Medical Benfits: Chiropractors

Thirsk v. State Fund [5/11/99] 1999 MTWCC 34 Claimant sought compensation for 56 chiropractic adjustments over 9 month period, all incurred after insurer informed him it would no longer cover chiropractic treatment for him. Persuasive medical evidence, along with statements made by claimant, indicated claimant had reached maximum medical healing and the chiropractic treatments were maintenance treatments, not actually leading to improvement in claimant. WCC held that under section 39-71-704, MCA (1993), the insurer was responsible for primary and secondary medical services as defined in the statute. Under the circumstances of this case, the chiropractic treatments were not primary medical services. The insurer was liable for secondary medical services only upon a clear demonstration of cost effectiveness of the services in returning the injured worker to actual employment. Claimant did not make this demonstration. Indeed, the evidence showed the treatments provided no more than temporary relief and did not improve his condition.

Murphy v. CIGNA Companies [10/15/98] 1998 MTWCC 73 A 73-year old claimant receiving PTD benefits following severe 1979 back injury sought coverage of chiropractic treatment on as-needed basis for flare-ups of back condition. Chiropractor testified flare-ups were inevitable and treatments provided only temporary relief. WCC followed Synek v. State Compensation Mutual Ins. Fund, WCC No. 9401-6989, Order on Appeal (August 26, 1994), aff'd 272 Mont. 246, 900 P.2d 884 (1995), which applied section 39-71-704, MCA, and ARM 24.29.2003 and -2004, to find not compensable chiropractic treatments providing only temporary relief and not restoring claimant to either a preclinical or stationary status.
Cary v. Lumbermens Mutual Casualty Co. [7/7/95] 1995 MTWCC 56 Under 1993 statutes, claimant proved that adjunctive therapy provided by chiropractor was part of a treatment plan formed in conjunction with her treating physician and thus was authorized, compensable medical services