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Colorado Administrative Code
Department 1100 - Department of Labor and EmploymentDivision 1101 - Division of Workers' Compensation
Rule 7 CCR 1101-3 R17 Ex 08 - Rule 17, Exhibit 8 - CERVICAL SPINE INJURY MEDICAL TREATMENT GUIDELINES
Appendix 7 CCR 1101-3-17-08

7 Colo. Code Regs. § 1101-3 R17 Ex 08, app 7 CCR 1101-3-17-08

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Current through Register Vol. 47, No. 24, December 25, 2024
Appendix 7 CCR 1101-3-17-08

Functional Outcome Measures

Name of Test

Body Part

Description

36-Item Short Form Survey (SF-36) and 12-Item Short Form Survey (SF-12)

Physical Health

Assesses activities of daily living (ADLs)

Brief Pain Inventory

General

Sleep, walking, ADLs

Focus on Therapeutic Outcomes (FOTO)

Various Body Parts

Functional ADLs specific to body part

Oxford Shoulder Instability Score

Shoulder

Functional ADLs

Quick DASH (Disabilities of the Arm, Shoulder and Hand)

Upper

Extremity

Shoulder, elbow and hand

assessment

Simple Shoulder Test

Shoulder

Shoulder function only

Upper Extremity Functional Scale

Upper

Extremity

Functional ADLs related to Upper

Extremity

Psychological Screens

Name of Test

Description

Brief Battery for Health Improvement, 2nd Edition (BBHI 2)

Measures pain, functioning, somatization, depression, anxiety, and defensiveness; brief measure of risk factors for delayed recovery

Distress and Risk Assessment Method (DRAM)

Measures depression and somatic symptoms of anxiety, risk factors commonly associated with chronic pain

Center for Epidemiological Studies Depression Scale (CES-D)

Measures depression, 20 items

Beck Depression Inventory-II (BDI-II)

Measures depression, 21 items

Primary Care Evaluation for Mental Disorders (PRIME-MD) Must be filled out by a provider

2 components: paper and pencil screen for patient and follow-up interview by physician. Assesses mood, anxiety, somatoform tendencies, and alcohol and eating disorders

Zung Depression Inventory

Measures depression, brief measure

Patient Health Questionnaire (PHQ) and PHQ-9

Self-administered version of the PRIME-MD. Assesses mood, anxiety, somatoform tendencies, and alcohol and eating disorders

Generalized Anxiety Disorder Scale (GAD-7)

Assesses generalized anxiety, 7 questions

Behavioral Health Index-Multimedia Version (BHI-MV)

Screens for addiction

7 CCR 1101-3 R17 Ex 08, app 7 CCR 1101-3-17-08

37 CR 13, July 10, 2014, effective 7/30/2014
38 CR 01, January 10, 2015, effective 2/1/2015
38 CR 05, March 10, 2015, effective 4/1/2015
38 CR 11, June 10, 2015, effective 7/1/2015
38 CR 17, September 10, 2015, effective 1/1/2016
39 CR 04, February 25, 2016, effective 3/16/2016
39 CR 13, July 10, 2016, effective 7/30/2016
39 CR 16, August 25, 2016, effective 9/14/2016
39 CR 19, October 10, 2016, effective 1/1/2017
40 CR 03, February 10, 2017, effective 3/2/2017
40 CR 11, June 10, 2017, effective 7/1/2017
40 CR 21, November 10, 2017, effective 11/30/2017
40 CR 18, September 25, 2017, effective 1/1/2018
40 CR 20, October 25, 2017, effective 1/1/2018
41 CR 11, June 10, 2018, effective 7/1/2018
41 CR 19, October 10, 2018, effective 1/1/2019
41 CR 20, October 25, 2018, effective 1/1/2019
41 CR 23, December 10, 2018, effective 1/1/2019
42 CR 01, January 10, 2019, effective 1/30/2019
42 CR 11, June 10, 2019, effective 6/30/2019
42 CR 12, June 25, 2019, effective 7/15/2019
42 CR 21, November 10, 2019, effective 11/30/2019
42 CR 20, October 25, 2019, effective 1/1/2020
42 CR 23, December 10, 2019, effective 1/1/2020
43 CR 03, February 10, 2020, effective 1/1/2020
43 CR 07, April 10, 2020, effective 4/30/2020
43 CR 11, June 10, 2020, effective 7/1/2020
43 CR 16, August 25, 2020, effective 10/14/2020
43 CR 21, November 10, 2020, effective 1/1/2021
44 CR 07, April 10, 2021, effective 4/30/2021
44 CR 08, April 25, 2021, effective 7/1/2021
44 CR 13, July 10, 2021, effective 7/30/2021
44 CR 20, October 25, 2021, effective 1/1/2022
44 CR 23, December 10, 2021, effective 1/1/2022
44 CR 23, December 10, 2021, effective 1/10/2022
45 CR 01, January 10, 2022, effective 1/30/2022
45 CR 11, June 10, 2022, effective 7/1/2022
45 CR 13, July 10, 2022, effective 8/10/2022
45 CR 21, November 10, 2022, effective 12/6/2022
46 CR 01, January 10, 2023, effective 12/6/2022
45 CR 19, October 10, 2022, effective 1/1/2023
46 CR 02, January 25, 2022, effective 1/1/2023
46 CR 02, January 25, 2023, effective 3/2/2023
46 CR 05, March 10, 2023, effective 3/30/2023
47 CR 23, December 10, 2024, effective 1/1/2025