Objective Medical Reviews Protect Both Parties

Objective medical reviews serve a dual purpose. They protect employers/plans by ensuring that decisions regarding disability claims are legally sound and medically justified. At the same time, they protect participants/claimants by guaranteeing that their cases are evaluated based on clinical facts rather than assumptions or bias. The clinical evidence is under review in an objective claim review process, not the person themself.

These reviews often involve detailed assessments by impartial physicians who have no prior involvement in the case, and have no relation to the claimant or the client. They consider the claimant’s history, diagnostic results, treatment plans, and current functional status. In doing so, the process ensures that each party is treated fairly and that the final decision is rooted in sound medical practice.

Ultimately, this approach enhances transparency, reduces the risk of litigation, and fosters trust in the claims process as well as the integrity of the overall plan/program.