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Rehabilitation Nurse Second Most Seen Provider By Injured Employees

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Injured Employees and Rehabilitation Nurses Work Well Together

 The second most seen medical provider by injured employees would be the rehabilitation nurse if assigned to the file. Last week, I covered the medical provider that Injured Employees see the most overall.    

As I have often said, rehabilitation nurses or case managers can be one of the best loss reduction techniques.Workers Compensation Case Managers  or rehabilitation nurses function as multifaceted costs reducers on files.  We received a batch of mishandled files a few years ago.

Picture of Injured Employees with Nurse
StockUnlimited

 The main theme was there were no rehabilitation nurses assigned to them. We immediately assigned out a nurse on almost every file.  

These files were at least one year old with an injured worker who had drawn Temporary Disability benefits since the date of the injury.  The files were all settled or closed within eight months.

The rehab nurse will usually visit the injured worker at home to assess their medical condition, return to work, considerations, and other important factors when they create their initial report.   Rehab nurses are not there to spy on employees.

Many times the rehab nurse will accompany the employee to the physician’s office for their medical appointments.  This is very helpful in cases where there is a complex medical condition or often the rehab nurse acts as a medical term “translator” of  sorts.

The main benefit is that the injured employee feels there is someone they can call if they have any questions about their medical treatment and return to work besides the adjuster.

One of the most critical jobs that a rehab nurse performs is as a hub for a return to work analysis between the physician, employee, and employer.   The state of Delaware is the only state that I know of that requires a job bank provided by employers for a successful return to work.

The rehab nurse will often:

  • Picture Injured Employees and Rehabilitation Nurses 
    Wikimedia Commons – Djstoney

    Obtain a job description or descriptions from the employer

  • Discuss the modified duty jobs with the employee
  • Discuss the jobs  and provided job description to the treating physician
  • Have the treating Dr. sign off on the appropriate job description
  • Facilitate the communication and assist with the return to work

The above bullet points are all performed by field case managers.  There are many state laws on how the rehabilitation nurses or case managers can operate under the WC statutes.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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