IMPLICATIONS FOR ACCESS TO CHIROPRACTIC SERVICES IN THE WORKERS' COMPENSATION SYSTEM
 
   

Implications for Access to Chiropractic Services in the
Workers' Compensation System: A State-by-State
Coverage Policy Comparison

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:
    Frankp@chiro.org
 
   

FROM:   J Integr Complement Med 2026 (Jul 13): 27683605261469674 ~ FULL TEXT

  OPEN ACCESS   


Morgan Young, DC

Washington State Department, Labor and Industries,
Tumwater, WA, USA.


Background:   Chiropractic services are well-aligned with the goals of workers' compensation (WC) coverage in returning patients to work timely, safely, and cost-effectively. Coverage policies in WC dictate the extent of utilization and participation in chiropractic and define patient access.

Methods:   This article accessed online-available U.S. WC chiropractic coverage policies through artificial intelligence tools and search engines. The article compares state-by-state chiropractic coverage policies while also examining general trends, significant divergences, and common models across WC chiropractic coverage plans.

Results:   Utilization of chiropractic between states is highly variable, despite many similarities in coverage. Most states include chiropractic, but with a variety of stipulations and limits which are described.

Conclusions:   Opportunities are available for chiropractors in WC, where coverage is often broader than many other national coverage plans. Employers and jurisdictions may find enhanced chiropractic utilization and participation beneficial for patient satisfaction, safety, and cost-effective care for musculoskeletal conditions.

Keywords:   access to care; chiropractic utilization; coverage policy; workers’ compensation.



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References:

  1. Nguyen AT, Aris IM, Snyder BD, et al.
    Musculoskeletal Health: An Ecological Study Assessing
    Disease Burden and Research Funding

    Lancet Reg Health Am 2024 (Jan 8): 29: 100661

  2. Qaseem A, Wilt TJ, McLean RM, et al.
    Noninvasive Treatments for Acute, Subacute, and Chronic
    Low Back Pain: A Clinical Practice Guideline From
    the American College of Physicians

    Annals of Internal Medicine 2017 (Apr 4); 166 (7): 514–530

  3. North American Spine Society (NASS).
    Evidence-Based Clinical Guidelines for
    Multidisciplinary Spine Care

    Burr Ridge (IL): North American Spine Society; 2020

  4. Elton D, Kosloff TM, Zhang M, et al.
    Low Back Pain Care Pathways and Costs: Association with
    the Type of Initial Contact Health Care Provider

    medRxiv

  5. Farabaugh R, Hawk C, Taylor D, et al.
    Cost of Chiropractic Versus Medical Management of
    Adults with Spine-related Musculoskeletal Pain:
    A Systematic Review

    Chiropractic & Manual Therapies 2024 (Mar 6); 32: 8

  6. Davis MA, Mackenzie TA, Coulter ID, et al.
    The United States Chiropractic Workforce:
    An Alternative or Complement
    to Primary Care?

    Chiropractic & Manual Therapies 2012 (Nov 21); 20: 35

  7. Chen B, Brown HS, Douphrate D, et al.
    National Trends in the Utilization and Expenditure of
    Chiropractic Care in U.S. Adults: Analysis of the
    2007-2016 Medical Expenditure Panel Survey

    J Manipulative Physiol Ther 2025 (Jan); 48 (1–5): 1–9

  8. Centers for Medicare & Medicaid Services,
    Office of the Actuary, National Health Statistics Group.
    National health expenditures 2023.
    Baltimore (MD): CMS; 2023

  9. Keeney BJ, Fulton-Kehoe D, Turner JA, et al.
    Early Predictors of Lumbar Spine Surgery After Occupational
    Back Injury: Results From a Prospective Study
    of Workers in Washington State

    Spine (Phila Pa 1976). 2013 (May 15); 38 (11): 953–964

  10. Turner JA, Franklin G, Fulton-Kehoe D, et al.
    ISSLS prize winner: Early predictors of chronic work disability: A prospective, population-based study of workers with back injuries.
    Spine (Phila Pa 1976), 2008; 33(25):2809–2818

  11. Fritz J, Kim J, Dorius J.
    Importance of the Type of Provider Seen to Begin
    Health Care for a New Episode Low Back Pain:
    Associations with Future Utilization and Costs

    J Eval Clin Pract. 2016 (Apr); 22 (2): 247–252

  12. Fenton JJ, Fang S-Y, Ray M, et al.
    Longitudinal Care Patterns and Utilization
    Among Patients with New-Onset Neck Pain
    by Initial Provider Specialty

    Spine (Phila Pa 1976) 2023 (Oct 15); 48 (20): 1409–1418

  13. Wang D, Mueller KL, Murphy DL, Lea RD.
    Chiropractic Care for Workers with Low Back Pain
    Workers Compensation Research Institute (May 17, 2022)

  14. Bise CG, Schneider M, Freburger J, et al.
    First Provider Seen for an Acute Episode of
    Low Back Pain Influences Subsequent
    Health Care Utilization

    Physical Therapy 2023 (Jun 28); 103 (9): pzad067

  15. Bezdjian S, Whedon JM, Goehl JM, Kazal LA. Jr.,
    Experiences and attitudes about chiropractic care and prescription drug therapy among patients with back pain: A cross-sectional survey.
    J Chiropr Med, 2021; 20(1):1–8

  16. Newell D, Holmes MM.
    Patient Experience and Satisfaction With Chiropractic Care:
    A Systematic Review

    J Patient Experience 2024 (Dec 25): 11:23743735241302992

  17. Whedon JM, Song Y, Davis MA, Lurie JD.
    Use of Chiropractic Spinal Manipulation in Older Adults
    is Strongly Correlated with Supply

    Spine (Phila Pa 1976). 2012 (Sep 15); 37 (20): 1771–1777

  18. Emary PC, Corcoran KL, Coleman BC, et al.
    Impact of chiropractic care on opioid use for noncancer spine pain: Systematic review and meta-analysis.
    Pain Rep, 2026; 11(1):e1374

  19. Trager RJ, Cupler ZA, Gliedt JA, et al.
    Association Between Spinal Manipulative Therapy for Low Back
    Pain With or Without Sciatica and Opioid Use Disorder:
    A Retrospective Cohort Study

    Health Sci Rep 2025 (Sep 19); 8 (9): e71267

  20. Lisi AJ, Bastian LA, Brandt CA, et al.
    The Impact of Chiropractic Care on Opioid Prescriptions
    in Veterans Health Administration Patients
    Receiving Low Back Pain Care

    J Gen Intern Med 2025 (Dec); 40 (16): 3973–3981

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