# ERISA Disability Claim File Review Services

> Administrative record review for ERISA disability appeals — cited chronology, physician-by-physician response, occupational demand mapping.

Canonical page: https://medrecords.ai/solutions/erisa-disability-claim-file-review/

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[Home](https://medrecords.ai/) ›[Solutions](https://medrecords.ai/solutions/) ›ERISA Disability Claim File Review
ERISA DISABILITY CLAIM FILE REVIEW

## The administrative record is the whole case. Build it cited.

ERISA disability claim file review turns five hundred to five thousand pages of claim file, peer reviews, surveillance, functional capacity evaluations and vocational reports into a cited chronology and a point-by-point response to every reviewing physician, ready inside the 180-day appeal window.

[Test a file ](https://medrecords.ai/test-a-file/?src=erisa-disability-claim-file-review)
 [Book a demo](https://medrecords.ai/demo/)
Click any row → the source page it cites
Administrative record · Case #IME-4812
 appeal-ready
Adams, Timothy
 · LTD claim file
342 pp / 2 packets received
 logged
11 duplicate pages removed
 free
p.140 — wrong patient
 quarantined
Pages 342
 Visits 7
 Cited 100%

### The rulebook is published. So is the referee.

We do not build for a case type until we can name the standard that defines a correct response and the person who grades it against that standard. In ERISA disability appeals, both are already in federal regulation.

The rulebook and the referee
The rulebook
- 29 CFR §2560.503-1 full-and-fair-review — the 2018 amendments require the plan to address every piece of evidence
- ERISA §502(a)(1)(B) — the claimant's right to judicial review of the denial
- Firestone / MetLife v. Glenn — the standard of review the court applies to the file
- The policy's own definition of disability, mapped against DOT/O*NET occupational codes

The referee
- A federal judge, on the administrative record, in a written opinion that says exactly which evidence the reviewer mishandled
- DOL/EBSA audits of the claim file and the review process
- State DOI market conduct exams

Peer reviews at $300–900, records review with narrative at $600–1,800, IMEs at $1,200–3,500 — per claim, per side

 Flat 10¢/page here, duplicates free
Administrative record · Case #IME-4812
 cited 100%
Claim file342 pp / 2 packets · 11 deduplicatedlogged
Wrong-patient pagep.140 quarantinedflagged
Functional-capacity threadImproving since 4/02 · 7 visitstracked
Occupational mappingDOT/O*NET codes appliedmapped
DeterminationNot produced — yours to makeyou
2 packets · 7 visits tracked · cited 100% · no scores, no decisions
How it works

### Three steps between the claim file and the appeal.

01

#### Send the claim file

The full administrative record — claim forms, attending physician statements, peer reviews, surveillance, FCEs, vocational reports — in any format. In the demo case, 342 pages across 2 packets, with a wrong-patient page quarantined before the read starts.

02

#### The AI drafts the response, every line cited

A cited chronology of the file plus a point-by-point response to every reviewing physician's findings, mapped against DOT/O*NET occupational codes. Nothing is summarized without a page citation attached.

03

#### You review, verify, and file

Click any line to the page it cites, export into the appeal, and file inside the 180-day window. The AI never signs, never scores the claim, and never decides.

The boundary, in writing

### A record that knows it isn't the appeal.

We organise the administrative record and cite every page. We do not review the medical evidence, form a legal opinion, or decide the claim. The appeal, and the argument behind it, belongs to the attorney or claims professional filing it.

In the demo case, page 140 turned out to belong to a different patient. The chronology flags it and quarantines it in its own line, instead of folding it silently into page 342 of the record.

Audit trail · Case #IME-4812
 exportable
08:12Claim file received · 342 pp / 2 packetssystem
08:3111 pages deduplicatedsystem
08:44p.140 flagged — wrong patientsystem
08:54Chronology complete · 7 visits tracked · cited 100%system
09:20Response reviewed · citations verifiedreviewer
09:26Response exported · appeal drafted off-platformreviewer
Every access logged · file deleted 30 days after delivery
Why Medrecords AI

### The rules the platform never breaks.

EVERY LINE CITED
CASE #IME-4812 · ADAMS, T.342 pp
2/14 — ER visit, right knee
 p.4
4/18 — arthroscopic surgery
 p.61
p.140 — wrong patient
 quarantined
Medrecords AI
Read every page · cite every line

#### HIPAA, under a signed BAA

Every file is handled under our Business Associate Agreement, from the first byte.

#### Never trains a model

Your records are never used to train any AI model — ours or anyone else's.

#### Every line cited

If we can't cite it, we don't say it. Every sentence links to its source page.

#### Deleted after delivery

Files are deleted 30 days after delivery, with a full audit log of every access.

Powered by the platform

### Four capabilities behind every response.

The ERISA administrative record review is one deliverable of the same platform that reads, sorts, and cites the whole claim file.

[

#### Medical Records OCR

Every claim file document read in full — provider records, peer reviews, surveillance logs, FCEs — nothing skipped, nothing guessed.

IN ACTION · 342 pp / 2 packets → read in full
](https://medrecords.ai/product/ocr/)
 [

#### Medical Chronology

The claim history builds itself from the administrative record, synced to every source page.

IN ACTION · 2/14 ER visit → 4/18 surgery, one continuous timeline
](https://medrecords.ai/product/chronology/)
 [

#### Verifiable AI Citations

If we can't cite it, we don't say it. Every line in the response links to the page it answers.

IN ACTION · 7 visits tracked → cited 100%
](https://medrecords.ai/product/citations/)
 [

#### Medical Summary Reports

The chronology and physician-by-physician response format straight into the appeal — your template, your letterhead.

IN ACTION · administrative record → appeal-ready export
](https://medrecords.ai/product/summaries/)
FAQ

### ERISA disability claim file review, answered.

Support it. We return a cited chronology of the administrative record and a point-by-point response to every reviewing physician's findings. The appeal itself, the legal argument, and the filing stay with the attorney or claims professional.

The 2018 amendments require the plan to address every piece of evidence in the file, not just the evidence it relies on. Our chronology and physician-by-physician response are built to that standard — organised so nothing in the record goes unanswered.

No. Medrecords AI does not retrieve records from providers or facilities. You bring the records you already have — review starts in minutes from upload. Retrieval vendors take days; you can keep yours and still cut the review to minutes.

Each reviewing physician's findings — peer review, FCE, vocational report, surveillance summary — are extracted separately and matched against the treating record, with a page citation on every line. Nothing is summarized without a citation attached.

Yes. Group LTD and individual disability claim files typically run 500 to 5,000 pages once peer reviews, surveillance, and vocational reports are added. The platform reads the full file at a flat 10¢ a page, duplicates removed at no cost.

### Send one file. We'll tell you what we can read.

No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so.

[Test a file ](https://medrecords.ai/test-a-file/?src=erisa-disability-claim-file-review)
 [Book a demo](https://medrecords.ai/demo/)
[See every case type we process →](https://medrecords.ai/solutions/case-types/)
