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Claims and disability management extend our core service by integrating our medical support for medical time loss cases with the administration and follow-up that is also required.
Often, clients either do not have the resources or expertise to follow-up on the medical information provided by us as their “Company Doctor” or the claims management is fragmented by occupational and non-occupational “silos” and various outside, non-medical service providers, adjudicators and consultants.
Simply put, we believe claims and disability management is a medical service and therefore, should be provided by a medical services company and medical professionals.
The result is that integrating disability and claims management with your occupational health program creates a uniquely powerful and effective way to reduce WSIB, Short Term Disability (STD) and Long Term Disability (LTD) costs.
Our claims and disability management program is designed to ensure each claim is properly managed and administered regardless if the payer is the WSIB, your insurance company or your own company if you are self insured. The goal is the same – the early and safe return to work of your employee with the oversight to ensure the related costs are minimized and the process is implemented properly.
Elements of the program include:
- Ensuring accident investigation forms are completed properly
- Providing claim advice for possible objections to the WSIB or insurance provider
- Submitting of objection letters and representation at appeals if required
- Reviewing NEER statements and providing cost projections
- Medical support and advice to proactively manage the medical issues, including our unique “Time Loss Review” medical exam and doctor-to-doctor communication
- Nurse case management to assist in the employee Return-to-Work, including following up with the employee, the employees’ physician, the WMC physician as well as coordinating additional tests and services, such as Functional Abilities Evaluations, Physical Demands Analysis and Independent Medical Exams
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