When it comes to both workers’ compensation claims and automobile no-fault claims, a wide variety of claimant injury types present unique challenges for examiners and adjusters alike. Minor injuries typically present fewer challenges within the administration of a claim while catastrophic injuries may necessitate the use of more in-depth and costly solutions in order to ensure the best possible outcome for each claimant.
When a claim involves such catastrophic injuries, it ma y be most beneficial to the injured claimant to consider bringing in an occupational therapist. If the claimant is unable to complete the activities of daily living (ADLs) for example, an occupational therapy program is typically the most efficient and accurate method of treatment. In general, occupational therapy assists claimants in returning to the original level of functionality that they enjoyed prior to their injury. This includes returning the claimant to their previous level of independence, or as close to it as possible, so they can go back to performing ADLs. As the occupational therapist assists the claimant with recovery and making accommodations for working around their injuries, improvements in overall quality of life and a reduction in caregiver stress may result as well.
Even though there are many benefits to administering occupational therapy to injured claimants, it can be challenging for an adjuster or examiner to properly evaluate a claimant’s needs. Fortunately, Northwood provides on-site claimant evaluations to determine the claimant’s ADLs and to determine his or her score of Functional Independence Measurement (FIM) levels.
FIM levels encompass a wide range of claimant abilities that include: transfers, grooming, toileting, dressing, feeding and meal preparation, housekeeping, community mobility, communication, wound care, mobility, cognition, home assessment, attendant care and more. Claimants are evaluated on a scoring scale of one through seven*. A FIM score of one indicates that a particular activity is unsafe for a claimant to attempt while a score of seven signifies the claimant is able to perform the activity on his or her own without help or modifications.
As a third-party administrator (TPA) of both workers’ compensation and automobile no-fault claims, Northwood brings efficient claims administration and exceptional claimant care to the insurance companies it partners with. As part of this commitment to excellence, Northwood offers on-site evaluations of claimants to help adjusters and examiners accurately determine whether a claimant would benefit from occupational therapy and to what extent.
Together with the on-site home evaluation that Northwood also offers, this claimant evaluation process creates many benefits for all parties with the ultimate goal of claimant recovery and independence in mind. Claimants will enjoy a higher level of satisfaction with the outcomes of their claim. Adjusters and examiners will appreciate having immediate access to this valuable resource and insurance companies will reduce claims costs through their partnership with Northwood as their TPA and provider of claimant occupational therapy evaluations.
For a more customized look at how Northwood can benefit your insurance company and provide higher claimant satisfaction levels, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 at your convenience.
*FIM Levels Key:
7 – Complete Independence (Timely, safely, without modification or aids)
6 – Modified Independence (assistive device required, increased time to perform, some risk)
5 – Supervision (Subject = 100% Stand-by assistance, cueing for safety without physical contact)
4 – Minimal Assistance (subject = 75% or more, no more help than touching)
3 – Moderate Assistance (Subject = 50% to 74% , requires, more help then touching;
2 – Maximal Assistance (Subject = 25% – 49%, maximum or total assistance required)
1 – total Assistance (Patient does less than 25% of effort; and
0 – Not safe, medically unable, refuses, does not occur
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