Disability Reviews (STD & LTD)
Defensible, evidence-based medical opinions for STD and LTD claims — specialty matched, full and fair review ready, delivered on the timelines your adjudication windows demand.
Getting Employee Lives Back on Track™
Overview
CMRS delivers short term and long term disability peer reviews and consultative services for Insurance Carriers, Third Party Administrators, Managed Care Organizations, Self Insured Employers, and Attorneys.
Every review is performed by a U.S.-licensed, board certified physician, matched in the same or similar specialty as the clinical question on file, and structured to support a full and fair review under 29 CFR §2560.503-1 — from initial determination through appeal.
Our reports deliver clear, defensible medical opinions addressing diagnosis, treatment, impairment, functional capacity, restrictions, and return to work (RTW) capacity, aligned with plan language, clinical standards, and regulatory timelines.
What You Get
Faster, defensible disability determinations that withstand appeal scrutiny, reduce downstream reopen activity, and support accurate, timely claim outcomes.
What Our Disability Reviews Address
CMRS disability reviews provide structured, evidence-based analysis of:
- Medical necessity and appropriateness of restrictions and limitations
- Consistency of objective findings versus reported impairment, including primary and co-morbid conditions and treating provider opinions
- Treatment plan appropriateness and prognosis
- Ability to meet own-occupation and any-occupation demands, including stay-at-work considerations, RTW capacity, accommodations, and absence duration benchmarking against ACOEM, MDGuidelines, and ODG where applicable
- Maximal Medical Improvement (MMI)
- Specialty-matched clinical review (orthopedic, neurologic, psychiatric, occupational medicine, physiatry, internal medicine)
- Mental health and cognitive functional demands, reflecting the rising complexity of behavioral-health-driven disability claims
Why Choose CMRS for Disability Reviews
Top-Tier Physician Network
Every review is conducted by a U.S.-licensed, board-certified physician, matched in the same or similar specialty as the clinical question on file. Reviewer credentialing verifies licensure, board certification, malpractice history, and active clinical practice. All assignments include documented conflict-of-interest screening, ensuring reviewer independence consistent with URAC accreditation standards and ERISA medical judgment requirements.
Accurate and Useful Reports
Each CMRS report directly answers the clinical questions submitted and includes:
- Records reviewed
- Diagnoses and co-morbidities
- Treating provider opinions
- Occupational or any-occupation requirements
- Applicable evidence-based guidelines (ACOEM, MDGuidelines, ODG where applicable)
- Prognosis for restrictions, functional capacity, and return to work
Reports are written to support transparent decision-making and to withstand scrutiny at internal appeal, external review, and litigation, with conclusions explicitly tied to cited medical evidence.
Customized Solutions
CMRS offers flexible engagement models tailored to the needs of carriers, TPAs, employers, and legal counsel – from comprehensive peer reviews of complex claims to targeted medical consultative services addressing specific clinical or functional questions.
Rigorous Quality Assurance
CMRS operates as a URAC-accredited Independent Review Organization with HIPAA-compliant operations on a SOC 2 Type II audited cloud platform. Every report undergoes documented quality assurance review against:
- The clinical question
- Applicable plan language
- Regulatory and accreditation requirements
Secure, auditable technology supports intake, records management, reviewer assignment, QA review, and delivery.
Leadership
Chief Medical Officer
David Berube, MD, MPH, FACOEM brings decades of insurance medicine leadership experience from senior roles at Aetna, Liberty Mutual Insurance, and Lincoln National Corporation. He oversees clinical standards, quality assurance, guideline governance, and physician network management.
His FACOEM credential reflects senior level standing in occupational and environmental medicine — the specialty most directly aligned with disability evaluation and return to work determinations.
Request Information — Disability Reviews
Tell us about your program and we’ll respond within one business day with materials tailored to your line of business — typically including a service overview, sample report excerpts, turnaround commitments, and pricing structure. No obligation. Your information is used solely to respond to your request and handled in accordance with HIPAA and our privacy policy.
One-Page Service Sheet
Disability Reviews Overview
A concise, print-ready PDF summary you can forward to a colleague or print for a meeting. Includes an overview of Disability Reviews, what it delivers, and what makes CMRS the right partner.