With the enactment of SB 91-218 in July 1991, the Colorado Legislature modified the Colorado Workers’ Compensation Act (Act). The Act mandated the Division to develop and implement medical treatment guidelines addressing the most frequent and most costly occupational injuries and/or diseases. The primary purpose of the Medical Treatment Guidelines (guidelines) was to assure appropriate medical care at a reasonable cost. Medical treatment guidelines were developed through a process of consensus incorporating community input. One important use of the guidelines is educational, however, they are enforceable under the Workers’ Compensation Rules of Procedure 7 CCR 1101-3. At the same time, the Division recognizes acceptable medical practice may deviate from the Guidelines (Rule XVII, Department of Labor & Employment, 1998).