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Independent Medical Evaluations (IME) Depending on the type and extent of injury or disability, these evaluations provide third party opinions regarding diagnosis, prognosis, and appropriateness of current treatment. We have well over 100 physicians on our roster. Please refer to our accompanying list of specialties. Pre-Claim Evaluations (PCE) Requested when an insured has been admitted to a hospital or LTC facility (or has been there for three days prior), and there is entitlement to attendant care/ assistive devices or modifications, and no other benefit application is pending. Functional Capacity Evaluations (FAE/FCE) Quantifies physical tolerances and weight handling abilities of the individual, as they relate to specific employment tasks, home activities and other activities of daily living. May be performed over one or two days. In-Home Evaluations (In-Home) Evaluation of the domestic environment to determine the individual’s requirement for attendant care, housekeeping, home maintenance, care giving, and the need for any assisitive devices. Pre/Post Accident Activities of Normal Living Evaluation (ANLI) Assessment of an individual’s ability to perform usual daily activities. Its focus is on promoting an early & safe return to ADL’s and employment duties. Job Site Analysis (JSA) Assessment of the workplace to determine essential employment tasks and provides a detailed breakdown of job requirements. Most valuable when combined with a functional abilities evaluation and is employee specific. Physical Demands Analysis (PDA) A comprehensive analysis of the work environment that measures physical demands of the job or employment category. Vocational Evaluations (Psychovocational, Neuro-psychovocational, etc) This type of evaluation is useful to answer questions regarding employability, earning capacity, and alternative employment options. Diagnostic Testing With our partnerships and experience in the industry, we have the capacity to expedite MRI’s, CT’s, x-rays, and other diagnostic/investigative services including vision testing, ECG, PFT, audiometry, and lab tests including liver function and drug screening. Medical Documentation and File Review A review by a medical practitioner can assist in obtaining additional relevant information prior to an evaluation/ intervention, or as a means of follow-up. It is meant to determine the need for additional intervention, diagnostics, interpretation of results, or to provide additional opinions as required. Paper Review A paper review may be performed when there is a request for ancillary goods and services (pursuant to 37.2 SABS), there is a question about application of the PAF (pursuant to 38 SABS), there is a question about similar goods/ services recommended in a subsequent OCF18 that had been denied in a prior OCF18 (pursuant to 38 SABS, concerns about an exam approval application, and when there is a question about brain impairment (certain criteria apply). Future Care Cost Analysis/Life Care Planning A comprehensive medical-legal document specifying all long term (lifetime) needs and associated costs as they relate to an individuals disability. Transferable Skills Analysis If the individual cannot return to pre-injury employment, a TSA will assess the his/ her current skills inventory and suggest occupational alternatives. Labour Market Survey A comprehensive and highly individual determination of available employment options based on TSA and FCE results, geographic limitations, qualifications and education as well as long term feasibility. Domestic Modifications Modifications (temporary and permanent)to the home environment meant to promote safety and self-sufficiency at home. Work Site Modifications Provision of environmental adaptations including adaptive equipment and devices, process modification or other ergonomic changes to promote return to work. Modified and Graduated Return to Work Programs This is an employee and job-specific process of increasing employment hours and/or job tasks with the goal of gradual return to work. Useful as part of an ESRTW program. Work Hardening Programs This is an individualized program meant to gradually improve a workers ability to handle employment related demands. May be initiated in clinic, and then expanded to include on-site sessions. May be used in conjunction with a modified/ graduated return to work program. Post Offer/Pre-Placement Evaluations Once an individual is hired, but before they are placed. This evaluation is performed with the goal of job-matching; ensuring the new employee has the physical ability to perform the job for which he has been hired. This evaluation usually takes the form of a functional abilities evaluation and medical screening. A PDA is usually required for this assessment to be effective. Chronic Pain Management Programs Aimed at individuals suffering from chronic pain syndromes who have not responded well to conventional medical and surgical approaches. The emphasis is on learning pain self-management techniques with the goal of leading a more active, satisfying life despite having chronic pain. Involves a multidisciplinary approach, physical reconditioning, vocational counseling, and follow-up support. Some individual psychology pain management training is offered on a limited basis. STD/ LTD Claims Management Consulting Disability management consulting for both short term and long term non-work-related injury and illness. It is our goal to maximize your employee benefits while ensuring quality care. We work with your employee and their physician to facilitate a prompt, safe return to work. This allows you to maintain a neutral position relative to your disabled employee. |