Making the Most of Official Disability Guidelines (ODG): A Practical Review
At Viscardi, we’re constantly looking for the most powerful tools to help us effectively manage claims and get injured workers back to work. One tool we’ve consistently used is the Official Disability Guidelines (ODG) by MCG Health. ODG helps us navigate complex cases, make informed decisions, and ultimately ensure better outcomes for injured workers and our clients. But like any system, there are aspects we love—and areas where we see room for improvement. Here’s our honest take on how ODG supports our work and what we think could make it even better.
What is ODG and Why Does It Matter?
We think of ODG as the GPS for case management. It provides a structured, evidence-based approach to treatment guidelines and return-to-work (RTW) planning. By offering benchmarks based on real-world data, ODG takes the guesswork out of determining how long an employee may be out of work following an injury.
The Three Key Disability Durations
ODG categorizes time away from work into three benchmarks:
Maximum: The statistical mean disability duration based on similar real-world claims.
Average: The average disability duration after removing the top 5% of outliers.
Best Practices: The estimated time needed for an uncomplicated physiological recovery.
Using the ODG calculator, we can enter case-specific details—such as diagnosis, age, state, comorbidities, legal representation and job type—to refine the estimated recovery timeline.
Why We Use ODG
Workers’ compensation and disability claims come with many variables, and ODG helps us manage them more effectively. Here’s how it supports our work:
Consistently Updated Guidelines: ODG is updated quarterly, ensuring we always have access to the latest medical best practices.
Data-Driven Return-to-Work Benchmarks: We rely on ODG to set realistic return-to-work expectations for injured workers, reducing unnecessary time away from the job.
Reserve Planning for Adjusters: Adjusters use ODG to help set claim reserves more accurately, leading to better financial planning and claim oversight.
A Second Opinion Beyond NYS MTG: Having an additional resource outside of the New York State Medical Treatment Guidelines (MTG) allows us to consider multiple perspectives for treatment and return-to-work decisions.
Reliable Out-of-Work Estimates: ODG’s data-driven framework helps us determine realistic recovery times, making case management more efficient and effective.
Total Cost of Injury Analysis: A newer feature we’ve been using is the ODG Costs tab. This tool estimates total claim reserves—including indemnity, medical expenses, travel costs, and administrative fees—helping our clients plan ahead with financial confidence.
Real-World Example: How ODG Helps
Let’s take a look at how ODG plays out in an actual case:
Scenario: A 49-year-old Field Technician in New York slipped and fell at work, injuring his left shoulder. After undergoing arthroscopic surgery, ODG provided the following estimated timeframes:
Before Surgery:
Maximum: 374 days
Average: 223 days
Best Practice: 44 days
After Surgery:
Maximum: 392 days
Average: 279 days
Best Practice: 116 days
Since the surgery extended recovery time, our Telephonic Case Managers (TCMs) monitored the case closely. When the employee returned to work earlier than the maximum timeframe, claims savings were documented and reflected in the closure report.
Key Takeaways:
ODG provides clear, data-backed RTW timelines based on an employee’s specific circumstances.
Employers and adjusters use these projections to plan appropriately and control costs.
Returning to work before the maximum estimated time generates measurable cost savings for clients.
The ODG Cost Tab offers additional insight into claim reserves, helping injury managers refine financial projections.
What We Wish ODG Could Do Better
No system is perfect, and we have a few suggestions that would make ODG even more valuable:
Track Updates to Guidelines in Real Time: We’d love a way to see exactly what’s changed in the RTW benchmarks and treatment guidelines when updates occur. Right now, there’s no easy way to compare old vs. new data.
Improve User Experience: The platform isn’t always intuitive. You have to spend time figuring out where to go for specific tools and data. A more user-friendly interface would be a game-changer.
Provide Quick Update Videos: A simple 2-5 minute video summarizing key updates would be incredibly helpful. We love the existing tutorial videos and the regular system updates—helping us understand them faster would allow us to put them into practice right away.
More Frequent Updates on New Treatments: The guidelines are comprehensive, but we’d like to see even more real-time updates when new treatment protocols emerge.
Final Thoughts
ODG has proven to be a valuable resource, helping us refine return-to-work planning, manage costs, and ensure that injured workers receive appropriate care. While we see room for improvement around the edges, the core service is excellent.
As we continue to innovate and advocate for best-in-class Case Management and Workers’ Comp solutions, we look forward to seeing how ODG evolves. We’ll keep pushing for enhancements that make it even more effective for our clients, case managers, and the injured workers we support.
For more information on how Viscardi can optimize your Workers’ Compensation strategy, visit www.viscardicorp.com.