Is this injury work-related?
Where the mechanism of injury and the reported story do not line up, the provider explains what the exam and imaging actually support — and what is still an open question.
Claims Review · For employers
Sit down with the doctor and go through every open claim.
For employers carrying a steady number of injuries, ICA hosts a working meeting with your HR and safety leads and one of our providers. We take your active claims one at a time and talk through where each one actually stands — medically, not just on paper.
01
A conversation, not a reportYou ask the provider questions in real time.
02
Every active claimNot just the ones that have gone sideways.
03
Medical plain-spokenWhat the injury is, what recovery looks like, what you can do.
04
You leave with next stepsPer claim: who does what, and by when.
What it is
A standing meeting about the injuries you are already carrying.
Most employers only hear about a claim when something goes wrong — a worker is still out, an adjuster is asking questions, a bill looks strange. A claims review flips that. We schedule time, put your active claims on a list, and work down it with a provider in the room.
HR and safety usually know the worker and the job. Our provider knows the injury and the care plan. Putting both in the same conversation is what makes the meeting worth having.
Who is in the room
- An ICA providerUsually the physician or PA treating your people, so the answers come from someone who has seen them.
- Your HR or claims contactThe person fielding the paperwork, the adjuster calls, and the employee questions.
- Your safety leadKnows the tasks, the crews, and what modified duty is realistically available.
- A supervisor, when it helpsFor a complicated claim, the person who runs the shift often has the detail that unlocks it.
Claim by claim
What we actually talk through
Not every question comes up on every claim. These are the ones that come up most.
Is the treatment tracking the way it should?
For each claim: what care has been given, whether recovery is on the expected curve, and what happens next if it is not.
Where is this worker on restrictions?
Current limits, what they realistically rule out on your floor, and what modified duty could look like this week rather than next month.
Is the claim near MMI?
When a worker is approaching maximum medical improvement, we talk through what that means for the claim and what an impairment rating would cover.
Should we get another opinion?
On claims being treated elsewhere, or where care has stalled, the provider will tell you straight whether a second look is worth pursuing.
How it runs
Before, during, and after the meeting
- 1
Setting it up
You send the list
Your HR or claims contact sends over the active claims — names, dates of injury, and anything you already know is a problem. If a claim is being treated somewhere other than ICA, say so; we handle those differently in the meeting.
- 2
Before we meet
Our provider reviews the files
The provider goes through the charts for the ICA-treated claims ahead of time, so the meeting is spent on discussion rather than on reading.
- 3
The meeting
We work down the list
One claim at a time. Current status in plain language, what is driving the timeline, and what would move it. Your team asks questions as we go — that back-and-forth is the point.
- 4
The meeting
Decisions, not just updates
Where something needs to change — a recheck, a referral, a modified-duty offer, a conversation with the adjuster — we name it and name who owns it.
- 5
After
You leave with a short list
A per-claim summary of what was decided goes back to your contact. The next review picks up from that list, so nothing quietly sits.
Come prepared
Bring what you have. We will bring the rest.
You do not need a formal packet. A list of open claims and the questions your team keeps running into is enough to make the meeting work.
- A list of open claims — name, date of injury, body part
- Any claim where the worker is still fully off work
- Claims your adjuster has flagged or questioned
- What modified duty is actually available right now
- Questions your supervisors keep asking you
Is it for you
When a standing review earns its place
Claims reviews make sense for employers with enough injury volume that claims overlap. If injuries are rare for you, a phone call to the clinic is usually faster.
You carry several claims at once
Enough that keeping each one straight takes real effort, and a few always drift.
Claims stay open longer than they should
Nobody can say exactly why, and each one has a different story.
HR and safety are not in sync
One sees the paperwork, the other sees the floor, and the medical piece falls between them.
Your adjuster keeps asking questions
You would rather answer with the provider next to you than relay guesses.
Common questions
How long does a review take?
Long enough to work through your list. Volume drives it — a handful of straightforward claims goes fast, a few complicated ones take longer. We would rather cover a short list properly than a long one quickly.
How often should we do this?
It depends on how many injuries you carry. Employers with steady volume tend to land on a regular rhythm; others schedule one when the list gets long enough to be worth sitting down over.
Does it cost anything?
No. Claims review is part of working with ICA — there is no separate charge for employers who send us their injuries.
Can we do it remotely?
Yes. Most reviews work fine over video, and we can come on site if it makes the meeting easier to staff.
What about claims treated by another provider?
Bring them anyway. Our provider cannot speak to a chart they have not seen, but they can tell you what the care described sounds like, what questions to ask, and whether a second opinion is worth it.
What about employee privacy?
The meeting stays on the ground workers’ compensation actually covers: work status, restrictions, treatment plan, expected timeline. It is the same information you are entitled to as the employer on the claim.
Should our adjuster or carrier sit in?
That is your call. Some employers find it useful; others prefer a candid internal conversation first and take the outcome to the adjuster themselves.
We only have the occasional claim. Is this overkill?
Probably. At that volume, call the clinic about the specific claim — you will get the same answer faster.