BEFORE THE DEPARTMENT OF LABOR AND INDUSTRY
OF THE STATE OF MONTANA
In the matter of the amendment of ARM 24.29.1591 related to utilization and treatment guidelines for workers' compensation injuries
NOTICE OF AMENDMENT
TO: All Concerned Persons
1. On September 2, 2016, the Department of Labor and Industry (department) published MAR Notice No. 24-29-316 regarding the public hearing on the proposed amendment of the above-stated rule, at page 1520 of the 2016 Montana Administrative Register, Issue Number 17.
2. On September 23, 2016, a public hearing was held in Helena on the proposed amendment. Several persons commented on the proposed amendments during the public comment period.
3. The department has thoroughly considered the comments received. A summary of the comments, and the department responses are as follows:
Comment 1: A commenter asked which chapters of the Utilization and Treatment Guidelines were being updated.
Response 1: The "shoulder injury" chapter is being updated, and two new chapters are being added, "cumulative trauma" and "thoracic outlet syndrome." Cumulative trauma and thoracic outlet syndrome were previously contained in the "upper extremity" chapter. The upper extremity chapter is being deleted.
Comment 2: Two commenters stated that the department should not change the "upper extremity" chapter to "thoracic outlet," because the upper extremity guidelines cover more than just thoracic outlet syndrome. The commenters expressed concern that practitioners would be confused by the changes.
Response 2: The department notes that the original "upper extremity" chapter included thoracic outlet syndrome and cumulative trauma syndrome, and was based on a combination of guidelines adopted by the State of Colorado and the American College of Occupational and Emergency Medicine (ACOEM). Since that time, the department has been making annual updates to the Guidelines based solely on those changes adopted by the State of Colorado. The department has elected to follow the recent updates adopted in Colorado, and is following Colorado's decision to separate the chapters and revise the organization with respect to matters formerly covered by the upper extremity section.
The department will continue to provide training to medical providers in the use of the Utilization and Treatment Guidelines. The department is confident that providers will become familiar with the changes, and provide appropriate treatment.
4. The department has amended ARM 24.29.1591 as proposed.
/s/ Mark Cadwallader /s/ Pam Bucy
Mark Cadwallader Pam Bucy, Commissioner
Alternate Rule Reviewer DEPARTMENT OF LABOR AND INDUSTRY
Certified to the Secretary of State December 12, 2016.