Official Disability Guidelines
OTHER AND UNSPECIFIED DISORDERS OF BACK
(3-digit ICD9 724)
724 Other and unspecified disorders of back
724.2 Lumbago
| Return-To-Work Summary Guidelines | |
| Midrange: 20 days | At-Risk: 79 days |
| Return-To-Work "Best Practice" Guidelines Vague, descriptive diagnosis with multiple causes -- Mild, clerical/modified work: 0 days Mild, manual work: 7-10 days Severe, clerical/modified work: 0-3 days Severe, manual work: 14-17 days Severe, heavy manual work: 35 days Severe, heavy manual work, chemical dependence comorbidity: 49 days With radicular signs, see 722 (disc disorders) With radiating pain, no radicular signs, see 847 (sprains & strains) Obesity comorbidity (BMI >= 30), multiply by: 1.31 |
Capabilities & Activity Modifications for Restricted Work:
RTW Claims Data (Calendar-days away from work by decile)
Clerical/modified work: Lifting with knees (with a straight back, no stooping) not more than 5 lbs up to 3 times/hr; squatting up to 4 times/hr; standing or walking with a 5-minute break at least every 20 minutes; sitting with a 5-minute break every 30 minutes; no extremes of extension or flexion; no extremes of twisting; no climbing ladders; driving car only up to 2 hrs/day.
Manual work: Lifting with knees (with a straight back) not more than 25 lbs up to 15 times/hr; squatting up to 16 times/hr; standing or walking with a 10-minute break at least every 1-2 hours; sitting with a 10-minute break every 1-2 hours; extremes of flexion or extension allowed up to 12 times/hr; extremes of twisting allowed up to 16 times/hr; climbing ladders allowed up to 25 rungs 6 times/hr; driving car or light truck up to a full work day; driving heavy truck up to 4 hrs/day.
Description: Pain, discomfort, stiffness, and weakness of the lower back which may or may not extend to the legs, hips, and buttocks. This is a symptom of many diagnoses but it is not a disease in itself. Lumbago and other back problems are second only to upper respiratory infections as a reason for lost work.
Low back pain
Low back syndrome
Lumbalgia
ICD-10 Code(s): M54.4, M54.5, M54.8, M54.9
ODG Treatment Guidelines: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
AHCPR Guideline | Merck Manual | Merck Home Edition | Mayo Clinic | WebMD | State Guidelines
Medical Costs: $6,076 (average of 20,895 cases)
Procedure Codes: 97110 97124 97140
CM Triage: Level 1 (low touch), inflection point 20 days, algorithms 2A B2A B2B
Physical Therapy Guidelines:
Allow for fading of treatment frequency (from up to 3 visits per week to 1 or less), plus active self-directed home PT
9 visits over 5 weeks
Chiropractic Guidelines:
Therapeutic care --
Mild: 6 visits over 2 weeks
Severe: Trial of 6 visits over 2 weeks
Severe: With evidence of objective functional improvement, total of up to 18 visits (12 additional) over 6-8 weeks, avoid chronicity of care
Elective care -- As needed
Disability Duration Adjustment Factors by Age Age Group 18-24 25-34 35-44 45-54 55-64 65-74 Adjustment Factor 0.66 0.74 1.07 1.10 1.35 1.64 At-Risk Days 52 58 85 87 107 130 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Mean 10 12 14 15 20 31 35 42 79 365 37.41 CDC NCHS LOD (Length Of Disability, in days)*
Median (mid-point) 5.0 Mean (average) 15.19
Mode (most frequent) 2 Calculated rec. 7
Percent of Cases
(12719 cases)
15.7
10.6
7.5 7.0
6.0
4.2
1.9 2.5
1.2 0.7 1.4 0.8 1.2 0.6
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
1 2 3 4 5 6 7 8 9 10 11 12 13 14+
Days
*CDC NHIS cases with no lost workdays: 4922 (38.7%)
Impact on Total Absence: Prevalence 1.0705% of total lost workdays; Incidence 9.10 days per 100 workers OSHA DAW (Days Away from Work, in days)
Median (mid-point) 6 - Benchmark Indemnity Costs $3,234
Percent of Cases
(43198 cases)
22.1 22.6
14.7
13.5
11.2 10.7
5.3
______ ______ ______ ______ ______ ______ ______
1 day 2 days 3 to 5 6 to 10 11 to 20 21 to 30 31 or more
Range of Days
Impact on Occupational Absence: Prevalence 2.5960% of occupational lost workdays; Incidence 0.42 days per 100 workers NHDS LOS (Hospital Length Of Stay, in days)*
Median (mid-point) 4.0 Mean (average) 5.02
Mode (most frequent) 1 Calculated rec. 4
Percent of Cases
(369 cases)
14.9
13.0
9.5 9.2 10.3
8.7
5.4 5.4
3.5 4.3
___ ___ ___ ___ ___ ___ ___ ___ ___ ___
1 2 3 4 5 6 7 8 9 10+
Days
*NHDS cases with no overnight stay: 29 (7.9%)
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