Therapists lose bid to alter workers’ comp

Art Nadler

Tuesday, Dec. 1, 1998 | 11:15 a.m.

Physical therapists were stunned Monday when the Legislative Committee on Workers' Compensation rejected their proposal to change the way managed care organizations review rehabilitation.

Presently, an insurance company's claims examiner authorizes rehabilitation ordered by an injured worker's physician. That person need not be a trained medical professional.

The Nevada Physical Therapy Association, which met in Las Vegas at the Grant Sawyer State Office Building, had proposed that the committee draft a bill allowing an injured worker to seek a second opinion from a physician.

"A lot of claims examiners say they won't authorize treatment," said Lynn Maguire, president-elect of the association. "We want a medical person making that decision."

But Assemblyman Lynn Hettrick, R-Gardnerville, said the law already allows for second opinions during a health maintenance organization's appeals process. The committee agreed and decided to take no action on the proposal.

The committee also rejected group's request that would have allowed an injured worker to go outside a manage-care organization's approved group of physical therapists.

"Physical therapy is trying to turn back the clock," said Jim Wadhams, a spokesman for the managed-care industry. "The state has gone on the record for supporting managed care. Fee-for-service won't fly."

Allowing for a second opinion would delay the appeals process, Jack Kim, a regulatory representative with the Sierra Health Insurance Group, argued. Kim added that allowing injured workers to go outside a managed-care organization's physical therapy group would not be fair to the therapists who signed contracts.

Janene Izatt, the physical therapist group's secretary, noted normally it takes two weeks to start an appeal and several weeks to get an approval to continue physical therapy.

After an injury, "The beginning of care is the most critical time," Izatt said, adding that group's proposal would have required that a physician review the therapy request within five working days.

"I'm really surprised that the committee did this," Izatt said. She added that the issue could be brought up again once the Legislature reconvenes in February.