case management in workers comp

Case Management in Workers Comp

Jim Miller

Certified Rehabilitation Counselor

What type of case manager is assigned? Telephonic: They will call and fax you.

What type of case manager is assigned? Telephonic: They will call and fax you. Field Base or On-site case manager:

They may call and/or fax you, but most times they will attend the appointment with the injured worker.

What type of case manager is assigned? Telephonic: They will call and fax you. Field Base or On-site case manager:

They may call and/or fax you, but most times they will attend the appointment with the injured worker.

• Both: Sometimes a telephonic case manager will ask an on-site case manager to attend a specific appointment.

There is a reason we are there.

• 95% of all workers compensation cases do not have case managers involved.

• So if we are involved, there are barriers that need to be removed to get the case moving.

• The goal is to allow the worker to RTW.

Examples: Client’s injury is a serious one, with

complications.

Examples: Client’s injury is a serious one, with

complications. We don’t have a good diagnosis or

treatment plan. (Reason for time off from work)

Examples: Client’s injury is a serious one, with complications. We don’t have a good diagnosis or treatment

plan. (Reason for time off from work) Client is missing work, when light duty work

may be available with his employer.

Examples: Client’s injury is a serious one, with complications.

We don’t have a good diagnosis or treatment plan. (Reason for time off from work)

Client is missing work, when light duty work may be available with his employer.

The client may have some other personal or employment issue.

Examples: Client’s injury is a serious one, with complications. We don’t have a good diagnosis or treatment plan. (Reason for

time off from work) Client is missing work, when light duty work may be available

with his employer. The client may have some other personal or

employment issue. Communication issues among the parties.

Examples: Client’s injury is a serious one, with complications. We don’t have a good diagnosis or treatment plan. (Reason for

time off from work) Client is missing work, when light duty work may be available

with his employer. The client may have some other personal or

employment issue. Communication issues among the parties. Employer not communicating options.

Timelines to the game plan. Need for a treatment plan.

Timelines to the game plan. Need for a treatment plan. Need communication to all parties.

Timelines to the game plan. Need for a treatment plan. Need communication to all parties. Need for a written RTW release.

Timelines to the game plan. Need for a treatment plan. Need communication to all parties. Need for a written RTW release.

ER has work available but they need help with the details.

EE is not able to go back to his ER without a RTW release.

Injured worker needs some assurance that they will be able to RTW by provider and employer.

Timelines to the game plan. Need for a treatment plan. Need communication to all parties. Need for a written RTW release.

ER has work available but they need help with the details. EE is not able to go back to his ER without a RTW release. Injured worker needs some assurance that they will be able

to RTW by provider and employer. Workers comp wage loss benefits kick in after 7

consecutive days of lost time. A survey of providers was made, and only 10% of

time was time off work due to the injury alone.

Things to help yourself. Look at your operations now to ID good

light duty jobs that need to be done.

Things to help yourself. Look at your operations now to ID good

light duty jobs that need to be done. Send note to medical provider that you

have a light duty RTW program available.

Things to help yourself. Look at your operations now to ID good

light duty jobs that need to be done. Send note to medical provider that you

have a light duty RTW program available.

As an employer you do not have to make a decision to keep light duty available forever. (Temp situation)

Things to help yourself. Look at your operations now to ID good light

duty jobs that need to be done. Send note to medical provider that you have

a light duty RTW program available. As an employer you do not have to make a

decision to keep light duty available forever. (Temp situation)

Make job descriptions for these jobs.

Things to help yourself. Look at your operations now to ID good light duty

jobs that need to be done. Send note to medical provider that you have a

light duty RTW program available. As an employer you do not have to make a

decision to keep light duty available forever. (Temp situation)

Make job descriptions for these jobs. List of medical providers that know your company

for your employees. (Injured workers 1st choice)

ERTW Programs Injured worker off work for 4 weeks the

chance that they ever will RTW is 90%. Injured worker off work for 8 weeks the

chance that they ever will RTW is 75%. Injured worker off work for 12 weeks the

chance that they ever will RTW is 50%. If an injured worker does not RTW within 6

months or less on average, 95% of them never return to work.

ERTW Programs Early Return To Work Program.

Graduated RTW 4-6-8 Simply put, they make a difference.

Lower overall costs. Better outcome. Less legal involvement.

Case Management in Workers Comp Questions?

Jim Miller

Certified Rehabilitation Counselor

605-520-1639

Jimm@oharallc.com