The fee schedule for Oregon workers' compensation medical services can be found on our website at www.oregonwcdoc.info under the title "Fee Schedule." There is a fee schedule calculator that will calculate payments based on the date of service and the maximum allowable payment table for the concurrently effective rules, which can be viewed in pdf or Excel format.

Call the insurer. If you do not receive a call back within 48 hours, or you are not satisfied with the response you receive, you can request administrative review by the director. The deadline for requesting administrative review is 90 days from the mailing date of explanation of benefits (EOB). (Form 2842)

You can either send us the signed explanation of benefits with supporting documentation (copy of CMS-1500 and chart notes), and indicate what you believe is incorrect, or you can fill out the Form 2842 (and 2842a when your disputing a reduction in payment). Let us know what steps you have already taken in trying to resolve the issue with the insurer.

Because an insurer is required to include all the bills in its possession at the time of the DCS agreement, you may request the director to review the issue and determine if your bills should have been included in the settlement.

If the director finds in your favor, the director may order the bill paid at either the billed amount or the fee schedule, whichever is less.

Controlling statutes: ORS 656.313(4) and ORS 656.325 (4)

Per OAR 436-009-0015(6), the following treatments are excluded from compensability:

OAR 436-009-0015 (10) requires the use of this modifier to identify when the service billed for was performed by a physician assistant or nurse practitioner.

The Oregon workers' compensation fee schedule allows these providers to be paid at 85 percent of the physician's allowed fee for the service.

When physician assistants or nurse practitioners perform services as surgical assistants then they are paid at 15 percent of the surgeon's fee.

When they are the primary provider of the surgical service, they are paid at the 85 percent rate of the physician's fee schedule.

The only no-show appointments you can charge for are the following:

Workers' compensation insurers are not required to pre-authorize diagnostic services, such as an MRI. Bill the responsible workers' compensation insurer like you would any other medical service. If the insurer does not pay the bill, then you may file a dispute and request administrative review. (Form 2842)

Insurers are required by Oregon statue and rule to pay for exams arranged by the director, such as a physician review exam. Fax the following to the Medical Section Resolution Team:

Fax the above documents to 503-947-7629. The Resolution Team will contact you with the results of the review.

Controlling statutes: ORS 656.262

Tell the employer that providers are not allowed to bill anyone but a workers' compensation insurance company when it is a work-related injury. The law requires those claims to be reported to the insurer.

Employers believe that because they have heard they can pay for nondisabling claims and not have it count against their experience rating, that it means they can pay directly. The employer should know that the bill has to be submitted to the insurance carrier in order for the employer to receive the discounted rate of the fee schedule.

Note: The right of an employer to reimburse on nondisabling claims is predicated on multiple conditions: The claim is actually classified as nondisabling, the claim is accepted by the insurer as a work-related injury, and the employer has an agreement with the insurance carrier to reimburse on these claims.

If the insurer denies the claim by the 14th day after the employer knows of the claim, the insurer is not liable for any medical services.

If the insurer denies the claim after the 14th day after the employer knows of the claim, the medical services may be payable under interim medical benefits rules.

Payments for medical services under the interim medical benefits may be made if all of the following apply:

When treating workers' compensation patients, you only need to complete and have the patient sign Form 827 for these circumstances:

If this is the first report of injury or disease, be sure to give the worker a copy of Form 827 and Form 3283 included with the Form 827. You must send the form to the insurer within three days (72 hours). For all other circumstances listed above, you have five days to mail the form.

Do NOT ask the worker to sign Form 827 when you use the form for the following reports:

The medical office should offer the patient the 827 form. If the patient declines to sign it, the medical provider should keep a copy of the 827 form in the file with the notation that the patient has declined to sign the form to file a claim. Patients need to understand that they may have a limited amount of time to file a claim after being treated for a work-related condition. Patients also need to understand that their health insurance, if they have any, may not pay for the visit and they may be personally liable.

Note: There is no requirement that patients file a claim, so long as it is the their choice not to file.

Providers should document the patients' request to withdraw, and maintain the withdrawal of Form 827 in the patients' file.

Note: If medical providers have already submitted Form 827 to the insurer, then the patients will have to write to the insurer to notify the insurance carrier they are withdrawing the claim.

As of April 1, 2011, if you are prescribing one of the seven listed brand-name drugs, you are required to fill out and submit Form 4909 to the appropriate workers' compensation insurance company.

For more information on Form 4909, see Bulletin 361

While the rules do not set a timeframe for submission of the form, the division recommends that you submit Form 4909 to the insurer as soon as possible. This may help prevent any misunderstanding or issues associated with prescribing one of the listed brand-name drugs.

We wanted to alert you to the high cost of these drugs and remind you that there may be a therapeutically equivalent, lower cost alternative.

No.

No. The rule does not place responsibility on the workers. You may ask workers to start with one of the less expensive drugs, but the workers will still receive needed medications for their compensable injury or illness.

No. You only have to fill out and submit Form 4909 for any new prescriptions you prescribe on or after April 1, 2011, for one of the seven listed drugs.

There really isn't anything the insurer can disagree about. If the insurer has questions or concerns, they will contact you.

If you have any questions, you can each the division's Medical Section either by phone at 503-947-7606, or by e-mail at mwcd.medicalquestions@state.or.us.

No. The listed alternative drugs are suggested drugs only, not required drugs. Also, you only have to fill out and submit Form 4909 for any new prescriptions for one of the seven listed "high-cost drugs," not for any other medications.

Yes, multiple reporter filings are accepted.

Insurers and self-insured employers are required to report all paid and denied medical bills on accepted claims within 60 days of the date of bill payment or denial. Per OAR 436-010-0005: "Medical Service" means any medical treatment or any medical, surgical, diagnostic, chiropractic, dental, hospital, nursing, ambulances, and other related services, and drugs, medicine, crutches and prosthetic appliances, braces and supports, and, where necessary, physical restorative services.

Please check the file name; that has been the most frequent error to date. For our File Naming Convention, see Question No. 17 below. Files that are misnamed will not be recognized by our file retrieval program, and can't be processed.

A TA1 acknowledgment means there was an Interchange-Level error that prevented us from creating a 997 acknowledgment. There's a structural error with your file that must be corrected before resubmission. The TA1 file name will be formatted just like all our other file names (see below), but ending in "TA1" instead of "997."

Medical bill files can be submitted daily during testing or on a different day than initially indicated. Once production status has been achieved, the division wants to predict and balance the processing of the submitted data load, so it is better for our submitters to send files on the day of the week that has been agreed to.

We require a Trading Partner Agreement and Transmission Profile from all data reporters. We do not require an Agreement from each carrier or self-insurer.

ID Code Qualifier = FI (FEIN)
Receiver FEIN = 930952020
Receiver Postal Code = 97301

Reconsiderations must be sent one of two ways. For example, if the original provider bill was for $100, and you paid $50 and then reconsidered and paid an additional $25, you could do either of the following:

1. Send a replacement (05) transaction, to replace it with the total reconsidered amount ($75)

2. Send a cancellation (01) transaction to remove the original payment ($50) and send another original (00) transaction with the total reconsidered amount ($75)

The list of insurers and self-insured employers (Bulletin 359) required to report medical bill data in Oregon can be found on our website: http://www4.cbs.state.or.us/ex/ins/inslic/company/search/index.cfm.

Yes. The division accepts all Oregon medical bill data, including those submitted voluntarily. In order to encourage reporting for nonrequired insurers, we will send an additional error message: "DN0006 Insurer FEIN: Error Code 039, No Match on Database" for any bill transactions from nonrequired insurers that reject for other data errors. That way, submitters can segregate those errors if they do not want to correct and resubmit them.

ANSI medical bills must be reported and accepted within 60 days of the date of bill payment or denial. Files can be submitted to the division on a weekly or monthly basis, depending on volume, but allow enough time for timely correction and resubmission of rejected transactions. If your expected volume is high, we prefer you report on a weekly basis. This will allow us to give quicker feedback on submissions and reduce the size of any error reports that may need to be processed after each submission.

To provide your company's technical contact for setting up SFTP filing, contact Ed Lanssens, WCD's EDI coordinator, at 503-947-7742 or by e-mail at ed.c.lanssens@state.or.us. Ed will then e-mail or call your technical contact person to get the process started.

Files are processed seven days a week, after 5 p.m. Pacific Time. Any files that are submitted before the 5 p.m. cut-off time will be processed that evening, and both 997 and 824 acknowledgments will be dropped off to your SFTP mailbox overnight. Files submitted after 5 p.m. will be processed on the next business day and the acknowledgments will be returned overnight.

Yes, sending information for multiple carriers in a single file is acceptable. For the 837 file name, the FEIN is required as part of the name. Some businesses support two different lines and have two different FEINs.

You can pick one of your FEINs and use it for all of your reporting. Just make sure to let us know, as part of the reporter profile information, so that we can set up our reporter FEIN table for matching purposes.

EDI filing of medical bills in Oregon is governed by the Division 160 Rules and can be found on our EDI webpage at http://www.cbs.state.or.us/wcd/operations/edi/ediindex.html.

Yes, the division is using the suggested IAIABC format, which is:

An example of the 837 File name is as follows:

OR_123456789_T_20080101_120100_001_837

The corresponding acknowledgement files would be named:

If the division does not require it, then we will skip it. An optional field will not cause a transaction to reject.

If the division does not require it, then we will skip it. An optional field will not cause a transaction to reject.

Although this is listed as optional, the division strongly suggests that reporters include a unique batch control number to help them match acknowledgments to submissions. We will return the reported batch control number in our 824 acknowledgement, even if it is all zeroes.

No, we will not be validating provider license prefixes. You only need to report the provider license number when the provider does not have an NPI. You are encouraged to collect and report the NPI for all providers.

Yes, we require reporting of denied bills on accepted claims. A denied bill is defined as any bill in which there is a non-zero charge and a zero payment.

We have found quite a few loop segment problems. Even if we have not specified required data fields in segments that begin the loop containing the required data, the (loop-starting) segment itself must be present, or else a structural error will be triggered. For example, NM1 indicates that a new loop is starting and should be used, with asterisks showing the presence of the fields/absence of data, before the group of REF segments indicating a provider's license number, NPI, etc.

We do not consider it a structural error if a segment that we do not use is reported. However, those unutilized segments must be structurally correct, including proper codes, as defined in the IAIABC manual.

There may be two scenarios: 1. The PBM pays the pharmacy and then submits that bill payment to us. The insurer pays the PBM and that bill is also submitted to us (two bills). 2. The PBM pays the pharmacy and does not submit that bill payment to us. The insurer pays the PBM and that bill is submitted to us (one bill).

In the first case, the PBM will send us a replacement bill (same unique bill identification as the one originally submitted to us) when the insurer/self-insured pays the PBM. Each bill will have its own received and paid dates.

In the second case, the PBM sends us an original bill telling us how much the insurer paid the PBM, along with the received and paid date. We will not know how much the PBM paid the pharmacy, or when that payment was made.

There may be two scenarios: 1. The PBM pays the pharmacy and then submits that bill payment to us. The insurer pays the PBM and that bill is also submitted to us (two bills). 2. The PBM pays the pharmacy and does not submit that bill payment to us. The insurer pays the PBM and that bill is submitted to us (one bill).

In the first case, the PBM will send us a replacement bill (same unique bill identification as the one originally submitted to us) when the insurer/self-insured pays the PBM. Each bill will have its own received and paid dates.

In the second case, the PBM sends us an original bill telling us how much the insurer paid the PBM, along with the received and paid date. We will not know how much the PBM paid the pharmacy, or when that payment was made.

No, there is no generic NDC code. All OTC drugs have their own NDC code associated with them. If you pay for OTC drugs, indicate the correct NDC code on the line.

We want the pharmacy's information (NPI), not the individual pharmacist's NPI or license number. All pharmacies in Oregon are licensed, and most, if not all, should have NPIs. If a pharmacy does not have an NPI, you must report the pharmacy's state license number.

Yes, we expect the "billing" provider's FEIN, the one who is being paid. In some cases, the "billing" provider does not have a state license number, i.e., billing companies that bill on behalf of the pharmacy.

For pharmacy bills, we expect only the rendering provider's NPI, i.e., the pharmacy's NPI. There is no rendering line provider for pharmacy bills.

The one exception to this is for physician-billed drugs on the CMS 1500 form. In this case only, if the rendering bill provider is different from the rendering line provider, then provide the rendering line provider's NPI on the correct line in box 24J. The rendering bill provider's NPI goes in box 33a.

We require the pharmacy's NPI or, if the pharmacy does not have an NPI, the state license number. If one of these numbers is not available, then you must use the default of 99999.

All pharmacies in Oregon must be licensed, so even in those rare instances when the pharmacy may not have an NPI, the pharmacy will always have a state license number. We highly recommend you contact those entities who report pharmacy bills to you and alert them that the NPI or state license number should be collected and reported for all pharmacy bills reported to Oregon.

A fee discount agreement is an agreement between an insurer or self-insured employer and a medical service provider or clinic for the purpose of discounting payments under OAR 436-009-0040. An insurer may only apply a discount to a medical service provider's or clinic's bill when the provider or clinic has entered into a fee discount agreement. However, if the worker has been enrolled in a managed care organization (MCO), the MCO discount rate must be applied, even when the parties have entered into a fee discount agreement. See OAR 436-009-0018 and -0040.

Fee discount agreements created under OAR 436-009-0018 only apply to medical service providers and clinics. OAR 436-010-0005 defines a medical service provider as a person duly licensed to practice one or more of the healing arts. OAR 436-009-0005 defines a clinic as a group practice in which several medical service providers work cooperatively.

Under the administrative rules, an insurer may not apply a provider-network discount rate (other than a discount under a managed care organization contract) to a medical service provider's or clinic's payments calculated under OAR 436-009-0018. Insurers may apply provider-network discounts to other medical providers such as an ambulatory surgical center or hospital, supplies under the rules, or when the director has not adopted a fee schedule. However, those contracts or agreements are not reported through the online registration form. Only fee discount agreements are required to be reported.

No. OAR 436-009-0018(1) places a limitation on the types of contracts or agreements the insurer may apply to a medical service provider's or clinic's billing. The rule provides that an insurer may only apply an MCO discount rate, or fee discount agreement discount rate to a medical service provider's or clinic's bill. Because there is a limitation, if an insurer applies any other type of discount rate, such as a provider network discount that is not a certified MCO, the insurer may be subject to penalties and sanctions.

No. It is considered a disagreement about the service provided, not the discount rate. However, the insurer's decision is subject to administrative review if the provider requests a review.

OAR 436-009-0100(2) applies when an insurer and medical service provider have entered into a fee discount agreement and the insurer applies an incorrect discount rate. For example, an insurer may be subject to civil penalties if the parties enter into a fee discount agreement for a discount rate of 5 percent, but the insurer applies a 10 percent discount to the provider's bill. The director's decision may be appealed to the Workers' Compensation Board in the same manner as any other civil penalty.

No. The rule requires that the insurer respond with some type of answer within 48 hours. An answer can include a short response with assurances of a more complete answer to follow.

No. OAR 436-009-0018(2) states, "Any discount under a fee discount agreement cannot be more than 10 percent of the fee schedule." The rule does not place a limitation on the discount rates a managed care organization may negotiate and apply.

An insurer or someone acting on behalf of the insurer may conduct utilization review and case management activities as part of its business operations.

However, only a provider network that has certified with the director as a managed care organization may limit choice of providers available to an enrolled worker or compel a provider to adhere to specific guidelines, protocols, or standards adopted by the MCO. An example of behavior to compel specific performance is when a provider is threatened with being removed from an MCO panel unless the provider conforms to the MCO's treatment guidelines.

When a worker is not enrolled in an MCO, the worker may choose any provider allowed under ORS chapter 656, unless the worker has exceeded three initial choices. Through utilization review and case management activities, the insurer or someone acting on behalf of the insurer may not compel the provider to pursue specific or suggested treatments. If the insurer disagrees with the treatment choices of the provider, the insurer may request administrative review to resolve the disagreement.

No. Under the administrative rules, an insurer may not apply a provider-network discount rate (other than a discount under a managed care organization contract) to a medical service provider's or clinic's payments calculated under OAR 436-009-0040. However, insurers may apply provider-network discounts to other medical providers or supplies under the rules, or when the director has not adopted a fee schedule.

The rule very narrowly defines a "fee discount agreement" as a contract between a medical service provider and an insurer. Insurer is defined to be the State Accident Insurance Fund Corporation (SAIF), an insurer authorized to transact workers' compensation insurance in the state under ORS chapter 731, an assigned claims agent under ORS 656.054, or an employer or employer group certified under ORS 656.430 as meeting self-insured qualifications under ORS 656.407. As a result of that narrow definition, the insurer must be a party to the fee discount agreement.

No. The fee discount agreement is between the insurer and the provider, but only the insurer needs to register the agreement with us.

The online registration is only for the insurer or self-insured employer to sign up once they have entered into an agreement with a provider. Starting Jan. 1, 2009, medical service providers and clinics may enter into fee discount agreements with insurers and self-insured employers. Once the insurer and provider sign the agreement, the insurer must register the agreement online with the division.

Insurers and self-insured employers must report agreements online before applying a discount. The agreement (Form 3659) must be on the provider's letterhead to be valid. Once that is done, anyone may go and view the report that lists the insurer and providers they have agreements with.

Partially, we collect proprietary information through the online registration process. Individuals visiting the website will be able to generate a report that will identify which medical service providers or clinics have fee discount agreements, but it will not contain any proprietary information such as discount rates.

No. The agreement may not be changed once the insurer reports the agreement. However, an active agreement can be terminated and the insurer and medical service provider or clinic may enter into a new fee discount agreement. The insurer must report the new fee discount agreement once the insurer and the medical service provider or clinic has signed the new agreement.

An MCO is a health care provider or group of medical service providers who are certified by the DCBS director. MCOs contract with insurers and self-insured employers to manage medical care for injured workers.

Your employer's workers' compensation insurance company enrolls you in the MCO. In order for you to be enrolled in an MCO, the insurer or self-insured employer must send you an MCO enrollment letter notifying you of your enrollment, including the name of the MCO.

You become subject when you receive your MCO enrollment letter or the third day after the insurer mails it to you, whichever occurs first.

Currently there are five MCOs in Oregon, and they vary by geographical service area (GSA).

You will not be subject to an MCO agreement if you live 100 miles or more outside the geographical service area (GSA). Workers must be able to access an MCO provider within a reasonable distance from their place of employment and their home.

Yes, but your family doctor or nurse practitioner must agree to meet certain conditions and the MCO must authorize him or her to provide your medical treatment.

First try contacting the MCO in which you are enrolled. If you are still having problems finding a provider or scheduling an appointment, contact WCD.

Yes. You have the choice of up to three physicians, but you must choose physicians within the MCO. When you are required to change to a physician that is on the MCO panel as a result of your enrollment, you still have the right to change physicians two more times.

Yes. Every MCO has a dispute resolution process (DRP). Administrative rules require that your MCO provide you with a summary of their DRP upon request.

If you choose not to treat with the MCO physician after you have been informed that your claim has been enrolled with an MCO, your employer, insurer, or both have the right to suspend your benefits.

No. Workers are not subject to managed care contracts that expire or terminate without renewal. However, a worker may continue to treat with his or her attending physician or authorized nurse practitioner under an expired or terminated managed care contract if that physician or authorized nurse practitioner agrees to comply with the rules, terms, and conditions under any subsequent managed care contract to which the worker is subject.

Yes. No later than three days before the contract's expiration or termination date, an insurer must simultaneously provide written notice to the worker, the worker's representative, all medical service providers, and the MCO that the worker is no longer subject to the managed care contract. The worker also must be informed of the manner in which medical services may be obtained after the worker is no longer subject to the contract.

An insurer or self-insured employer may disenroll a worker from an MCO even when a contract is not expired or terminated. In this case, no later than seven days before the date the worker is no longer subject to the contract, the insurer must simultaneously provide written notice of disenrollment to the worker, the worker's representative, all medical service providers, and the MCO. The insurer must also inform the worker of the manner in which the worker may receive compensable medical services after the worker is no longer enrolled.

Only insurers or self-insured employers can contract with an MCO. If you have workers' compensation coverage through an insurance company, contact your insurer to discuss options possibly available to obtain managed care services with an MCO.

You will need to contact the MCO directly. If the MCO denies your request to participate, they must provide a written explanation.

All the information you need to become authorized to perform independent medical exams (IMEs) is on our website at www.oregonwcdoc.info under the title IME & WRME.

You are required to either read the IME provider guide, view an IME DVD provided by the DCBS director, or attend a training that has been approved by the DCBS director. Once you have completed the training, you need to complete the IME application, which is also online. The staff in the Medical Section/Outreach Team will review your application for completeness and verify you are in good standing with the medical boards. You will receive a letter either approving or denying. If your application is received and it is not complete, we will contact the provider to resolve those issues.

Beginning Jan. 2, 2008, chiropractic physicians must certify with the director of the Department of Consumer and Business Services before they can treat patients with Oregon workers' compensation claims. You will find all the documents you need to review and the application at www.oregonwcdoc.info or by clicking here for chiropractors.

Once you have submitted your application online, your name will be added to your database for certified authorized care providers and you may treat patients with Oregon workers' compensation claims.

Since Jan. 2, 2008, every chiropractor, naturopathic physician, and physician assistant must certify to the director of the Department of Consumer and Business Services that they have read informational materials about the workers' compensation system before treating any patient with an Oregon workers' compensation claim, whether they assume the role of attending physician or not. This certification requirement also applies to similarly licensed providers outside of Oregon that treat any patient with an Oregon workers' compensation claim.

Effective Jan. 1, 2012, podiatrists are classed as type A attending physicians and do not need to certify to treat and receive payment for Oregon injured workers.

House Bill 2756 allows chiropractors, naturopathic physicians, and physician assistants to be attending physicians on the initial claim for up to 60 days or 18 visits, whichever occurs first, from the first visit to any of these attending physicians. Podiatrists are no longer limited to 60 days or 18 visits.

House Bill 2756 allows chiropractors, naturopathic physicians, and physician assistants to authorize time loss for up to 30 days from the first visit to any chiropractor, naturopathic physician, podiatrist, or physician assistant on the initial claim. Podiatrists are no longer limited to 30 days of time-loss authorization.

Type B attending physicians are only granted attending physician status on the initial claim. The initial claim refers to the time period of the claim, starting from the date the worker files the claim until the worker becomes medically stationary. If a worker sees a type B attending physician after he or she has been declared medically stationary, or the claim has been closed, the type B attending physician must refer the worker to a type A attending physician.

The time period the type B attending physician is allowed to be an attending physician is a cumulative amount of time. Once the worker has reached 60 days or 18 visits from the date of first visit with the type B attending physician, the worker may not see another type B attending physician. At the end of the 60 days or 18 visits, the worker must be referred to a type A attending physician or authorized nurse practitioner. The 60 days or 18 visits start even if that first provider (type B attending physician) has failed to certify to the director.

Except chiropractors, type B attending physicians are not allowed to make impairment findings.

Example:
Jan. 10, 2008
The worker sustains a compensable injury and starts treatment with a medical doctor who assumes the role of the attending physician.

April 1, 2008
The worker selects a naturopathic physician to assume the role of attending physician. The naturopathic physician was the worker's attending physician for 30 days and authorized time-loss benefits from April 1 through April 15.

May 1, 2008
The worker goes to a chiropractor that becomes the worker's attending physician. Because it has now been 30 days since the worker first saw the naturopathic physician, the chiropractor is not allowed to authorize any further time-loss benefits. Additionally, remember that podiatrists, chiropractors, naturopathic physicians, and physician assistants are only allowed to serve as the attending physician for up to 60 calendar days or 18 visits from the first visit to any of these providers. Since the worker saw a naturopathic physician for the first time on April 1, the chiropractor is now only allowed to serve as the attending physician until May 30 (60 days from April 1).

Except chiropractors, type B attending physicians may not make impairment findings. If the worker appears to have any impairment, a naturopathic physician or a physician assistant must refer the worker to a type A attending physician for a closing exam. A naturopathic physician or physician assistant may determine that the worker is medically stationary with no impairment. However, if naturopathic physicians or physician assistants suspect there may be some residuals due to the injury, they must refer the worker to a type A attending physician or a chiropractor.

House Bill 2756 does not apply to managed care organization (MCO) enrolled workers. MCOs are not required to allow chiropractors, naturopathic physicians, or physician assistants as attending physicians; however, an MCO may do so if it chooses.

When the first visit is before Jan. 2, 2008, the following applies: If the worker's first visit to a chiropractor, naturopathic physician, podiatrist, or physician assistant on the initial claim is before Jan. 2, 2008, the attending physician authority introduced by House Bill 2756 does not apply. However, the requirement that providers certify to the director after Jan. 2, 2008, remains, even if the worker's first visit was before Jan. 2, 2008.

Example:
Dec. 15, 2007
A worker is injured, and he sees a podiatrist the same day he is injured. The podiatrist can treat the worker for 30 days from the date of injury without assuming the role of attending physician and without the authorization from an attending physician.

Jan. 14, 2008
The worker must now choose an attending physician or an authorized nurse practitioner.

In this example, the worker's visit to the podiatrist triggered the application of the old law, because that visit was before Jan. 2, 2008. Under the old law, a naturopathic physician, podiatrist, or physician assistant is allowed to treat a worker for 30 days or 12 visits from the date of injury without the authorization from an attending physician but is not allowed to assume the role of attending physician. Under the old law, a chiropractor may assume the role of attending physician for 30 days or 12 visits from the date of the first visit, any time during the initial claim.

Jan. 1, 2012
A podiatrist may now act as a type A attending physician.