Automated association of rating diagnostic codes for insurance and disability determinations

A system for adjudicating, for a payor, a medical disability request, comprising:

• a memory comprising instructions;
• a processor configured to execute the instructions to:
• receive an indicator of a diagnosis of a medical condition of a claimant;
• present, to a user, by a processor and from a predetermined set of health condition classification codes, at least two health condition classification codes based on the diagnosis;
• receive, from the user, a selection of at least one of the at least two health condition classification codes;
• and
• associate, based on a disability rating rules collection, the selected at least one health condition classification code with at least one rating diagnostic code selected from a predetermined set of rating diagnostic codes;
• wherein each of the at least two health condition classification codes represents a classification of at least one of an injury, disease, sign, symptom, abnormal finding on a physical exam, abnormal lab finding, claimant complaint, social circumstance, and an external cause of an injury or a disease;
• and
• wherein the at least one rating diagnostic code is configured to determine a degree of disability of the claimant and an indicator of an amount of money to be paid to the claimant by the payor.

A machine-readable storage medium comprising machine-readable instructions for causing a processor to execute a method for adjudicating, for a payor, a medical disability request, comprising:

• receiving an indicator of a diagnosis of a medical condition of a claimant;
• presenting to a user by a processor and from a predetermined set of health condition classification codes, at least two health condition classification codes based on the diagnosis;
• receiving from the user a selection of at least one of the at least two health condition classification codes;
• and
• associating, based on a disability rating rules collection, the selected at least one health condition classification code with at least one rating diagnostic code selected from a predetermined set of rating diagnostic codes;
• wherein each of the at least two health condition classification codes represents a classification of at least one of an injury, disease, sign, symptom, abnormal finding on a physical exam, abnormal lab finding, claimant complaint, social circumstance, and an external cause of an injury or a disease;
• and
• wherein the at least one rating diagnostic code is configured to determine a degree of disability of the claimant and an indicator of an amount of money to be paid to the claimant by the payor.