Our Registered Return to Work Disability Management (RTWDM) and Vocational Rehabilitation (VRC) consultants possess several years of experience with various disability insurance legislation, regulations and procedures, providing expert, confidential advice, representation, advocacy and education on all insurance related matters.
Employers are entitled to representation at every step of the claims process, including initial adjudication, claims management, return to work plans and appeals. Insurance claims management and appeals can be a timely and complex process.
Our consultants will improve your chances of ensuring all decisions made on a claim are accurate and fair, reducing employee sick leave and insurance costs.
Services:
Claims management:
- Handle all communication between you, your employee, the insurance company and your employee’s medical practitioners.
- Facilitate and manage the return to work process.
- Collaborate with the insurance company in the development of customized individualized return-to-work plans that shorten claim duration and reduce claims costs.
- Our team will monitor and scrutinize all claim costs for accuracy and savings.
Appeals:
- Conduct a detailed review of all file documentation to determine appeals issues and likelihood of success.
- Analyze the evidence and decisions made on the claim to determine if the legislation, regulations and procedures have been fairly and properly applied.
- Consult with employer in order to discuss and identify potential appeal issues, then determine the appropriate course of action under the appropriate legislation, regulations and procedures.
- Collect additional pertinent information through investigation and research to support appeal issues—this may require contact with medical professionals.
- Approach the insurance agency in order to seek resolution of issues prior to appeal process by providing further evidence or alternate interpretation of legislation, regulations and procedures.
- Represent employers at the appeals process, including attending, developing and presenting evidence and arguments in accordance with the legislation, regulations and procedures of the hearing bodies.
Our commitment is to ensure the employer’s rights are upheld, based on the rules of natural justice and administrative fairness.