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The California Division of Workers’ Compensation (DWC) is issuing a notice of public hearing for the Medical Treatment Utilization Schedule (MTUS) regulations. The proposed rulemaking updates the Chronic Pain Medical Treatment Guidelines and adopts Opioids Treatment Guidelines to the MTUS. A public hearing on the proposed regulations has been scheduled at 10 a.m., September 1, in the auditorium of the Elihu Harris Building, 1515 Clay Street, Oakland, CA 94612. Members of the public may also submit written comments on the regulations until 5 p.m. that day.

“California continues to be on the forefront of evidence-based medicine to treat injured workers, and these regulations will help workers obtain appropriate care,” said Christine Baker, Director of the Department of Industrial Relations (DIR). DWC is a division of DIR.

The proposed Chronic Pain Medical Treatment Guidelines are based on a reformatted version of the April 6, 2015 version of the Work Loss Data Institute’s Official Disability Guidelines (ODG) Treatment in Workers’ Compensation – Pain (Chronic) chapter. The proposed Opioids Treatment Guidelines were developed by DWC based on evidence-based guidelines available as of April 2014 and supplemented with high-level evidence from high-quality studies. The Opioids Treatment Guidelines are divided into two parts: Part 1 contains the executive summary, abbreviated treatment protocols, and complete recommendations, while Part 2 contains supplemental information.

“DWC is concerned about workers who suffer when chronic pain is inadequately treated or when opioid medications are improperly managed,” said DWC Executive Medical Director Dr. Rupali Das. “These are separate, but often related, issues of major public health concern that can lead to devastating consequences, including prolonged disability and delayed recovery.” She added that “we have proposed two complimentary guidelines that provide evidence-based best practices for multidisciplinary approaches to managing chronic pain as well as factors to consider for safe and effective prescribing of opioids for acute, subacute, perioperative, and chronic pain.”

The proposed changes to the MTUS Chronic Pain Medical Treatment Guidelines are set forth in section 9792.24.2 of Title 8 of the California Code of Regulations and the proposed addition of the MTUS Opioids Treatment Guidelines is set forth in section 9792.24.4 of the California Code of Regulations.

DWC will consider all public comments, and may modify the proposed regulations for consideration during an additional 15-day public comment period. The notices of rulemaking, text of the regulations, and the initial statement of reasons can be found on the MTUS rulemaking page.

More information about the rulemaking process can be found in the Office of Administrative Law’s (OAL) website.

California Department of Industrial Relations, www.dir.ca.gov