Periodically, either the treatment of or nature of an injured worker’s disability may require you to recommend additional
conditions. For example, a claim may be allowed for a lumbar sprain/strain, but additional diagnosis and treatment reveals that a
herniated disc is the underlying cause of the injured worker’s disability. By law, this condition must be added to the claim to
pay compensation to the injured worker and reimburse providers for their services.
The policy for proactive allowance establishes guidelines for processing physician recommendations for additional allowances and improves coordination and communication between BWC, MCOs and providers
on the result of BWC’s proactive allowance consideration.
BWC’s proactive pursuit of additional allowances provides the physician an opportunity to deliver services to an injured worker
earlier, resulting in appropriate quality care and the potential for earlier return to work. The primary focus areas of this
policy are to improve delivery of services, reduce lost workdays and improve treatment outcomes.