Work Loss Data Institute has released the Official Disability Guidelines (ODG) used by the Ohio Bureau of Workers Compensation and many national groups. The bureau has instructed the MCOs in the BWC to use the ODG whenever they are analyzing the medical necessity of treatment requests. Unfortunately the way it is being used, is as a denial mechanism versus an analysis of the appropriateness of treatment. As a result, many treatment requests for Ohio workers compensation are going to hearing where the Industrial Commission reverses the denial of treatment because they are reviewing the preponderance of all the evidence before them.
Without effective representation most Ohio workers will have treatment denied using this erroneous analysis, and their cases would never be taken before the Ohio Industrial Commission. The ODG advises users that they are merely guidelines, not inflexible prescriptions and should never be used as the sole evidence for the absolute standard of care. Therefore, treating physicians, injured workers, and representatives must always pursue appropriate treatment based upon all of the circumstances behind the injured workers medical condition and injury.