Managing Chiropractic Care in Oregon

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By: Megan Vaniman

Chiropractic care is often frequent and long-lasting. Oregon Workers’ Compensation laws limit the time a chiropractic doctor can act as an attending physician. ORS 656.005(12)(b)(B)(i). However, a claimant can continue to receive chiropractic care if an otherwise authorized attending physician continues to prescribe it. Once the new attending physician prescribes the treatment, the chiropractic doctor becomes an ancillary care provider. The chiropractic doctor can continue to treat under a treatment plan authorized by the attending physician. This, of course means, chiropractic care can continue for some time.

Several studies have concluded there is little to no evidence of the effectiveness of chiropractic treatment for acute or chronic low back pain.[1] While this may be the case, it does not simply mean attending physicians will stop prescribing chiropractic care as an ancillary service. Oregon Administrative Rules allow an insurer to challenge ongoing care if it is unnecessary or inappropriate according to accepted professional standards. OAR 436-010-0230. The Oregon Board of Chiropractic Examiners has published Oregon Chiropractic Practices and Utilization Guidelines. This publication can be used to demonstrate what the accepted professional standards are in chiropractic care. The publication provides time-line treatment for common conditions. While this is not a fool-proof method to regulating chiropractic care for the injured worker, it may direct the injured worker toward care that is more effective in returning the worker to his or her job at injury.

http://www.oregon.gov/OBCE/Pages/index.aspx

http://www.oregon.gov/OBCE/publications/pu_guide.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447290/

[1] E Ernst, MD, Chiropractic Care: Attempting a Risk-Benefit Analysis, 92(10) American Journal of Public Health, 1602 (2002).