General | Specialized | Insurer

General

SOMA Medical Assessments Corp. is a full handle IME service provider.

Our assessors provide services from our centralized facilities. At SOMA, we pride ourselves in facilitating the entire process. We control all the incoming and outgoing reports, client communication, follow-up teleconferencing as well as supplying interpreters and transportation as needed. With one call you can be assured you will receive a quality defensible medical report and we will handle all the logistics.

Pre-Referral

  • Referral triage
  • Clinical / Medical advice

Referral

  • Clinical coordination
  • Referral intake and scheduling
  • Medical documents handling
  • Teleconference with assessors

Appointment

  • Examinee appointment reminders where appropriate
  • Examinee satisfaction measured and improved
  • Examinee informed consent secured and confirmed

Post-Appointment

  • Teleconference with assessors
  • Report development
  • Quality assurance
  • Regulatory and case law compliance
  • Secure report transmission
  • Accurate billing practices
  • Trial/Arbitration preparation and attendance coordination on tort files

Other Value Add Services

  • Consensus review on multi-disciplinary files
  • Examinee accommodation, transportation, and interpretation where requested
  • Usage reports by specialty, service, average fees, total spend, etc.

Specialized Services

Catastrophic Impairment Assessments – SOMA specializes in providing Catastrophic Impairment Assessments to Ontario’s automobile insurance industry. Each and every Catastrophic Impairment Assessment is reviewed and handled by our CAT Claims Coordinator who is certified in the 4th and 5th Edition AMA Guides to the Evaluation of Permanent Impairment.

We only utilize assessors who have experience in evaluating serious, complex impairments. They are extremely well versed in the SABS legislation and legalities of the Catastrophic Impairment process, and work closely with our CAT Claims Coordinator.

Claims Review Committee – BC-based review committee based on collective agreements in the province for long-term disability appeals. A three doctor panel collaborates together to determine a majority decision based on the panel's examinations and the opinions of any additional specialists.  The panel is composed of one employee appointed doctor, one employer appointed doctor, and an agreed upon third chairman of the committee. The parties are all bound by the final decision from the Claims Review Committee.

Ergonomic Assessments – SOMA provides onsite ergonomic assessments at any workstation location. An experienced kinesiologist, occupational therapist or ergonomist will conduct a customized assessment that includes observation of the workplace as well as an examination of the employee regarding pain levels, work duties, and practices.

Ergonomic Assessments are often conducted when an individual is experiencing pain or discomfort with their job demands. The assessment analyses current working conditions to identify risk factors. Assessments provide an understanding of a workstation or home environment.

Recommendations including physical changes to the form of the workstation or work area, addition of assistive equipment and suggestions on work practices, and habits within the workplace will be included in a comprehensive report.

Neuropsychological Assessments – Physicians assess visio-spatial functions to rate impairments in visual perception and constructional abilities. Certified medical professionals provide a detailed opinion about an examinee’s cognitive functions based on effort testing. Additionally, a determination of overall perception is conducted regarding the examinee's processing of sensory information. Neuropsychological Assessments cover areas such as: memory, reasoning, attention, concentration, problem solving, and the speed in which the examinee is able to process information.

Vocational Assessments – A vocational assessment provides information about an individual’s skills, education and aptitudes, abilities and interests, and identifies possible career paths an individual may pursue. An assessment is typically undertaken following an injury or illness which necessitates occupational change from a pre-disability occupation to another suitable occupation. A thorough vocational assessment includes an in-depth interview to obtain background information, review of a medical and vocational file, and a full battery of vocational and psychometric tests.

Insurer Services

IME – An Independent Medical Evaluation is an objective, physical exam conducted by a physician or allied  professional. In complex cases, a multi-specialty physician may be assigned to the case. The purpose of the exam is to determine the nature and extent of an injury. The findings of the examination are documented in a formal written report that addresses specific questions associated with the diagnosis and treatment.

IE – SOMA service professionals are experts with respect to Insurer Exams. Our assessors have been conducting these exams under different incarnations of the legislation for years and are well versed in the legislative frameworks including regulatory guidelines, policy requirements, and issues associated with the various clients and jurisdictions served, including the SABS and the AMA Guides to the Evaluation of Permanent Impairment. In addition to coordinating all aspects of the examination, SOMA can provide assistance including arranging accommodations, interpretation, and transportation services.

FCE – A Functional Capacity Evaluation (FCE) assesses an examinee’s capabilities, limitations, motivational status, and reliability of effort based on accepted testing protocols, and is performed typically by a kinesiologist. The testing protocols for an FCE are designed to determine the examinee’s functional abilities and limitations in order ascertain functional status for employability. The findings of the evaluation are contained in the FCE report.

JDA – Job Demands Analysis (JDA) examines the physical demands of the tasks or duties required in a specific job and is performed typically by a kinesiologist. JDA is designed to measure and quantify the physical strength and positional tolerances required in a specific job. The JDA report contains quantitative measurements and analytics to facilitate appropriate occupational recommendations and assignments.

Medical File Review – Medical File Review determines the reasonableness and appropriateness of the medical care rendered; medical necessity of care; and causal relationships. The paper-based review, conducted by a physician with the appropriate specialty and training, examines a previous diagnostic report, and is an economical way to determine if a claimant’s condition is properly documented, diagnosed, and understood. The Medical File Review report can assist in fair claims resolution.

Cost of Future Care Assessment – Cost of Future Care Assessment or Life Care Plan is a comprehensive report that details current and future needs and financial requirements for individuals with a catastrophic injury or chronic health care needs. The assessment includes a review of medical information; interview in the home environment; consultation with health professionals and family members; data analysis and research to understand the extent of injury and disability; and how it impacts on the individual’s daily life.