Claims are assigned to our Nurse Case Management Staff whom have over thirty years of experience in workers compensation arena reviewing files, participating in active medical case management and has worked closely with adjusters and employers in reference to their workers' compensation cases. At times a full medical file review is needed to determine the treatment which has occurred for the injury reported and more importantly has the treatment provided appropriate care, has there been care outside of the accepted injury, what barriers to recovery are noted and what is the next step to obtain claims resolution. In addition often times the claims get lengthy, are older injuries and the medical records cumbersome and are in need of clarity of treatment and glean out what is not appropriate for the reported injury. Then the adjuster can determine the next course of action with an up to date file and ideas to address.
Independent medical evaluations are often an outcome of a medical file review and the review in itself will assist not only the adjuster to direct the correct Independent Medical Examination providers but also prepare questions and obtain any missing information.
