Continuous Monitoring of the Claim

Throughout the life of the claim, the claimant’s medical condition is intently monitored to guarantee a speedy return to work. Adjusters remain in close contact with a claimant’s treating physician to ascertain if the most effective treatment plan has been developed. All medical documentation related to a claim is carefully and closely studied by skilled adjusters. The adjusters are educated in many medical conditions and are equipped with the skills necessary to properly assess a claimant’s status based on the provided medical reports.

When necessary, a qualified nurse case manager is assigned to the case for medical advice to ensure that the claimant does not undergo any unnecessary medical procedures. Our nurses are URAC accredited and provide competent guidance in establishing a medical management plan. Field case managers are assigned to a case to visit with a claimant or doctor in cases that become too complex to follow over the phone. They can help pinpoint the reason for prolonged treatment in an effort to find a solution to control costs.

In addition to the contact with the treating physician, claimants are scheduled for independent medical examinations to get independent evaluations of their degrees of disability and need for treatment. Dynamic Claim Services uses only Board Certified doctors with a good experience rating and a history of credible testimony. When utilized correctly, the use of these examinations proves to be valuable tools for litigation on issues such as need for treatment, degree of disability, ability to work, and permanency ratings.

One of the most effective tools to reduce the duration and cost of a claim is a modified duty program. Dynamic encourages employers to establish modified duty programs to minimize their loss exposure. When claimants are unable to return to work at a full duty capacity, adjusters work with the treating physicians and employers to create or adapt modified duty positions which are in accordance with the claimant’s limitations. Returning employees to work sooner assists in the healing process and prevents disruption in the workforce. We have seen incredible success in this process and are confident in our ability to minimize time lost from work.

Throughout the course of the claim, subsequent investigations are routinely conducted to determine the extent and nature of the claimant’s continuing disability including but not limited to possible fraud signals. Some of the types of investigations performed involve medical status, work activities, volunteer activities, sources of income, and ability to perform activities of daily living.

In addition to minimizing the medical expenses of a claim, attention is given to ensure that the total amount of indemnity benefits payable to a claimant is kept to an absolute minimum.

The timeliness and efficiency of our claims process also prevents any unnecessary penalties. All state mandated forms are filed in a timely manner and all practices are in full compliance with state regulations.