Official Disability Guidelines
SCHIZOPHRENIA
(3-character ICD10 F20)

SCHIZOPHRENIA, SCHIZOTYPAL, DELUSIONAL, AND OTHER NON-MOOD PSYCHOTIC DISORDERS (F20-F29)

F20  Schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
See F20.3

              Excludes1:
              brief psychotic disorder (F23)
              cyclic schizophrenia (F25.0)
              mood [affective] disorders with psychotic symptoms (F30.2, F31.2, F31.5, F31.64, F32.3, F33.3)
              schizoaffective disorder (F25.-)
              schizophrenic reaction NOS (F23)
              Excludes2:
              schizophrenic reaction in:
              alcoholism (F10.15-, F10.25-, F10.95-)
              brain disease (F06.2)
              epilepsy (F06.2)
              psychoactive drug use (F11-F19 with .15. .25, .95)
              schizotypal disorder (F21)

ICD-9 Code: 295
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Costs: $18,336 (average of 271,546 cases)
Hospital Length Of Stay: 13.7 days
CM Triage: Level 3 (long term planning)

F20.0  Paranoid schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data42 days45 days
All absences15 days44 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization, no job safety issues: 0-7 days
With hospitalization: 42 days or by report

Description: A preoccupation with the delusion of being conspired against and persecuted by others.  In addition, the person may hear voices and have delusions of grandeur, which bring on greater delusions of persecution by envious people.  Except for the delusions, the rest of the person's thinking, speech, and behavior may appear normal.
Other names: Paranoid schizophrenia
              Paraphrenic schizophrenia
              Excludes1:
              involutional paranoid state (F22)
              paranoia (F22)

ICD-9 Code: 295.3
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Causality Likelihood: Zero
Hospital Costs: $19,407 (average of 93,473 cases)
Hospital Length Of Stay: 13.8 days
CM Triage: Level 1 (low touch), inflection point 43 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
9144041424243444536538.45

   Integrated Disability Durations, in days*
   Median (mid-point)     15.0       Mean (average)        25.78
   Mode (most frequent)   1          Calculated rec.       14
                           Percent of Cases
                              (685 cases)
                                                                      
                                                                  39.7
                                                                      
                                                                      
                                                                      
                                                                      
 18.8                                                                 
           13.3                                                       
                                                                      
       6.0                                                            
                 2.5  3.9  1.8  0.3  0.1  0.3  0.4  0.3  0.3  0.0     
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    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: 84 (12.3%)

Impact on Total Absence: Prevalence 0.0382% of total lost workdays; Incidence 0.40 days per 100 workers

F20.1  Disorganized schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
See F20.3

              Hebephrenic schizophrenia
              Hebephrenia
ICD-9 Code: 295.1
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Costs: $30,048 (average of 3,139 cases)
Hospital Length Of Stay: 14.0 days
CM Triage: Level 3 (long term planning)
Impact on Total Absence: Prevalence 0.0003% of total lost workdays

F20.2  Catatonic schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
See F20.3

              Schizophrenic catalepsy
              Schizophrenic catatonia
              Schizophrenic flexibilitas cerea
              Excludes1:
              catatonic stupor (R40.1)

ICD-9 Code: 295.2
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Costs: $23,605 (average of 1,146 cases)
Hospital Length Of Stay: 21.0 days
CM Triage: Level 3 (long term planning)

F20.3  Undifferentiated schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization, no job safety issues: 0-7 days
With hospitalization: 16-42 days

Capabilities & Activity Modifications for Restricted Work:
Avoid eliciting symptoms affecting work/other job issues:  Limit to low project responsibility and minimal supervision of others; avoid situations of conflict and stress; minimal interaction with the public; personal driving only; minimal handling of heavy machinery (if not limited by medication).
Non-cognitive/modified work: Limit to moderate project responsibility and moderate supervision of others; personal driving only; minimal handling of heavy machinery (if not limited by medication).
Description: A mental disorder characterized by intellectual, emotional, and behavioral disturbances often accompanied by loss of contact with reality, hallucinations, and delusions.  Other symptoms could include disorganized thinking, lack of emotional response, and unsocial behavior.
Other names: Schizophrenia
              Atypical schizophrenia
              Excludes1:
              acute schizophrenia-like psychotic disorder (F23)
              Excludes2:
              post-schizophrenic depression (F32.8)

ICD-9 Code: 295.9
ODG Treatment Procedure Summary (not all recommended): Acceptance and commitment therapy (ACT); Activity restrictions; Acupressure; Acupuncture; Antidepressants (therapy); Antidepressants - SSRI's versus tricyclics (class); Aromatherapy; Brain wave synchronizers (for stress reduction); Cognitive therapy for depression; Cognitive therapy for panic disorder; Cognitive therapy for stress; Cognitive behavioral stress management (CBSM) to reduce injury and illness; Computer-assisted cognitive therapy; Cymbalta; Depression screening; Depression: effect on heart health; Depression: the gene factor; Disease management (programs); Distractive methods (to reduce acute stress); Duloxetine (Cymbalta); Education (to reduce stress related to illness); Electroconvulsive therapy (ECT); Exercise; Expatriate employee adjustment; Fatigue (job related); Folate (for depressive disorders); Hypnosis; Innovation promotion (program); Kava extract (for anxiety); Light therapy; Massage therapy (MT); Mind/body interventions (for stress relief); Music (for relaxation/stress management); Opioid antagonists (especially naltrexone) for alcohol dependence; Optimism (and its effect on schema-focused therapy); Peer support (for postpartum depression); Psychological debriefing (for preventing post-traumatic stress disorder); Psychosocial/pharmacological treatments (for deliberate self harm); Psychosocial empowerment (programs); Psychotherapy; Return to work; SAMe (S-adenosylmethionine); St. John's wort (for depression); Stress & atherosclerosis (effect); Stress & blood pressure (effect); Stress & depression (effect); Stress & physiology/mental performance (effect); Stress & post-myocardial infarction (effect); Stress & myocardial ischemia (effect); Stress inoculation training ; Stress management, behavioral/cognitive (interventions); Stress management, physical (interventions); Tension headaches (pharmaceuticals vs. behavioral therapy); Technological stress; Vitamin B6; Vitamin use (for stress reduction); Work; Yoga
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Causality Likelihood: Zero
Hospital Costs: $18,260 (average of 21,194 cases)
Hospital Length Of Stay: 13.7 days
CM Triage: Level 1 (low touch), inflection point 17 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
12151616172142424436535.87

   Integrated Disability Durations, in days*
   Median (mid-point)     16.0       Mean (average)        27.14
   Mode (most frequent)   1          Calculated rec.       15
                           Percent of Cases
                              (455 cases)
                                                                      
                          18.2                                    20.2
                                                                      
                                                                      
                                                                      
 11.0                                                                 
            9.5                                                       
                      7.5                                             
       4.8                                                            
                                                                      
                 1.1            2.0  0.0  0.0  0.2  0.9  0.4  0.0     
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    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: 110 (24.2%)

Impact on Total Absence: Prevalence 0.0231% of total lost workdays; Incidence 0.24 days per 100 workers

F20.5  Residual schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data35 days39 days
All absences35 days38 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization: 0 days
With hospitalization: 35 days

Description: This is a form of Schizophrenia based on residual symptoms, lacking any evidence of hallucinations, etc.  See 295.6 for more information.
              Restzustand (schizophrenic)
              Schizophrenic residual state
ICD-9 Code: 295.6
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Causality Likelihood: Zero
Hospital Costs: $19,389 (average of 16,630 cases)
Hospital Length Of Stay: 20.9 days
CM Triage: Level 1 (low touch), inflection point 36 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
16343535353636373936534.86

   Integrated Disability Durations, in days*
   Median (mid-point)     35.0       Mean (average)        27.27
   Mode (most frequent)   35         Calculated rec.       33
                           Percent of Cases
                              (1450 cases)
                                                                      
                39.8                                                  
                                                                      
                                                                      
                                                                      
                                                                      
 19.9                16.3                                             
                                                                      
                                                                      
       6.5                                                            
            0.3            0.3  0.1  0.2  0.0  0.0  0.0  0.0  0.3  0.4
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    9   18   27   36   45   54   63   72   81   90   99  108  117 118+
                       Range of Days (up to)
   *CDC NHIS cases with no lost workdays: 232 (16.0%)

Impact on Total Absence: Prevalence 0.0820% of total lost workdays; Incidence 0.86 days per 100 workers

F20.8  Other schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
See F20.3

ICD-9 Code: 295.8
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Causality Likelihood: Zero
Hospital Costs: $17,745 (average of 2,511 cases)
Hospital Length Of Stay: 14.2 days
CM Triage: Level 3 (long term planning)

F20.81  Schizophreniform disorder

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
See F20.3

              Schizophreniform psychosis NOS
ICD-9 Code: 295.4
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Costs: $13,668 (average of 2,033 cases)
Hospital Length Of Stay: 10.9 days
CM Triage: Level 1 (low touch), inflection point 43 days

F20.89  Other schizophrenia

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
See F20.3

              Cenesthopathic schizophrenia
              Simple schizophrenia
ICD-9 Code(s): 295.0, 295.8
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Hospital Length Of Stay: 13.1 days
CM Triage: Level 3 (long term planning)

F20.9  Schizophrenia, unspecified

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data17 days44 days
All absences16 days43 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization, no job safety issues: 0-7 days
With hospitalization: 16-42 days

Capabilities & Activity Modifications for Restricted Work:
Avoid eliciting symptoms affecting work/other job issues:  Limit to low project responsibility and minimal supervision of others; avoid situations of conflict and stress; minimal interaction with the public; personal driving only; minimal handling of heavy machinery (if not limited by medication).
Non-cognitive/modified work: Limit to moderate project responsibility and moderate supervision of others; personal driving only; minimal handling of heavy machinery (if not limited by medication).
Description: A mental disorder characterized by intellectual, emotional, and behavioral disturbances often accompanied by loss of contact with reality, hallucinations, and delusions.  Other symptoms could include disorganized thinking, lack of emotional response, and unsocial behavior.
Other names: Schizophrenia
ICD-9 Code: 295.9
ODG Treatment Procedure Summary (not all recommended): Acceptance and commitment therapy (ACT); Activity restrictions; Acupressure; Acupuncture; Antidepressants (therapy); Antidepressants - SSRI's versus tricyclics (class); Aromatherapy; Brain wave synchronizers (for stress reduction); Cognitive therapy for depression; Cognitive therapy for panic disorder; Cognitive therapy for stress; Cognitive behavioral stress management (CBSM) to reduce injury and illness; Computer-assisted cognitive therapy; Cymbalta; Depression screening; Depression: effect on heart health; Depression: the gene factor; Disease management (programs); Distractive methods (to reduce acute stress); Duloxetine (Cymbalta); Education (to reduce stress related to illness); Electroconvulsive therapy (ECT); Exercise; Expatriate employee adjustment; Fatigue (job related); Folate (for depressive disorders); Hypnosis; Innovation promotion (program); Kava extract (for anxiety); Light therapy; Massage therapy (MT); Mind/body interventions (for stress relief); Music (for relaxation/stress management); Opioid antagonists (especially naltrexone) for alcohol dependence; Optimism (and its effect on schema-focused therapy); Peer support (for postpartum depression); Psychological debriefing (for preventing post-traumatic stress disorder); Psychosocial/pharmacological treatments (for deliberate self harm); Psychosocial empowerment (programs); Psychotherapy; Return to work; SAMe (S-adenosylmethionine); St. John's wort (for depression); Stress & atherosclerosis (effect); Stress & blood pressure (effect); Stress & depression (effect); Stress & physiology/mental performance (effect); Stress & post-myocardial infarction (effect); Stress & myocardial ischemia (effect); Stress inoculation training ; Stress management, behavioral/cognitive (interventions); Stress management, physical (interventions); Tension headaches (pharmaceuticals vs. behavioral therapy); Technological stress; Vitamin B6; Vitamin use (for stress reduction); Work; Yoga
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
Merck Manual | Merck Home Edition | NGC
Causality Likelihood: Zero
Hospital Costs: $18,260 (average of 21,194 cases)
Hospital Length Of Stay: 13.7 days
CM Triage: Level 1 (low touch), inflection point 17 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
12151616172142424436535.87

   Integrated Disability Durations, in days*
   Median (mid-point)     16.0       Mean (average)        27.14
   Mode (most frequent)   1          Calculated rec.       15
                           Percent of Cases
                              (455 cases)
                                                                      
                          18.2                                    20.2
                                                                      
                                                                      
                                                                      
 11.0                                                                 
            9.5                                                       
                      7.5                                             
       4.8                                                            
                                                                      
                 1.1            2.0  0.0  0.0  0.2  0.9  0.4  0.0     
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    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: 110 (24.2%)

Impact on Total Absence: Prevalence 0.0231% of total lost workdays; Incidence 0.24 days per 100 workers

ODG 2010 Work Loss Data Institute. All Rights Reserved.

CPT 2010 American Medical Association. All Rights Reserved.

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