Amid constant change in the world of medicine and health care, insurance adjusters must keep a close eye on the latest advances, notes David Nowell, PhD, a clinical staff member at UMass Medical School and an expert in independent medical evaluations as a practicing neuropsychologist.
Medical care and allied interventions, occupational therapy and mental health are changing all the time, with major implications both for the prognosis of patients and for insurance adjusters trying to ensure the most effective possible treatments are used.
“Medical care… is constantly changing,” notes Nowell, part of the Disability Evaluation Services team, which provides training to insurers, nonprofits and government agencies. “There are new treatments emerging which means there are new treatment options.”
When new treatments become available, it can have a direct impact the daily work of insurance adjusters, offering up a new option for patients.
Research can also call into question the effectiveness of current treatments, he says.
“Sometimes options which we thought were evidence-based at one point we have come to discover are not as effective or there are interventions that are more effective,” Nowell says.
A new, more effective treatment may result in a more rapid recovery and return to health or work for the patient.
That, in turn, has significant implications for the insurance adjuster.
“Understanding the appropriate treatment allows the insurance adjuster to determine what is the timeline, what is the expected length to get to maximum medical improvement,” Nowell says.
Ensuring that the latest and best treatment is used also has wider implications, protecting against liability and ensuring “the claimant is being treated fairly, being treated well,” he adds.