Texas Selects The Medical Disability Advisor for Return-to-Work Outcomes

January 24, 2007

The Texas Department of Insurance, Division of Workers’ Compensation on Dec. 29, 2006, adopted state-wide return-to-work guidelines; the DWC selected Reed Group’s The Medical Disability Advisor: Workplace Guidelines for Disability Duration, Fifth Edition, by Presley Reed, MD.

This rule establishes that beginning May 1, 2007, health care providers will be required to use The Medical Disability Advisor return-to-work guidelines (MDA) when providing non-network health care to injured or ill employees in the workers’ compensation system. Serving one of the nation’s largest workers’ compensation markets, the adoption of the MDA guidelines for Texas will optimize return-to-work outcomes for employees in a medically appropriate timeframe.

“These rules provide a framework to improve communications among injured employees, health care providers, employers, insurance carriers, and the Division,” Commissioner Betts said. “Disability management is a process designed to optimize health care and return-to-work for injured employees in order to avoid unnecessarily delayed recovery.” Commissioner Betts adopted the MDA as the return-to-work guideline excluding all sections and tables relating to rehabilitation.

“It is important to remember that a tool is only as good as its user,” said Presley Reed, MD, editor-in chief of the MDA. “As such, the MDA guidelines should be applied within the context of the users’ experience, training, and judgment. This tool should never be used to tell the doctor what to do or not do. As an example, no injured worker should be denied payment based on the guidelines.”

As described in the Adopted Rules http://www.tdi.state.tx.us/wc/rules/adopted/dmaorder1206.html, the Division made the following comments about the MDA guidelines:

The guidelines are benchmarks to facilitate communication between system participants and to formulate return-to-work plans. The benchmarks establish starting points, which may be adjusted based on the specific circumstances of the claim. The Division agrees that the return-to-work guidelines are not directly designed to reduce excessive or inappropriate medical care. However, early and appropriate return-to-work directly impacts the need for, and types of, medical care provided to injured employees. Ultimately, this early intervention impacts system costs. As previously stated, these guidelines are a tool to develop return-to-work plans and set benchmarks. They provide the foundation for implementation of Section 413.021(b) of the Labor Code, which include job analysis, job modification and restructuring assessments.

“The Medical Disability Advisor provides information on appropriate periods of recovery for injured or ill workers. Employers wish to ensure that employees receive appropriate recovery time for illnesses and injuries, but are concerned about controlling costs related to extended periods of absence and lost productivity. The MDA guidelines are used by medical and non-medical users to gain valuable information on normal recovery periods and natural language descriptions of the most common illnesses and injuries of working people. Professionals assisting injured or ill workers can rely upon this tool to ensure that employees receive appropriate treatment and services for a productive and safe return-to-work,” commented Dr. Reed.

To obtain additional information on the MDA return-to-work guidelines in Texas, visit http://www.rgl.net/states/Texas.aspx. In addition to the English version of the MDA guidelines, Reed Group also offers the MDA in Spanish via Internet access.

Source: The Reed Group

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