ODG for Disability overview

ODG for Disability provides evidence-based and data-driven duration guidelines, risk scoring, and clinical content for the claim handler, benefit manager, and/or disability clinician to effectively manage, triage, and close short and long-term disability (LTD) claims.

Disability scenario: A forklift operator broke their leg playing football with their child over the weekend. As a result, they can no longer go to work and perform their job.

By leveraging the tools provided in ODG for Disability, users can:

• Identify conditions and codes to better understand the claimant’s condition (broken leg) and accurately code the claim.

• Identify out-of-work duration guidelines, LTD transition risks, and best practices for the diagnosis.

• View evidence-based clinical summaries, criteria for impairment determination, and activity modification recommendations based on physical demand level.

• Identify strategies for communicating with the provider and claimant to help facilitate claim resolution. Reducing the need for added claim costs, such as peer review, Independent Medical Evaluation (IME), and Functional Capacity Evaluation (FCE).

When evidence-based and data-driven information is shared early on with the treating provider and stakeholders there is a positive response with shortened durations and earlier identification of potential barriers to recovery.

What to learn more? See Key features and Using ODG for Disability.