INVESTIGATIONS

All incoming claims are reviewed and processed considering the jurisdiction of the claim and the scope of the assignment. We develop a proactive action plan to conduct a thorough investigation on the pertinent file matters. During the initial phase of investigation we gather preliminary claim information to help determine compensability and jurisdiction. We perform domestic and international investigations. 

Compensability

● Recorded Statements
● Facts of Incident(s)
● Alleged Injur(ies)
● Medical Records
● Causation: DBA/WHCA
● Diagnosis and Prognosis
● Work Status
● Job Description

● Photo Identification
● Choice Physician Forms
● LS-207 Delivery (when applicable)
● Documents Needed to Calculate AWW
● Proof of Wages
● Employment Contracts
● Bank Statements/Tax Filings

Surveillance

When fraud is suspected on a claim it is imperative that we utilize all available options to complete due diligence on behalf of our clients. Surveillance is an essential tool and must be properly managed in order to ensure the best results. We provide our local surveillance agents with a comprehensive outline of relevant claim info, alleged injuries, and associated mental and/or physical limitations. While surveillance is underway we manage the field data in real time to provide immediate direction to agents while conducting their investigation.

● Photographic and Video evidence documenting claimant’s activity
● Social Media Check
● Physical Address Check
● Criminal and Government Agency Records

War Hazard

The War Hazards Compensation Act allows carriers the right to pursue reimbursement of costs incurred on claims related to events/circumstances where injuries were a result of “war-risk hazards”. We have built the tools aiding in the establishment and swift processing of WHCA claims for reimbursement into our custom CMS. Our billing structure is Federal Employees Compensation Act (FECA) compliant and designed to support a seamless transfer of information over to the Department of Federal Employees Compensation (DFEC).

● Link Cause of Incident to WHCA Coverage via Collection of Supporting Documentation
● Medical Records
● Police, Military & Incident Reports
● News Articles
● Witness Statements (when applicable)
● FECA Compliant Billing Structure
● WHCA Information Packaged for Swift Transfer of claim DFEC

Death

The investigation of death claims must be completed with special considerations for varying cultural norms that can impact the extension of eligibility of legal dependents (i.e. decedent’s parents). Knowledge of the laws that govern these claims is a vital part in gathering the necessary evidence especially in places where proper documentation is often unavailable.

● Alive and Well Checks of Legal Dependents of Decedent
● Collect and Verify Dependent’s Documentation
● Photos
● Marriage Certificate
● Birth Certificate
● Proof of School Enrollment
● Dependency Questionnaire
● Funeral Expenses and Executed LS-265
● Witness Statements
● Signed Stipulations with Photographic Evidence and Thumbprints

Medical Case Management

We assist injured workers,  from all around the world, who often lack the resources and knowledge to access reasonable/necessary care for work related injuries.

IME Services

Our comprehensive IME program provides clients with objective expert medical opinions that address specific carrier/defense counsel questions.

Translations, Transcriptions & Interpreting

Our professional translation services provide bifurcated documents leaving the original text fully intact. We make special considerations for the type of document and apply that in our final product.