Case Management in Workers Comp

1. Case Management in Workers Comp Jim Miller Certified Rehabilitation Counselor

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

3. 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.

4. 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.

5. 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.

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

7. 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)

8. 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.

9. 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.

10. 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.

11. 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.

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

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

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

15. 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.

16. 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.

17. Things to help yourself. • Look at your operations now to ID good light duty jobs that need to be done.

18. 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.

19. 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)

20. 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.

21. 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)

22. 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.

23. 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.

24. Case Management in Workers Comp • Questions? Jim Miller Certified Rehabilitation Counselor 605-520-1639 Jimm@oharallc.com