State of California Division of Workers’ Compensation
Carrie Nevans, acting administrative director
Newsline No. 33-09
June 23, 2009
For Copy of New Regs
Division of Workers’ Compensation new medical treatment utilization schedule regulations approved by
Office of Administrative Law New schedule becomes effective July 18, 2009
The Division of Workers' Compensation (DWC) has adopted new regulations updating the medical
treatment utilization schedule (MTUS), commonly referred to as medical treatment guidelines. The final
regulations were filed with the secretary of state on June 18, 2009 and become effective July 18, 2009. The
regulations add a new section for chronic pain and postsurgical physical medicine treatments to the MTUS,
as well as updating the chapter on treatment of elbow injuries. The regulations also restructure the MTUS
into a clinical topics format, which will allow for easier updates in the future.
“In addition to adding the new sections for chronic pain and postsurgical treatment, the clinical topics format
allows us to make future updates on a chapter by chapter basis,” said DWC acting Deputy Administrative
Director Destie Overpeck. “In this way, we can continuously incorporate quality, evidence-based treatment
for injured workers, which help them recover quicker and keep costs down for employers.”
The postsurgical section sets forth an exception to the 24-visit limit for therapeutic and chiropractic care for
postsurgical physical medicine and rehabilitation services. The section is based on the Official Disability
Guideline (ODG) with approximately one third based on evidence-based reviews (EBRs) by the DWC in
conjunction with the Medical Evidence Evaluation Advisory Committee (MEEAC). The section applies during
the postsurgical physical medicine period. The section also establishes the goal that therapy should result
in functional improvement, patient education and self-management of symptoms. It covers approximately
130 surgeries.
The chronic pain section provides for treatment of close to 200 chronic conditions. The section is based on
the ODG, but contains an introduction written with input from the MEEAC. It also contains additional
treatment recommendations based on EBRs. The section is evidenced-based and stresses the
importance of returning patients to work through the use of treatments that show functional improvement
and independence.
The revised elbow chapter reflects an update from ACOEM.
The regulations, found in the California Code of Regulations, Title 8, sections 9792.20 through 9792.26, are
authorized by Labor Code sections 4604.5 and 5307.27.
Non-substantive changes were made to the text of the regulations. The approved regulations, as filed with
the secretary of state, can be found on the DWC Web site at: http://www.dir.ca.
gov/dwc/DWCPropRegs/MTUS_Regulations/MTUS_Regulations.htm.
The final statement of reasons for the rulemaking, a summary of public comments made during the
rulemaking, and the division’s responses to those comments are also available on the Web site.
Carrie Nevans, acting administrative director
Newsline No. 33-09
June 23, 2009
For Copy of New Regs
Division of Workers’ Compensation new medical treatment utilization schedule regulations approved by
Office of Administrative Law New schedule becomes effective July 18, 2009
The Division of Workers' Compensation (DWC) has adopted new regulations updating the medical
treatment utilization schedule (MTUS), commonly referred to as medical treatment guidelines. The final
regulations were filed with the secretary of state on June 18, 2009 and become effective July 18, 2009. The
regulations add a new section for chronic pain and postsurgical physical medicine treatments to the MTUS,
as well as updating the chapter on treatment of elbow injuries. The regulations also restructure the MTUS
into a clinical topics format, which will allow for easier updates in the future.
“In addition to adding the new sections for chronic pain and postsurgical treatment, the clinical topics format
allows us to make future updates on a chapter by chapter basis,” said DWC acting Deputy Administrative
Director Destie Overpeck. “In this way, we can continuously incorporate quality, evidence-based treatment
for injured workers, which help them recover quicker and keep costs down for employers.”
The postsurgical section sets forth an exception to the 24-visit limit for therapeutic and chiropractic care for
postsurgical physical medicine and rehabilitation services. The section is based on the Official Disability
Guideline (ODG) with approximately one third based on evidence-based reviews (EBRs) by the DWC in
conjunction with the Medical Evidence Evaluation Advisory Committee (MEEAC). The section applies during
the postsurgical physical medicine period. The section also establishes the goal that therapy should result
in functional improvement, patient education and self-management of symptoms. It covers approximately
130 surgeries.
The chronic pain section provides for treatment of close to 200 chronic conditions. The section is based on
the ODG, but contains an introduction written with input from the MEEAC. It also contains additional
treatment recommendations based on EBRs. The section is evidenced-based and stresses the
importance of returning patients to work through the use of treatments that show functional improvement
and independence.
The revised elbow chapter reflects an update from ACOEM.
The regulations, found in the California Code of Regulations, Title 8, sections 9792.20 through 9792.26, are
authorized by Labor Code sections 4604.5 and 5307.27.
Non-substantive changes were made to the text of the regulations. The approved regulations, as filed with
the secretary of state, can be found on the DWC Web site at: http://www.dir.ca.
gov/dwc/DWCPropRegs/MTUS_Regulations/MTUS_Regulations.htm.
The final statement of reasons for the rulemaking, a summary of public comments made during the
rulemaking, and the division’s responses to those comments are also available on the Web site.
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