The Rise of ODG

| | Evidence Based Medicine, Physician Peer Review

Dr Cortes February 2017 Article on the Rise of ODG
Official Disability Guideline (ODG), published by Work Loss Data Institute, has now been adopted by Texas, Oklahoma, Kansas, New Mexico, North Dakota, Tennessee, Ohio and Arizona (Arizona for chronic pain and opioids). As ODG continues to gain momentum, it’s hard not to acknowledge its success. In this article I want to share my thoughts on why I think ODG has been on the rise.

While ODG is by no means perfect, and while this article should not be taken as an official endorsement of ODG over all other treatment guidelines, I think UR Nation readers will be interested in hearing my theory on why ODG has been so successful.

ODG is Comprehensive

The ODG guidelines cover an impressive number of conditions and procedures, covering all 10,000 ICD-9 codes, 65,000 ICD-10 codes and 11,000 CPT procedure codes. From my years of practice I’ve seen no reason to dispute their assertion. Because the guidelines are comprehensive, they can help minimize uncertainty and many disputes between medical providers, insurance carriers and managed care entities. I’ve also noticed that because ODG is comprehensive, it rarely needs to be supplemented with other guidelines or resources to cover missing treatments.

ODG is Easy to Navigate

ODG has a user-friendly search feature for body parts and treatment procedures. Each recommendation is linked to the supporting medical evidence, provided in abstract form, which has been ranked, highlighted and indexed. And all treatments are either recommended, not recommended, or questionable. Specifically, the green check boxes mean it’s most likely going to be recommended. A red “X” means it’s probably not recommended. The yellow caution warnings mean the treatment is under study, or is questionable.

ODG is Continuously Updated

Unlike some guidelines that are not updated for several years, ODG reflects new studies as they are conducted and released throughout the year. ODG undergoes a comprehensive annual update process based on scientific medical literature review, claims data analysis and expert panel validation. And I like how the date of the version I’m looking at is always clearly visible. Another thing I’ve noticed is because ODG is frequently updated, ODG will often be the “secondary guide” when the primary guide (like the California Medical Treatment Utilization Schedule or “MTUS”) does not address the procedure in question.

ODG is Independent of Any Specialty Group

ODG tries to represent all medical specialties (occupational medicine, orthopaedic surgery, physical therapy, chiropractic care, etc.). I believe ODG has considerable provider acceptance, including adoption by more states than any other guideline because of its balanced approach focused sharply on improving the health and return-to-work outcomes for injured workers. In other words, unlike medical specialty society guidelines, ODG does not represent the interests of any one provider group over another group.


It will be interesting to see if ODG continues on its current successful trajectory. I know that recently a significant group of ODG supporters pushed the CA DWC to adopt the ODG based formulary; the effort was not successful. We at UR Nation will continue to examine ODG in light of the vast amount of treatment guidelines available and will continue to provide our thoughts and insights.

Zenia Cortes, MD, Orthopedic Surgeon

Dr. Zenia Cortes brings her combined expertise in sports and orthopaedic medicine to UniMed Direct, along with insights from her experience in peer and utilization review.