The Official Disability Guidelines (ODG) are the most comprehensive and up-to-date medical treatment and return-to-work guidelines that are nationally recognized, providing independent evidence-based decision support to improve as well as benchmark outcomes in workers’ compensation. Why not use ODG guidelines to actively leverage your efforts in helping injured employees return to work?
The Return to Work (RTW) comorbidity calculator takes claim intake information such as diagnosis codes, procedure codes, demographics, and confounding factors to forecast projected disability duration using predictive analytics on the ODG claims database on millions of claims. The guidelines provide minimum, optimum, and maximum averages of return-to-work timeframes that are considered to be an expected length of disability duration based on the claim information.
As a TPA, Intercare encourages treating physicians to adopt and use the Workplace Guidelines not only for Medical Guidelines but also for applying the Disability Duration Guidelines.
Exceeding what is allowed as best practice or maximum duration on disability by sitting idle and not taking action should never be the norm.
Most of the time, we see the disability duration exceed the maximum expectancy or return-to-work timeframes where physicians extend the disability duration based on an employee’s subjective complaints or lack of interest in returning to work. But if you combine your knowledge of the ODG disability duration guidelines along with providing the employee’s comprehensive job description to the physician and point out what is an acceptable disability duration average, you may be surprised with how fast you see a shift in the disability status from Temporary Total Disability to modified light duty work or even a release to return to full work.
There will always be other factors that may influence medical recovery and disability duration, such as comorbid conditions and other medical complications, but these should not be common. In addition, these disability guideline durations can represent points in time during an employee’s medical care where additional evaluations might need to occur to determine why the employee is not improving and is unable to return to work.
Exceeding what is allowed as best practice or maximum duration on disability by sitting idle and not taking action should never be the norm. As workers’ compensation professionals, we need to be proactive in keeping communication open and constant so that all stakeholders are aware of each other’s obligations and expectations. Employers are also encouraged to stay in contact with their injured employees during their disability duration and consider temporarily modifying or adjusting an employee’s job duties to accommodate their limitations, if they don’t have a formal modified duty program. Claims professionals need to actively communicate with the treating physician and the injured employee regarding their return-to-work goals and engage nurse case management if necessary.