Bay Terrace resident Keith Shepard said the state put him in a bind after he learned that his workers’ compensation no longer pays for his chiropractic visits.
Shepard said he was lifting barrels off the back of a truck about six years ago when he fell and injured his back. He went to court and was awarded coverage for symptomatic care.
“It allowed me to go two to three times a month, as long as I’m working,” he explained. “People don’t understand: A bad back is like a cold. You can be perfect one day and the next day you can’t get out of bed.”
Shepard said he would go to see his chiropractor every two weeks or so for adjustments, which allowed him to function.
In December, though, the Compensation Board put into effect changes to its medical guidelines, and now he says his chiropractor is not being reimbursed for his visits.
“I didn’t know she wasn’t getting paid. She’s been seeing me for free,” he said.
Chiropractor Scott Schwager, whose practice is in Brooklyn, said he believes it was an effort to cut costs that led the board to rewrite the new guidelines to only cover acute care for recent accidents.
“In essence, they wrote out symptomatic care,” he said. “As a doctor, I see some patients myself as much as 20 years. They continue to work so they don’t have to be a burden to society.”
He said a patient whose care is not classified as acute could fall under the guidelines of continued care, but the chiropractor would have to apply for a variance, one condition of which being that the patient has to show improvement.
“Let’s say 20 years ago someone herniated one or multiple disks. That’s a chronic injury. A guy like that is not going to show improvement,” he said.
Shepard said he thinks twice now before seeing his chiropractor, and that it is against the law for his union insurance to pay for his visits.
“It’s not fair to her. There are almost times that I don’t even want to go,” he said.
At his job now as a mechanic for a large crane company, Shepard said his boss gives him some leeway when he is in pain. He said his options are limited, and the alternatives are unattractive.
“I know I could lie and say I re-injured myself, but I don’t want to do that — lying, sneaking and cheating. I don’t want to be laying at home on disability,” he said.
“These patients are between a rock and a hard place,” Schwager said. “They really pulled the rug out from under them.”
In the meantime, when the state Legislature returns it will consider a bill that will stop the Compensation Board from making the changes to its guidelines retroactive.
“If you’re injured on the job and you got care under a settlement, it’s totally unfair for the board to go back and say out of luck,” said Sen. Tony Avella (D-Bayside), a co-sponsor of the bill.
“In my opinion, people should get whatever compensation granted them before 2010. I understand things change; that’s fine,” Shepard said. “Everybody pays into it. How do they just nonchalantly say, ‘You’re done?’”
Reach reporter Rich Bockmann by e-mail at email@example.com or by phone at 718-260-4574.
©2011 Community News Group
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