Treatment guidelines

Each managed care organization (MCO) must use nationally recognized treatment and return-to-work guidelines to evaluate the necessity and/or effectiveness of medical care, and be able to use these guidelines to communicate and educate providers in all decision correspondence.

MCOs use The Official Disability Guidelines (ODG). The ODG are evidence-based treatment guidelines BWC and the MCOs have available on their desktops. Because the ODG are in a Web-based tool, BWC and MCO staff can easily search and find pertinent information necessary for everyday issues in claims and medical case management. MCOs began using these guidelines in making their treatment authorization decisions effective April 1, 2004.

For more information on ODG, visit the Work Loss Data Institute.