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Medical Disability Advisor  >  Asthma  >  Failure To Recover

Asthma

Related Terms

  • Allergic Asthma
  • Asthmatic Bronchitis
  • Bronchial Asthma
  • Catarrhal Asthma
  • Chronic Desquamating Eosinophilic Bronchitis
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Exercise Induced Asthma (EIA)
  • Exercise Induced Bronchonspasm (EIB)
  • Hyper-reactive Airway Disease
  • Reactive Airway Disease (RAD)

Differential Diagnoses

Specialists

  • Allergist / Immunologist
  • Critical Care Internist
  • Emergency Medicine Physician
  • Pulmonologist

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Factors Influencing Duration

The factors most likely to influence disability are the severity of the attack, the development of complications, whether episodes are acute or part of a chronic condition, any underlying chronic medical conditions, the individual's type of work, and most importantly, the individual’s compliance with prescribed treatment.

Overall, the chronic, well-managed, mild to moderately severe asthmatic may experience very few days lost from work due to the disease. Smokers and individuals regularly exposed to known allergens are at greater risk for severe asthma with complications and increased duration.

Duration Trends from Reference Data

DURATION TRENDS
 ICD-9-CM: 493, 493.0, 493.00, 493.1, 493.2, 493.9  
CasesMeanMinMaxNo Lost TimeOver 6 Months
49872604170.6%0%
 
  
 
Percentile:5th25thMedian75th95th
Days:511173378
 
  
 

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

ICD-9-CM:
493 - Asthma
493.0 - Asthma, Extrinsic
493.00 - Asthma, Extrinsic, without Mention of Status Asthmaticus
493.1 - Asthma, Intrinsic
493.2 - Asthma, Chronic Obstructive
493.9 - Asthma, Unspecified
493.91 - Asthma, Unspecified, with Status Asthmaticus

Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual complain of wheezing, coughing, chest tightness, and shortness of breath?
  • Is individual only able to speak in one- to two-word sentences?
  • Is individual restless and confused?
  • Are asthma attacks episodic?
  • Is individual asymptomatic between attacks?
  • Does individual have allergies, upper respiratory infection (URI), allergic rhinitis, or sinusitis?
  • Does individual exercise? Does exercise produce asthma symptoms?
  • Were symptoms worse through the workweek, improved on the weekend, and recurring when the worker returns to the job?
  • Does individual have occupational asthma?
  • Does individual smoke cigarettes at present or formerly?
  • Was there wheezing on exhalation or inhalation, or both?
  • Were other conditions present, such as tachypnea, tachycardia, using the accessory muscles in the neck to help breathing, cyanosis, or an exaggerated fall in systolic blood pressure during inhalation?
  • Were pulmonary function tests, pulse oximetry, and CBC done?
  • Did symptoms and physical signs respond positively to the administration of bronchodilators?
  • Was microscopic exam of sputum done?
  • Were arterial blood gases and an ECG done?
  • Does individual have an elevated IgE?
  • Was a methacholine challenge test done?
  • Are symptoms present only on the job?
  • Were qualitative and quantitative tests for possible air and gas triggers done?
  • Were conditions with similar symptoms ruled out?

Regarding treatment:

  • Was individual treated with bronchodilator inhalants and oxygen? Was it necessary to use IV muscle relaxants and steroids?
  • Was individual admitted to the hospital? To the intensive care unit?
  • Were an intubation and mechanical ventilation necessary?
  • Has individual been immunized against influenza and pneumococcal pneumonia?
  • Does individual use an inhaler to relieve exercise-induced asthma?

Regarding prognosis:

  • Is individual's employer able to accommodate any necessary restrictions?
  • Is individual able to avoid fumes, gases, dust, extreme temperatures, and any other airway irritants known to trigger an attack?
  • Does individual use masks or respirators when required?
  • Is asthma triggered by exercise or exertion? Does individual need sedentary work?
  • Does individual have any conditions that may affect the ability to recover?
  • Does individual have any complications such as pneumothorax, bronchospasm or status asthmaticus, or other chronic respiratory conditions?
  • Has individual been on long-term steroid use?
  • Is any underlying condition being managed effectively?

Source: Medical Disability Advisor


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