Tips on Handling Workers’ Comp Claims Involving Chiropractic Care

By Denise Johnson | January 26, 2015

  • January 28, 2015 at 12:59 pm
    Cynthia Tays says:
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    Please note that to my knowledge there is no such word as “chiropracty”. In fact, my computer just tried to correct it automatically as I wrote that last sentence. The proper term is chiropractic.

  • January 30, 2015 at 7:20 pm
    Tony Kim says:
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    I feel that your source Dr. Marc Gilerovich was just fishing for issues to talk about. The subluxationists are the least likely to cause trouble for WC adjusters because they don’t treat WC. In fact, they are mostly cash based and would even take managed care cases even.

    As for those treaters who treat and treat and treat, it’s out of greed. That has nothing to do with chiropractic philosophy. I have acquainted with quite a few of those over utilizers and none of them were subluxation based practitioners. They were just greedy and did it for the bottom line.

    As for the decompression system, one can’t bill thousand of dollars because like the source stated, it’s just a glorified traction machine. I don’t care how expensive it is. If it’s traction you bill traction and there’s only one CPT code for it. The majority of the bill comes from the other adjunct therapy they perform on top of traction. However, WC in most jurisdiction limits amount of treatment per day. For example, here in CA, one is limited to 60 minutes or 4 units of therapy per session. Bill can hardly go over $80/visit and UR prevents over utilization. I don’t see how decompression practitioners would bulk up the bill with WC. That only happens with cash practice where those greedy practitioners are likely to add-on many services in addition to decompression and charge as a package deal for several months worth of treatments.

    I really feel you need to get a source who’s business savvy as your source missed all marks.

    • February 8, 2015 at 9:58 pm
      Dale Giessman DC says:
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      Tony is very correct on his post. As a chiro I cannot buy into the 3x week until my kids college is paid for. And UR is brutal in California so good luck with that anyway. As for decompression I bill the traditional traction code, not adequate compensation but if the patient benefits I still apply it. Chiro properly applied is still the best for musculoskeletal back or neck pain.

  • August 18, 2016 at 6:55 pm
    Patrick suckoo says:
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    The 3x for 2 was is nonsense. You will be referring most of your patients if you followed that rule. I had a patient who fell in her bathroom and fractured C5. She presented in my office with complete paralysis. she practically came in a body bag. I treated her every day for one month after which she was able to walk again. The only option the medical Drs had for her was to do surgery with no guarantee.

  • July 24, 2019 at 12:35 pm
    Ben McCay, DC says:
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    Most of the post is fairly accurate, but a few things are in error.
    1) Subluxation is NOT a misalignment of bones. This is an old-school way of thinking that has been shown time and again to be incorrect. “Loss of motion” or “segmental dysfunction” is a more accurate way to describe subluxation, and this is how the younger generation of chiropractors are taught.
    2) The gold standard of any physical rehab (including chiropractic) combines manual therapy WITH exercise therapy. Chiropractic by itself is not the gold standard. But it is true that chiropractic schools teach the 2-week trial of care. Logan University teaches that an appropriate trial of care is either 3x/ week for two weeks OR 2x/ week for three weeks. But a two-week trial is preferred.
    3) There is significant literature to suggest that if objective functional improvement can be demonstrated after the two-week trial of care, then ongoing care may be reasonable. While MOST people recover within 1-2 months, there are always outliers and should the effectiveness of treatment be continually demonstrated then ongoing care might be reasonable. If a duration cap were to be applied, then it should be around the 12-16 week mark as literature does not provide strong support for ongoing passive therapy beyond the 12-week mark.



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