Term Of the Day – Case Management
Case Management in the Workers Comp arena used to mean rehabilitation nurses or vocational experts that aid the injured employee in his/her medical care and return to work.
Case Management now seems to have become a buzzword that can actually mean anything from an adjusters to work to the medical bill review department.
This is from some older literature when case management meant health management in Workers Comp. Case Managers are usually RN’s, but not always. Their responsibilities are:
- Assist employers in decreasing worker’s compensation and health care costs
- Meet with the injured worker and the employer and complete a job evaluation
- Coordinate injured workers’ return to work by acting as a liaison between the worker, the physician and the employer
- Identify treatment plans, oversee medical care and monitor an injured worker’s progress
- Keep the employer and the insurance company informed of pertinent progress, return-to-work status and treatment recommendations
- Provide telephone case management as necessary
- Serve as a source of information for the injured worker, the employer and the physician
- Provide detailed reports for the employer and the insurance company and to the employee’s attorney, if represented.
A Vocational Case Manager is totally different. Their services include:
- Coordination with the client, referral source, physician, employer, attorney and others with the ultimate goal being the client’s timely return to gainful employment.
- Interviews and evaluates the client to determine the degree of disability, eligibility and feasibility of vocational rehabilitation services.
- Determines suitable job goals consistent with the client’s interests, aptitudes and physical limitations.
- This includes completing vocational evaluations, labor market surveys, job analysis, on-site job evaluations.
There are some case managers that are both a medical case manager and/or a vocational case manager. I have seen few, if any, that combine both disciplines.
©J&L Risk Management Inc Copyright Notice
