7 Colo. Code Regs. § 1101-3-17-08-1
This document has been prepared by the Colorado Department of Labor and Employment, Division of Workers' Compensation (Division) and should be interpreted within the context of guidelines for physicians/providers treating individuals who qualify as injured workers with shoulder injuries under the Colorado Workers' Compensation Act.
Although the primary purposes of this document for practitioners are advisory and educational, these guidelines are enforceable under the Workers' Compensation Rules of Procedure, 7 CCR 1101-3. The Division recognizes that acceptable medical practice may include deviations from these guidelines, as individual cases dictate. Therefore, these guidelines are not relevant as evidence of a provider's legal standard of professional care.
To properly utilize this document, the reader should not skip or overlook any sections.
The Division provides procedures to implement Medical Treatment Guidelines (MTGs) and to foster communication to resolve disputes among the provider, payer, and patient through the Workers' Compensation Rules of Procedure. In lieu of more costly litigation, parties may wish to seek administrative dispute resolution services through the Division or the Office of Administrative Courts.
All recommendations are based on available evidence and/or consensus judgment. Division staff researched and adopted evidence critique criteria. Evidence evaluation was performed in a manner congruent with national standards and completed independent of the multidisciplinary task force group that drafted recommendations. The methodology is described in detail on the Division's website, including documents on the literature search and evidence base.
References are provided in the evidence document when high-quality evidence that met the Division's methodological standards was available to support recommendations. Recommendations without qualifying evidence are based on consensus; consensus means the judgment of experienced professionals based on general medical principles.
All recommendations in the Medical Treatment Guidelines (MTGs) are considered to represent reasonable care in appropriately selected cases, irrespective of the amount of evidence or consensus attached to them. The inclusion of a treatment as acceptable does not imply that every patient meeting the MTGs criteria must or should have that treatment. It means that for individuals meeting the criteria, the treatment should be approved when the provider and patient decide to proceed with it. Those procedures considered inappropriate, unreasonable, or unnecessary are designated in the MTGs as "not recommended." Treatments or indications for treatments not addressed by the MTGs require prior authorization for a case-by-case assessment of appropriateness. See Workers' Compensation Rules of Procedure Rule 16 Utilization Standards for more information on prior authorization.
Colorado Division of Workers' Compensation. (2024). Shoulder Injury Medical Treatment Guidelines. Colorado Department of Labor and Employment. https://cdle.colorado.gov/medical-providers/medical-treatment-guidelines.
7 CCR 1101-3-17-08-1