What is a Disability Peer Review?

A disability peer review is a specialized type of medical evaluation conducted by a licensed physician with expertise in the claimant’s condition, often referred to as a “peer” because they share the same or similar medical specialty as the treating provider. This review plays a critical role in the disability determination process by offering an objective, evidence-based assessment of whether the medical information supports the claimed level of functional impairment.

At MMRO, disability peer reviews are part of our commitment to delivering accurate, defensible, and clinically sound decisions for group disability plans, employers, and third-party administrators.

What Happens During a Disability Peer Review?

In a typical disability peer review, MMRO follows a structured process:

Case Assignment to a Specialty-Matched Reviewer
The case is assigned to a board-certified physician whose specialty aligns with the condition being reviewed (e.g., a neurologist for multiple sclerosis, a psychiatrist for depression, etc.).

Review of Medical Records
The reviewing physician examines:

• Medical records from treating providers

• Diagnostic test results

• Treatment history

• Any clinical documentation related to the functional limitations claimed

Analysis of Functional Capacity
The peer reviewer evaluates whether the medical evidence supports or does not support the level of impairment described by the claimant or their provider. This includes assessing whether the individual can:

• Perform the duties of their own occupation

• Perform any occupation, depending on the client’s disability plan requirements

Final Report
The physician produces a written, detailed report that includes:

• Clinical rationale behind the decision

• Answers to specific questions posed by the client

• An objective, evidence-based determination of functional capacity

Why Disability Peer Reviews Matter

Peer reviews help ensure that disability decisions are:

• Clinically sound

• Unbiased and consistent

• Defensible in appeals, litigation, or regulatory audits

They offer a deeper level of analysis compared to standard record reviews by ensuring a qualified expert evaluates the case through a truly clinical lens.

The MMRO Difference in Peer Reviews

At MMRO, our disability peer reviews are conducted by a nationwide panel of board-certified physicians, selected not just for their clinical expertise, but for their professionalism, report quality, and ability to communicate medical findings clearly and objectively.

We provide:

• Specialty-matched, timely reviews

• Clear, well-reasoned determinations

• Optional provider outreach

• A seamless experience for our clients and their claimants

Objective. Expert. Defensible.
That’s the standard we uphold in every disability peer review—because the stakes are too high for anything less.

Want to learn more about how peer reviews can strengthen your claims process? Reach out to MMRO today or explore our insights using #TheMMRODifference on LinkedIn.