Does Workers’ Compensation Cover Physical Therapy?

Yes, New York Workers’ Compensation covers Physical Therapy for various physical injuries. Physical Therapy is a commonly prescribed medical treatment following an injury and/or surgery.  The Board has issued Medical Treatment Guidelines for many body parts, most of which include Physical Therapy.  Generally, 12 visits are authorized following an injury.  If your doctor feels you need more than 12 visits, a Prior Authorization Request, or PAR, must be submitted.  This is done through the OnBoard Portal.  Your doctor must lay the objective gains you made with the prior 12 sessions of Physical Therapy.  Your doctor must also specify what objective goals he or she hopes you will achieve with additional Physical Therapy visits.  For example, perhaps your range of motion improved to 90 degrees with the initial 12 visits, and your doctor hopes that 12 additional visits will get you to 120 degrees.

If the insurance company denies the request for additional Physical Therapy, they must sent the request to an Independent Medical Examiner to do a record review.  If that doctor denies the request, your doctor can seek review from the Medical Director’s Office.  This process can take weeks, and could still end up in a denial.  It is important that you have an experienced Workers’ Compensation attorney on your side in the event your Physical Therapy is denied.  At MCV Law, we are very familiar with this process and can help you get your treatment faster, so you can recover and get back to work.

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