Unlike other forms of insurance short and long-term disability programs are typically national in scope, serving large employee groups across the country, and regulated by federal standards. MCN is uniquely capable of handling these claims with east and west coast call centers. Providers are trained regarding the unique requirements of each Disability client and the proper concepts of disability assessment, including the importance of determining level of impairment. Additionally, when requested by clients, physicians may be asked to contact the treating provider as part of a disability assessment.

Table of Contents

• Peer Reviews
• Independant Medical Evaluations
• Independent Medical Observations
• Return-to-Work Determinations
• Fitness-for-Duty Examinations
• Third Medical Options
• Functional Capacity Evaluations
  
• Second Opinion Examinations (SECOPs)

Peer Reviews

Claims often raise questions regarding the delivery, appropriateness or necessity of medical services. When a face-to-face evaluation is not required or possible, consider MCN’s Peer Review services. MCN will compile complete medical histories, have a qualified physician consult and review all medial records and provide a comprehensive report. Depending on client protocols, MCN may ask that the physician contact the treating provider for further clarification in the case.

Independent Medical Evaluations

Medical assessments are MCN's core competency. They provide answers to questions about the medical nature, cause and treatment of injuries. MCN offers these services nationwide for insurance claims professionals, self-insured groups, regional and national government agencies and attorneys. The physician reviews all appropriate medical records, takes a detailed history, documents patient complaints and answers the requestor’s questions based on objective medical evidence.

Independent Medical Observations

Independent medical observation are employed by our Short Term Disability clients where there are insufficient medical records associated with a claim and the human resource or claims professional needs a medical assessment to determine appropriate handling. MCN provides suitable medical specialists to review the physical or mental status of the patient to determine he or she should be moved into a Long Term Disability program. The “quick report” is provided within 48 business hours from exam completion.

Return-to-Work Determinations

MCN performs these evaluations for claimants that are under Short Term Disability programs. In most cases the employee has been out of work beyond the usual scope of the diagnosis or the estimated return to work date has been frequently extended. An evaluation by an independent provider is performed to determine whether the return to work date is accurate. These exams can also help to determine a temporary return to work with restrictions until full strength is regained. MCN helps select the appropriate medical specialist to examine the employee toward a suitable determination.

Fitness-for-Duty Examinations

MCN works with human resource and claims professionals to determine whether an employee is able to return to the workplace without causing harm to themselves or others. In most cases the employee is not yet under any type of disability program but their behavior in the work place has caused concern and they are placed on temporary leave until an examination can be performed to determine their ability to return. MCN helps select the appropriate medical specialist to examine the employee toward a suitable determination.

Third Medical Opinions

MCN employs Third Medical Opinions when there are conflicting reports regarding a specific claim or case between two physicians. This provider acts as a “tie breaker”, as the name implies between two attending physicians or between the attending physician and an Independent Evaluating Provider. These exams are often requested when there are collective bargaining employment groups involved and when it is necessary to make final determinations on a claim, for example – Total Disability or Restrictions.

Functional Capacity Evaluations (FCEs)

FCE’s are an invaluable tool in providing an objective and complete assessment of an employee’s current level of physical functioning. They can also be tailored to assess a specific diagnosis, physical impairment, or ability to perform the essential functions of a specific job. The results provide valuable additional objective evidence when used in conjunction with an Independent Medical Evaluation.

Second Opinion Examinations (SECOPs)

MCN works directly with OWCP District Offices who have direct responsibility for processing Federal employment claims. We interface with claims managers in the District Offices that adjudicate incoming claims to determine eligibility for compensation payments; manage claims in which eligibility has been established; determine wage-loss compensation payments for covered disability or death; and process payments for allowed medical and vocational rehabilitation services incurred in the treatment of injured workers covered under the Federal Act. MCN provides active practice physicians to assist in the medical determination of these claims.