UR Clinical Criteria:

Effective 01/01/16, Tennessee adopted Official Disability Guidelines (ODG) in addition to their own Chronic Pain Guidelines.

ODG is a widely used workers鈥� compensation medical treatment, return-to-work (RTW), and drug formulary guideline. It is published by MCG Health and provides 鈥渦nbiased, evidence-based guidelines鈥� and analytical tools designed to 鈥渋mprove and benchmark return-to-work performance, facilitate quality care while limiting inappropriate utilization, assess claim risk for interventional triage, and set reserves based on industry data.鈥� >>

Tennessee Chronic Pain Guidelines >>

UR Appeal Process:

If you have received a notification of an adverse determination, please review this information on with the Tennessee Bureau of Workers鈥� Compensation. Additionally, here is the link to 聽for your use.