New York workers’ comp & no-fault DME
Back braces for workers’ comp & no-fault claims
A lumbar or back brace your treating provider prescribed after a work injury or car accident — handled under your New York claim, from the prescription through delivery and fitting.
Your treating provider decides what’s medically necessary; this page explains the process.
Does workers’ comp or no-fault cover a back brace in New York?
Yes — when your treating provider prescribes a back brace for a work injury or motor-vehicle accident, New York workers’ comp or no-fault can cover it. A prescription is always required; some workers’ comp braces also need prior authorization. Send the prescription through our referral form and we review it the next business day.
- Rx-first
Prescription confirmed before fulfillment
- Next-day
Referral review
- WC + NF
New York claim paths we handle daily
- 5
Boroughs served from Brooklyn
What back-brace situations are covered?
Coverage follows the claim and the prescription, not a catalog. The common paths we handle in New York:
Work injuries (workers’ comp)
Lumbar or lumbosacral bracing prescribed after an on-the-job back injury, billed to the workers’ compensation carrier on the claim.
Motor-vehicle accidents (no-fault)
Back bracing prescribed after a car accident, billed to the no-fault (auto) carrier once the claim details and assignment of benefits are in place.
Whatever the prescription specifies
We fill the brace the treating provider ordered. If a different item or size fits the order better, we confirm it against the prescription before anything ships.
What prescription and documents do you need for a back brace?
A prescription from the treating provider is always required. For workers’ comp, some braces also need a prior authorization (PAR) — submitted through OnBoard by the Board-authorized prescribing provider, not the DME supplier — and we flag when one is needed. For no-fault, we collect the claim number, carrier, accident date, and assignment-of-benefits paperwork so the carrier can be billed directly.
Does CityDME submit the workers’ comp prior authorization?
No. When a workers’ comp brace requires prior authorization, the PAR is submitted through OnBoard by the Board-authorized prescribing provider — DME suppliers are not eligible to submit PARs. We review the order and tell you exactly when a PAR is needed so it is not the reason a patient waits.
How do I send a back-brace referral?
Patients, attorneys, treating providers, and adjusters can all start it. Send the prescription and claim details through our referral form, and the Brooklyn desk runs a completeness review the next business day. If anything is missing, we tell you exactly what to send.
- 1. Send the prescription. Include the claim type — workers’ comp or no-fault — and whatever claim details you have.
- 2. We review it the next business day. We check the order for completeness and flag a PAR if the item needs one.
- 3. We deliver and fit. Once the documentation is complete, we schedule delivery, setup, and fitting.
Is fitting and delivery included, or an extra charge?
Under the New York fee-schedule reimbursement for a covered brace, delivery, setup, and any necessary fittings and adjustments are part of the service — not a separate add-on. $0 out of pocket where your claim applies and documentation is complete.
Which New York rules apply?
Back bracing is billed under New York’s claim rules — the workers’ compensation DME fee schedule, or the no-fault (Regulation 68) fee schedule for auto claims. A prescription is always required, patient billing for covered services is limited, and for workers’ comp any prior authorization is provider-submitted through OnBoard. The plain-language explainers live here:
Questions before you send a referral? Call (973) 850-3121.