Disability Solutions helps employers better manage work-related injuries by offering a comprehensive line of services, customized to the needs of each employer. Each service is available as part of a comprehensive package, or individually.

Disability Solutions' a-la-carte approach to workers compensation consulting ensures quality support regardless of your budgetary constraints.

SERVICES

Third Party Administrator (TPA)

Disability Solutions offers an innovative and aggressive approach to claims management, with tangible benefits beginning at the date of injury and realized through claim closure. A "Physician Driven", customized management plan is developed specifically for every claim. DS keeps you informed with claim updates at each stage of processing. Disability Solutions individualized claims management and detailed progress reporting ensure that every effort has been expended and every option explored.

Third Party Administrator Services:

• Claims Investigation
• Standard Initial Examinations (SIE)
• Claims Management
• Rehabilitation Programs
• Handicap Reimbursement
• Lump sum Settlement

Group Rating Program

Group rating is a program employers can use to reduce their workers' compensation costs. The Ohio Bureau of Workers' Compensation permits employers to join together and be "rated" as a group through our sponsoring organization, the Southern Ohio Chamber Alliance (SOCA) to save money.

More than 75,000 Ohio employers have joined a group rating plan. SOCA has 85 member chambers and each chamber has many members who participate in the group rating plan.

Your eligibility for group rating may change from year to year, meaning that even if you have not qualified in the past, you could qualify now.

Claims Management Audit (CMA)

The Claims Management Audit (CMA) is an independent file review, which provides the employer dual benefits. The CMA produces a customized claim management plan goaled to reducing employer's liability. The CMA identifies areas for improvement, in the employer's current management system.

A standard CMA overview:

• The employer and/or their Third Party Administrator (TPA) and a Disability Solutions auditor identify the claims to be reviewed.
• DS auditor reviews identified claims and prepares a detailed evaluation.
• DS auditor confers with the employer on claim evaluation results, to determine a plan of action for each claim reviewed. Action plans could include one or more of the following:
  
  • Independent Medical Examination
  • Physician Drug Review
  • Work Transition Program
  • Functional Capacity Examination
  • Hearing Preparation
  • Lump Sum Settlement
• DS auditor then makes proper referrals and manages the follow up process, at the employer's discretion.

Standard Initial Examinations (SIE)

The Standard Initial Examination (SIE) is a targeted independent medical examination performed within the first 21 days of an alleged industrial or occupational injury claim. The SIE can give employers peace of mind, knowing a medical expert is watching out for their interests, from the beginning of the claim process. The benefits of an SIE are numerous:

Benefits:

• SIEs are performed by an expert physician trained to understand work-related injuries and the Workers' Compensation system.
• The exam can define and expedite better care for the injured worker.
• An SIE exam may result in substantial savings in medical and compensation costs.
• The exam provides a solid medical basis from which to approve and/or deny a claim.
• SIEs can eliminate fraudulent claims before they get started.
• The exam provides independent documentation of legitimate work injuries, in a claim.
• SIE identify any of the possible 25 handicap diagnostic codes allowed by the Ohio BWC.
• The exam eliminates inappropriate and redundant allowed conditions on a claim.
• SIEs serve as a valuable reference and protect the employer from future liability by establishing early medical documentation of what was NOT injured (i.e. injured worker cannot claim additional injured body parts months or years later).

A physician performs the SIE. The exam includes:

Independent medical examinations (IME)

The Independent Medical Examination (IME) is a comprehensive medical examination performed at any time within the claims management process. The IME is an excellent tool for employers and injured workers and provides the following benefits:

Benefits

• An independent expert physician, skilled in the diagnosis and treatment of work-related injuries performs the exam.
• An IME can expedite the resolution of a claim.
• The exam reduces the use of unnecessary tests and treatments, thus reducing costs.
• An IME can identify and eliminate fraudulent claims.
• The exam can stop inappropriate and unnecessary Total Temporary Disability payments.
• An IME can result in recommendations for more effective injured worker treatments.
• The exam may stop the amending of a claim for inappropriate conditions.
• An IME can lead to more appropriate work restrictions in a claim.

A qualified physician performs the IME. The IME features are similar to the SIE, with the addition of the review of medical files pertinent to the claim. The IME is a more detailed, comprehensive examination, primarily used to establish if an injured worker has reached Maximum Medical Improvement (MMI).

MMI is a treatment plateau that is static or well stabilized, at which no fundamental, functional or physiological change can be expected within reasonable medical probability regardless of continuing medical or rehabilitation procedures.

Medical Functional Capacity Evaluations (FCE)

The Medical FCE report is "A unique product offered by Disability Solutions". The Medical FCE is an objective, interdisciplinary assessment of:

• Functional capacities
• Medical recovery status
• Readiness for return to transitional or full duty work
• Symptom magnification or fraud
• Appropriateness of ongoing treatment for allowed condition(s)

The FCE examinations are performed by an interdisciplinary team including:

Richard Wickstrom, PT, CPE (Certified Physical Therapist & Ergonomist).

The Medical FCE is a cost-effective, unique tool in the occupational and non-occupational disability marketplace. In one powerful report, the employer profits from the expertise of an experienced disability physician with the objective determination of functional capacity by an experienced therapist and ergonomist.

Benefits

• Objectively defining the physical capabilities of the injured worker, rather than relying entirely on the opinion of the treating physician.
• Facilitating a more rapid transition to full duty employment.
• Facilitating a speedy disposition of the industrial injury claim.
• Assist in identifying the non-compliant or fraudulent worker.
• Reducing time-lost claims and temporary total compensation.
• Reducing the "on again, off again" work patterns of many injured workers.
• Providing objective data that empowers employers at Industrial Commission hearings through the impact of an independent physician review combined with an objective physical capacity evaluation.

Physician File Reviews

The physician file review assists employers, and/or their representatives, with an evaluation of any medical and/or compensation question that may arise during the management of an industrial injury claim, including fraud and/or inappropriate pharmaceutical use.

District and Staff Hearings

The DS system was designed to address issues at hearing. Hearing decisions are based on a weighing of medical evidence in accordance with workers' compensation law. The Disability Solutions approach will allow every opportunity for the correct administrative decision to be made at any point in the process.

DS consultants work with the employer and/or their representative to address any and all issues of hearing preparations, up to including attending hearings as an additional advocate on the employer's behalf.

Ergonomic Consultation

Ergonomic consultation is accomplished at work sites, under the direction of a Certified Professional Ergonomist. The goal of the review is to:

• Review the circumstances of work-related injury claims.
• Observe workers performing critical job functions to identify risk factors for injury and physical qualifications for safe job performance.
• Recommend Workability Assessment priorities, job modification, transitional work on-site therapy, or other strategies to resolve worker safety, productivity or disability issues. Physician referral is required if the injured worker participates.

Lump Sum Settlement (LSS)

The lump sum settlement is the most powerful tool an employer has to reduce future liability of an industrial injury claim. The DS settlement team can reduce your workers compensation liability, while providing valuable insight on future claims management on those claims not settled. The LSS provides recommendations and negotiations on the employer's ongoing liability claims.

The DS settlement team will:

• Audit each claim.
• Provide a digested one-page analysis with a settlement recommendations
• Review the information, one-on-one, with the employer
• Negotiate on the employer's behalf, with the injured worker or their representative.

Physician Consulting Program

Our "team of physicians" are available to act as medical consultants to the employer on a broad range of medical issues including:

• Medical treatment concerns for employees.
• Interpretation, evaluation and cost-effective use of appropriate diagnostic studies such as MRI, CT, bone scans, EMG, discography, myelograms, etc.
• Helping with the establishment of provider networks in the community.
• Medical Second Opinion on difficult cases.
• Serving on any employer safety committees if applicable.
• Assist the employer's legal representatives in their preparation for Industrial Commission hearings.

In summary, Disability Solutions' philosophy is that the cornerstone of effective disability management is a solid, fundamental medical approach to an industrial injury. This approach sets a proper tone for the successful management of the subsequent financial and legal aspects of Worker's Compensation claims.

Disability Solutions helps providers, employers, and employees negotiate the potential pitfalls inherent in the current system. By adhering to these fundamental principles, many of the legal, financial, and liability concerns may be reduced by 30-50%. The most rewarding results are happier, more productive employees and a more financially secure business.