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The Cameruca case involved an injured worker who needed injections to treat chronic pain.  The Industrial Commission denied the injections based on a medical report that said the injections would not provide "lasting benefit."  It was appealed to the Franklin County Court of Appeals and argued that "no lasting benefit" is not the correct standard.  Many forms of treatment do not provide "lasting benefit" - medications, chiropractic care, even surgery.  All of these kinds of treatment are covered under the workers' compensation system, but they do not always provide "lasting benefit." 

The correct test for deciding whether treatment should be approved is called the "Miller" test - the Miller test asks 3 questions: 

1) is the treatment related to the allowed conditions in your claim?

2) is the treatment necessary to treat the allowed conditions?

3) is the treatment cost effective?

The Court agreed with the Injured Worker that "lasting benefit" is not the right test to use.

Now the "Miller rule" comes from State ex rel. Miller v. Indus. Comm. (1994), 71 Ohio St.3d 229.  Also, see Ohio Adm.Code 4123-7-02 and 4123-6-24 (they say that treatment can be approved for only for the allowed conditions - there is no limitation based on "lasting benefit" or other reasons used to deny treatment).
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Is my treatment Medically Necessary?
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