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Mda (medical Disability Advisor) An explanation and example

#1 User is offline   yesno 

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Posted 25 March 2006 - 11:04 PM

Hi All,

When you have an injury, and you get ACC cover, ACC then work out a period of time in which you will recover. This is taken from a US resource called Medical Disability Advisor. It is used in "most US states and aroun 38 Countries.

The time you will take to recover is measured against a Minimum, Maximum and Average time.

If you don't recover in this time then ACC will "exit" you and say "you should have recovered by now".

Attached is an example of how this is calculated with an "Back Strain/Sprain".

it is available at:

http://www.tdi.state.tx.us/wc/rules/planni.../rgspstback.pdf

Attached File(s)


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#2 User is offline   Paradigm Shift 

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Posted 26 March 2006 - 02:56 PM

I have read the attachment and can only say bollocks.

This is all part of the so-called best practice medicine.

Best practice medicine provides the most common causes of the symptoms and the most commonly successful treatment for that most common cause. This way it is very possible to get an 80% success rate.

Of the remaining 20% 90% will not complain that they have not been treated.

Out of the 100% take away 80% that's 20 90% of 20 as two people complaining. Obviously those two people need to be investigated by the fraud investigation team.

The insurers and the compliant and medical people are able to congratulate themselves that they are successfully treating 98% of the population.

Hurrah what a wonderful system we have a New Zealand. The whole world should copy our system.
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#3 User is offline   MadMac 

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Posted 26 March 2006 - 05:45 PM

:wub: Whoa weeeeeeeee ...

When you have an injury , and you get ACC cover , ACC will then work out a period of time that you will recover.

Great , in fact bloody fantastic ...

The time you take to recover is measured against a Minimum Maxium and Average time.

Yippeeeeeeeee Fair enough ...

If you don't recover in this time ACC will "exit" you and say " you should have recovered by now".

Oooooooooooooooooh thats a bit of a Bugger ...

:wacko: Mmmmmmmmmmmm what if ACC Whangarei had my Injury Description recorded as Null and it took some 14 years and 6 months to change this to show a fracture ...
No injury, NULL ... what part of Minimum Maxium Average is used to measure the recover time ? ... how can I be exited and recovered now when no-one knows what injury I'm supposed to recover from ?

errrrrrrrrrr ACC Whangarei Representive , by the way highly respected in the medicial field , tried explaining my injury was just a small fracture and would take 6-8 weeks to heal with no pain syndromes ... instant red face lots of coughing spluttering when she physically saw the extent.
:D I suggested to her wouldn't it be easier for you to make my injuries [multiple]
fit the paper work instead of trying to make the piles of paper work fit an injury [singular].

:D Funny thing is not long after she left ACC ... mmmmmmm also very interesting is that my injury description details had some changes made ...

Have a great day everyone ... back to basics ... what is the FULL extent of injury / injuries that you have cover for so that the process of elimination can apply ...

Null still means Null ... nothing so how did the claim get opened in the first place if I didn't have an injury ...
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#4 User is offline   yesno 

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Posted 30 March 2006 - 09:22 AM

Hey Paradigm Shift and Madmac,

there is other great news, yes ACC's business plan, that great document which has in it the basis for all Key Performance Indicators, states that the average time off work for each injury (MDA duration) will fall by 1 day in 2006.

Thats right, if you had a muscle strain last year, and it took you a week to recover, your clone that has a muscle strain this year will get better one day quicker that you did.

Yes, you guessed it, those great ACC people have decided that this year, the treatment providers will improve so much that the MDA durations will drop...

Or does this mean that they are far more sucessful at "hounding the doctors" and using Best Practice as a means of discrimination in Healthcare.

YESno
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#5 User is offline   Paradigm Shift 

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Posted 30 March 2006 - 12:38 PM

If the average injury was 10 days ACC liability in the corporation would be soliciting the production of a document for a pecuniary advantage of 10% of its liability. The only way the corporation could avoid criminal prosecution for fraud was to have clear evidence that the doctors were wrong in their medical science. Who is the medical provider, our medical professional or the insurance company?
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#6 User is offline   yesno 

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Posted 11 April 2006 - 04:57 AM

This is good background to Duration of incapacity

Attached File(s)


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#7 User is offline   yesno 

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Posted 11 April 2006 - 05:07 AM

The Publishers of the MDA durations state:

The Medical Disability Advisor:
Workplace Guidelines for Disability Duration, Fifth Edition, Presley Reed, MD, Editor-in-Chief

"Benchmarking with the MDA
The MDA is a benchmarking tool, not designed to replace the judgment of medical professionals, and is an essential resource for anyone managing disability in the workplace. The foundation of The Medical Disability Advisor is the renowned Reed Group disability duration guideline tables. Based on data derived from more than 5 million managed cases with careful analysis by panels of experts
throughout the world, the MDA guidelines provide reasonable, objective expectancy figures for normal recovery from a medical condition, injury or procedure."

http://www.rgl.net/pdfs/DisabilityDuration...nesBrochure.pdf


ACC states:

If the GP certifies an incapacity outiside the MDA duration, then investigate them for fraud and hound them...
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