MEMORANDUM - December 26, 1995

Medical Protocols


TO: Commissioners, Medical Practitioners, the Connecticut Medical Society, all County Medical Societies, the Connecticut Chiropractic Association, the Connecticut Physical Therapy Association, Insurance Carriers, Self-Insureds, Attorneys, Unions, Medical Advisory Panel, and Advisory Board Members
FROM: Jesse M. Frankl, Chairman
DATE: December 26, 1995
RE: Medical Protocols


On December 4, 1995 I issued a directive regarding medical protocols that had been adopted by the Medical Advisory Panel. This memorandum is to provide a clarification and to provide you with additional information regarding the use of the protocols.

The effective date for utilization of the protocols is January 1, 1996 for all injuries. Hopefully the material included in the protocols will be helpful in determining treatment for earlier injuries where it might be appropriate. These protocols apply to all workers whether or not they are included in an approved managed care plan, unless the managed care organization has developed their own protocols, furnished copies of same to their medical providers, and provided education on their use.

Protocols cannot be absolute. There must be room for medical judgment. Medical providers are urged to contact the insurer or managed care organization if they feel that a treatment pattern other than the published protocol is required. It is expected that the payer or managed care organization will work with the provider to ensure that the injured worker receives the most appropriate treatment.

The Workers' Compensation Commission protocols will be used by the Commission to evaluate whether or not payment for the service provided is required. If a managed care organization has published its own protocols and provided the appropriate medical provider training, their protocols will be used to determine appropriate payment.

The Medical Advisory Panel is very interested in feedback regarding these protocols. Please direct your comments and suggestions to my attention for consideration by the panel. With every change in the workers' compensation system, we can expect that there will be some problems with implementation. Therefore, your help in making the process go as smoothly as possible is extremely important.