Help with disability claim info.

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Specializes in Preop, Med-Surg, Education, Limited Peds.

I have an attorney that works only with disability claims that would like me to do some case screening for him. These will be my FIRST CASES AND I AM FREAKING OUT! He wants me to look at attending physician statements, peer review reports, I&E reports, etc. I don't know what a peer report or an I&E report is! Can anyone help me!? Am I in over my head, should I bail out now?

OK, I had to edit, I was so nervous talking with him, it is an IME report! Still would like any input or help you can provide!

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Specializes in Education, FP, LNC, Forensics, ED, OB.
I have an attorney that works only with disability claims that would like me to do some case screening for him. These will be my FIRST CASES AND I AM FREAKING OUT! He wants me to look at attending physician statements, peer review reports, I&E reports, etc. I don't know what a peer report or an I&E report is! Can anyone help me!? Am I in over my head, should I bail out now?

Hello, preop

Don't panic. Don't bail. Deep breath and calm down. You've come to the right place.

I don't think the attorney said, "I and E Report". I think he said, "IME Report".

IME=independent medical examination

In an IME, the client is claiming mental and/or physical disability(s). The disability insurer or other party such as SS, worker's comp, etc., will choose a physician to examine the allegedly disabled party. They have a legal right to request these exams. (LNCs can and do attend these IME's). A report will be issued the client and disability insurer (or other responsible party). So, I'm sure this is what he's referring to and wants you to review the IME report(s).

Peer review=a team of like colleagues (peers), physicians for example, reviewing the physician in question conducting him/herself during the event in question and if he/she adhered to/deviated from, the Standard of Care. Peer Review is a scrutiny, if you will, of the individual, or one's "peer".

I'm sure you will be also reviewing all medical records from all physicians, hospitals, claim documents, any appeals records, applicable wage/earning reports, and other pertinent reports, etc.

Do not be overly concerned. Take the case, get all the initial paperwork, review this, and you should do just fine.

If you have any other questions, please post here or send me a private message.

Congratulations on getting the case. And, good luck.

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Specializes in Preop, Med-Surg, Education, Limited Peds.
Hello, preop

Don't panic. Don't bail. Deep breath and calm down. You've come to the right place.

I don't think the attorney said, "I and E Report". I think he said, "IME Report".

IME=independent medical examination

In an IME, the client is claiming mental and/or physical disability(s). The disability insurer or other party such as SS, worker's comp, etc., will choose a physician to examine the allegedly disabled party. They have a legal right to request these exams. (LNCs can and do attend these IME's). A report will be issued the client and disability insurer (or other responsible party). So, I'm sure this is what he's referring to and wants you to review the IME report(s).

Peer review=a team of like colleagues (peers), physicians for example, reviewing the physician in question conducting him/herself during the event in question and if he/she adhered to/deviated from, the Standard of Care. Peer Review is a scrutiny, if you will, of the individual, or one's "peer".

I'm sure you will be also reviewing all medical records from all physicians, hospitals, claim documents, any appeals records, applicable wage/earning reports, and other pertinent reports, etc.

Do not be overly concerned. Take the case, get all the initial paperwork, review this, and you should do just fine.

If you have any other questions, please post here or send me a private message.

Congratulations on getting the case. And, good luck.

Thanks sirI. I remember that now from class, I must have just really stressed out! I really appreciate you putting it all in perpective. He actually said that he has 5 or 6 cases that he wants me to work on. When he said that is when I probably started to freak out. I pick them up on Monday!

It's absolutely GREAT to be able to come here and get support!!!! Thanks!!!!

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Specializes in Education, FP, LNC, Forensics, ED, OB.

That's normal, preop. Anxiety about new cases is quite normal. You are going to do just fine. Congratulations on all those cases. You are on your way!!!!!

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Specializes in Preop, Med-Surg, Education, Limited Peds.
That's normal, preop. Anxiety about new cases is quite normal. You are going to do just fine. Congratulations on all those cases. You are on your way!!!!!

Thanks sirI!

My next problem is - what is he going to be wanting from me? I know what to look for med. mal. wise but as for social security disability, and disability in general, I'm not so sure. He mentioned looking mostly at date of disability, attending physician statements, medical requirements of the patient need for disability, IME reports and peer review reports. But what am I looking for in these? Not quite what I expected my first cases to be!

Don't get me wrong, I am extremely excited to have my first case, I just wish I knew where to start!

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Specializes in Education, FP, LNC, Forensics, ED, OB.
Thanks sirI!

My next problem is - what is he going to be wanting from me? I know what to look for med. mal. wise but as for social security disability, and disability in general, I'm not so sure. He mentioned looking mostly at date of disability, attending physician statements, medical requirements of the patient need for disability, IME reports and peer review reports. But what am I looking for in these? Not quite what I expected my first cases to be!

Don't get me wrong, I am extremely excited to have my first case, I just wish I knew where to start!

Well, since I do not know the issues of the case, I cannot intelligently answer your question. And, we cannot discuss these issues per TOS.:wink2:

You need to ask of him exactly what he wants you to do. Point by point, issue by issue. Just handing you these records w/o outlining what he expects of you is not how to proceed. So, you ask specifics.

Good luck.

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Specializes in Preop, Med-Surg, Education, Limited Peds.
Well, since I do not know the issues of the case, I cannot intelligently answer your question. And, we cannot discuss these issues per TOS.:wink2:

You need to ask of him exactly what he wants you to do. Point by point, issue by issue. Just handing you these records w/o outlining what he expects of you is not how to proceed. So, you ask specifics.

Good luck.

OK, so it sounds like he would expect these questions and I won't look stupid if I ask them. Thanks again!

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Correct.

Never enter into a contract w/o first knowing exactly what is expected of you. Details.;)

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Specializes in Preop, Med-Surg, Education, Limited Peds.

I met with the attorney and he gave me 6 cases! He went through exactly what he wants and gave me examples of what he needs. He knows that I have never done it before and he said we will get through it together. I actually think I can do it! I am so excited to actually have my start! :typing

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Absolutely fantastic, preop!!!!!!!!!!!!!!!!!!

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Congratulations!!

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