CareReview / Who We Serve / Long-Term Disability Carriers

Objective Reviews Behind Every Long-Term Disability Decision

Specialty-matched physicians and functional capacity experts who strengthen claim defensibility and reduce bad-faith exposure on every determination.

We help LTD carriers manage disability claim reviews — initial determinations through peer-to-peer, appeals, and independent medical exams — with independent, specialty-matched clinical experts who strengthen compliance, protect claim objectivity, and build claimant and regulator confidence in every determination.

Woman with a prosthetic leg walking her dog on a neighborhood path

The Pressure LTD Carriers Are Under

Claim volumes for complex, comorbid conditions — chronic pain, mental health, cardiac, and neurological — are rising, straining in-house medical director capacity to evaluate specialty-specific functional capacity evidence.
When the same internal reviewer who approved a claim also reviews it for termination, appeals lack independence — and that's exactly the fact pattern plaintiffs' attorneys use to allege bad faith.
ERISA-governed group LTD plans require documented, evidence-based appeal review, and building a nationwide panel of board-certified specialists in-house is costly and hard to sustain.
Contested or high-value claims need objective independent medical examinations to support decisions, but coordinating board-certified specialists nationwide, on short turnaround, is difficult without a dedicated network.

Independence Is the Defensibility Card

CareReview is structurally independent from LTD claim decision-making. When a carrier reviews its own denials or terminations, claimants' attorneys and regulators ask who is actually checking the work. Every CareReview determination is issued by a specialty-matched physician outside the carrier's internal claims process — with written, evidence-based rationale that holds up under ERISA appeal review and litigation scrutiny.

How CareReview Helps LTD Carriers

Claim & Functional Capacity Review

Specialty-matched physician review of medical records and functional capacity evidence supporting initial and ongoing long-term disability determinations, backed by board-certified reviewers across orthopedic, cardiac, neurological, and behavioral health specialties.

Peer-to-Peer & Appeals

Independent physician peer-to-peer reviews and ERISA-mandated appeal determinations that protect claim objectivity and reduce bad-faith exposure, with rapid turnaround to meet regulatory appeal deadlines.

Independent Medical Examinations (IMEs)

Nationwide access to board-certified specialists for in-person and record IMEs on complex, high-value, or contested long-term disability claims.

Fraud, Waste & Abuse Support

Objective, evidence-based reviews to detect misuse, strengthen compliance, and protect claim program integrity.

Why CareReview for LTD Carriers

Physician panel with deep specialty expertise across orthopedic, cardiac, neurological, and behavioral health conditions, applying evidence-based criteria aligned to current clinical guidelines and functional capacity standards.
URAC-accredited IRO, HITRUST certified, and available nationwide — NCQA accreditation expansion underway.
Stradix® platform integrates with claims management systems for real-time case submission, tracking, and reporting.