Periodically, either the treatment of or nature of an injured worker’s disability may require you to recommend additional conditions. For example, a claim may be allowed for a lumbar sprain/strain, but additional diagnosis and treatment reveals that a herniated disc is the underlying cause of the injured worker’s disability. By law, this condition must be added to the claim to pay compensation to the injured worker and reimburse providers for their services.
The policy for requesting additional allowances establishes guidelines for processing physician recommendations for additional allowance(s). In addition, this policy improves coordination and communication between BWC, Managed Care Organizations (MCOs) and providers as a result of BWC’s proactive allowance consideration.
See the How a Medical Provider Recommends an Additional Condition fact sheet for additional information.
See additional information about BWC’s additional allowance policy