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Practice of Treating Concussion

Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.

Chiropractors licensed in New York must practice within their chiropractic scope of practice as part of an overall treatment plan for a chiropractic patient. Under Education Law §6551(1), the practice of the profession of chiropractic is defined as detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column.

According to the Centers for Disease Control and Prevention, a concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth (https://www.cdc.gov/headsup/basics/concussion_whatis.html). The treatment of concussion does not fall within the scope of New York chiropractic practice. Comorbidities such as concussion do not necessarily exclude chiropractic treatment or treatment of other concurrent conditions that fall within the profession’s scope.

When the history, examination and assessment of a patient leads to the working diagnosis of a concussion, the chiropractor is required to refer the patient to an appropriate medical provider. Chiropractors may not manage the diagnosis and treatment of a concussion patient. A chiropractor may treat the associated spinal and soft tissue injuries sustained during a concussive event concurrent with a medical provider overseeing the concussion treatment. Therefore, a chiropractor cannot issue a return to play or work clearance.

Citations of Pertinent Law, Rules or Regulations:

  • Education Law §6509(2) – defines professional misconduct as practicing the profession fraudulently, beyond its authorized scope, with gross incompetence, with gross negligence on a particular occasion or negligence or incompetence on more than one occasion.” Article 130 General Provisions Subarticle 3, Professional Misconduct           
  • Education Law § 6509(9) - defines professional misconduct as “Committing unprofessional conduct, as defined by the board of regents in its rules or by the commissioner in regulations approved by the board of regents.” Rules of the Board of Regents
  • Board of Regents Rules Part 29.1(b)(9) – defines unprofessional conduct as  "practicing or offering to practice beyond the scope permitted by law, or accepting and performing professional responsibilities which the licensee knows or has reason to know that he or she is not competent to perform, or performing without adequate supervision professional services which the licensee is authorized to perform only under the supervision of a licensed professional, except in an emergency situation where a person's life or health is in danger. " Part 29, Unprofessional Conduct