EVIDENCEWhat does the record show?
Proposed capability: These services are in development. Do not send claimant records, PHI, or identifiable case data through this website or by email inquiry. Any pilot requires a written scope, confidentiality terms, and an approved secure environment before case data is shared.
Insurance solutions · LTD & SSDI Intelligence →
STD/LTD CLAIMS INTELLIGENCE
Turn complex disability claims into clearer, evidence-based action.
DIG is developing a decision-support approach for short- and long-term disability insurers, third-party administrators, and self-insured employer programs: connecting medical documentation, functional limitations, policy requirements, and quality checks without replacing the judgment of qualified claims professionals.
INTELLIGENCE LAYERILLUSTRATIVE
REQUIREMENTSWhat must be addressed?
ACTIONWhat needs review next?
Deploy as a scoped review service, a controlled batch workflow, or, in a later phase, an integration with the administrator's current platform.
A RECURRING CHALLENGE
The problem is not a shortage of records. It is finding the evidence that matters.
Claims teams work through fragmented clinical records, employer information, occupation requirements, and time-sensitive benefit provisions. Important facts may be difficult to locate, reconcile, or explain.
DIG's proposed analytical tools help surface material evidence issues and produce documented findings for reviewer consideration.
DESIGNED FOR EXISTING SYSTEMS
An intelligence layer, not a claims-system replacement.
The work sits alongside current claims platforms and review procedures rather than replacing them.
For the evidence-review concepts behind this approach, see Claim Intelligence.
THREE INITIAL USE CASES
Intelligence for the points where claims get stuck.
Each use case can be scoped and validated on its own before broader adoption.
01 / BOTH STD & LTD
Medical evidence completeness
Develop medical timelines, distinguish reported symptoms from documented findings, flag record conflicts, and identify missing information relevant to functional assessment.
02 / BOTH STD & LTD
Claims quality assurance
Check whether critical evidence, required steps, and stated reasons are documented. Surface issues for human investigation before claim decisions or quality audits.
03 / STD TO LTD
Transition readiness
Identify approaching benefit milestones and incomplete medical, employer, or occupational information so teams can prepare for a potential LTD transition.
WHERE EACH SOLUTION FITS
Designed around the difference between STD and LTD.
WORKFLOW QUESTIONSTD EMPHASISLTD EMPHASIS
Evidence completeness
STDCurrent limitations, expected duration, treatment, and work status
LTDLongitudinal evidence, sustained limitations, and ongoing review
Occupational context
STDCurrent job duties and near-term work capacity
LTDOwn-occupation and any-occupation definitions, as applicable
Operational checkpoints
STDDuration and transition preparation
LTDPolicy transitions, continuation reviews, and coordination
Quality controls
STDTimely, documented decisions
LTDEvidence-linked determinations and appeal readiness
Requirements vary by contract, funding arrangement, governing jurisdiction, and claim. The applicable plan or policy language controls; SSA standards do not substitute for private-insurance standards. Related reading: Policy Intelligence.
A DISCIPLINED PILOT
Validate accuracy, traceability, and actual operational value.
A useful pilot compares proposed DIG outputs against a defined set of historical cases reviewed by the customer's qualified staff, using agreed performance criteria.
- 01Correct identification of relevant record evidence
- 02Source citations that reviewers can independently verify
- 03Issue-detection precision and missed-issue rates
- 04Processing time and human-review workload
- 05Conformity with applicable policy and review requirements
DIG tools are meant to support fair and consistent claim evaluation, not automate denials or substitute generic AI predictions for contractual eligibility analysis.
Pilots require a written scope, confidentiality terms, permitted data use, security controls, and an approved secure environment before any case data is processed.
Validation measures, human oversight, and clear handling of sensitive medical information are defined up front. No PHI is accepted through this website or email inquiry.
DEFINE THE PROBLEM FIRST
A practical pilot starts with one claims bottleneck.
DIG welcomes exploratory discussions with STD/LTD insurers, claims administrators, and self-insured employer programs interested in evidence quality, disability intelligence, and defensible review workflows.
Capabilities are proposed and require validation and agreement before deployment. DIG does not make SSA or insurer benefit determinations, provide clinical diagnoses, or guarantee awards, offsets, savings, or outcomes. Please do not include claimant information in your inquiry.