Official Disability Guidelines
SPRAINS AND STRAINS OF OTHER AND UNSPECIFIED PARTS OF BACK
(3-digit ICD9 847)
17. INJURY AND POISONING (800-999)
847 Sprains and strains of other and unspecified parts of back
| Return-To-Work Summary Guidelines | |
| Midrange: 16 days | At-Risk: 68 days |
| Return-To-Work "Best Practice" Guidelines Mild, clerical/modified work: 0 days Mild, manual work: 10 days Severe, clerical/modified work: 0-3 days Severe, manual work: 14-17 days Severe, heavy manual work: 35 days With radicular signs, see 722 (disc disorders) |
Capabilities & Activity Modifications for Restricted Work:
RTW Claims Data (Calendar-days away from work by decile)
847.2 Lumbar
Capabilities & Activity Modifications for Restricted Work:
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: Injury to the ligament (sprain) or to the muscle (strain) of the back. Sprains and strains are usually accompanied by a tearing of the tissue as well as symptoms of pain, limited motion, swelling, bruising, and/or a change in sensation.
Other names: Sprained back, Strained back
Excludes:
lumbosacral (846.0)
ICD-10 Code(s): S13, S16, S23.3, S29.0, S33, T09.2
ODG Treatment Guidelines: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
AHCPR Guideline | Merck Manual | Merck Home Edition | Medical Multimedia Group | Impairment Ratings | State Guidelines
Medical Costs: $5,429 (average of 14,618 cases)
Procedure Codes: 97110 97124 97140
CM Triage: Level 2 (case management), inflection point 16 days, algorithms 2A
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
10 visits over 5 weeks
Chiropractic Guidelines:
Therapeutic care --
Mild: up to 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 over 6-8 weeks, avoid chronicity
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 45 50 73 75 92 112 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Mean 10 13 14 15 16 18 35 38 68 365 28.25 CDC NCHS LOD (Length Of Disability, in days)*
Median (mid-point) 13.0 Mean (average) 19.78
Mode (most frequent) 14 Calculated rec. 15
Percent of Cases
(2704 cases)
15.9 15.8
8.9 8.9
6.8 6.7 7.7
5.5
3.6
0.0 0.0 0.0 0.1 0.7
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
3 6 9 12 15 18 21 24 27 30 33 36 39 40+
Range of Days (up to)
*CDC NHIS cases with no lost workdays: 524 (19.4%)
Impact on Total Absence: Prevalence 0.3898% of total lost workdays; Incidence 3.31 days per 100 workers OSHA DAW (Days Away from Work, in days)
Median (mid-point) 6 - Benchmark Indemnity Costs $3,234
Percent of Cases
(333026 cases)
22.1 20.9
13.8 13.7
13.1
10.9
5.5
______ ______ ______ ______ ______ ______ ______
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 20.0135% of occupational lost workdays; Incidence 3.20 days per 100 workers
Return-To-Work Summary Guidelines Midrange: 16 days At-Risk: 68 days Return-To-Work "Best Practice" Guidelines
Mild, clerical/modified work: 0 days
Mild, manual work: 10 days
Severe, clerical/modified work: 0-3 days
Severe, manual work: 14-17 days
Severe, heavy manual work: 35 days
With radicular signs, see 722 (disc disorders)
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: Injury to the ligament (sprain) or to the muscle (strain) of the lower back. Sprains and strains are usually accompanied by a tearing of the tissue as well as symptoms of pain, limited motion, swelling, bruising, and/or a change in sensation.
Other names: Lower back sprain, Lower back strain
ICD-10 Code: S33.50
ODG Treatment Guidelines: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
AHCPR Guideline | Merck Manual | Merck Home Edition | Medical Multimedia Group | Impairment Ratings | State Guidelines
Medical Costs: $5,062 (average of 6,896 cases)
CM Triage: Level 2 (case management), inflection point 16 days, algorithms 2A
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
10 visits over 5 weeks
Chiropractic Guidelines:
Therapeutic care --
Mild: up to 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 over 6-8 weeks, avoid chronicity
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 45 50 73 75 92 112 OSHA DAW (Days Away from Work, in days)
Median (mid-point) 6 - Benchmark Indemnity Costs $3,234
Percent of Cases
(163750 cases)
22.0 20.2
13.7 13.4 13.8
11.2
5.7
______ ______ ______ ______ ______ ______ ______
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 9.8407% of occupational lost workdays; Incidence 1.57 days per 100 workers NHDS LOS (Hospital Length Of Stay, in days)*
Median (mid-point) 4.0 Mean (average) 4.91
Mode (most frequent) 2 Calculated rec. 4
Percent of Cases
(111 cases)
16.2
13.5 13.5 14.4
11.7
7.2 7.2 7.2
4.5
0.9
___ ___ ___ ___ ___ ___ ___ ___ ___ ___
1 2 3 4 5 6 7 8 9 10+
Days
*NHDS cases with no overnight stay: 2 (1.8%)
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