environmental physicians manage growing caseloads. They were first

published in 1997 and revised in 2003. The Guidelines are presently

undergoing a three-year rotating update. The first update will deal

with elbow complaints and is scheduled for publication later this

month. Updates to the spine and hip chapters are scheduled for early

and late 2007 respectively.

The Occupational Medicine Practice Guidelines: Evaluation and

Management of Common Health Problems and Functional Recovery in

Workers, 2nd Edition , is published by ACOEM. To inquire about the

electronic version or order a print copy of the Guidelines, call ACOEM

at 847/818-1800, or visit www.acoem.org. The Guidelines are $175 for

ACOEM members; $199 for non-members.

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