Medical records, phone calls key to gathering information for insurance adjusters, UMass Medical School expert says

January 04, 2018

With the right training, insurance adjusters can learn how to cull a wealth of information from medical records and even just a simple phone call, says David Nowell, PhD, a clinical staff member at UMass Medical School and an expert in independent medical evaluations as a practicing neuropsychologist.

Part of UMass Medical School’s Disability Evaluation Services team, which provides training to insurers, nonprofits and government agencies, Nowell says forms filled out by the patient’s doctor can be a great place to start.

The attending physician’s statement and other forms can provide detailed descriptions of the client’s condition and impairments. The Family Leave Medical Act Certification form can be another good source.

“I have seen a number of forms which ask treating providers to document their clinical impressions,” says Nowell, who frequently speaks and conducts workshops on the complexities of disability evaluations.

Beyond clinical information, the medical forms may also provide crucial details on the individual’s work history, enabling the adjuster to “make a plan for a return to work and to determine if modifications are needed,” Nowell notes.

However, sometimes a “skillful” phone call can provide great information as well. It is some of the material Nowell says he typically covers in training sessions with insurance adjusters and which should be part of any good professional workshop.

“There are ways of asking questions in that phone call to get really good clinical information,” Nowell says.

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