Employers and insurers know that the cost of getting an injured
employee back to work relates directly to the amount of time it
The minute an injury occurs, an invisible time clock starts
clicking off dollars for the company and the worker. If quality of
life could be measured, that too would be keeping a downward pace
with the time. Studies have shown that, if employees are off work
for three months or more, the likelihood of ever getting them back
50 percent or less.
Injuries set off a chain of events that aren't always conducive
an employee's timely return. Usually, the employee will see a
physician for treatment, then will either return to work, be placed
on restriction, or be sent home, possibly with a prescription for
pain medication, instructions for self-care and physical therapy.
Unfortunately, sometimes an employee gets lost in the shuffle,
sitting at home waiting for further instructions and growing anxious
about the future, while the employer wonders when that person will
return. Lack of communication can result in delays in treatment,
poorly planned treatment or unnecessary procedures, and
charges to insurance companies.
The variable factor that can change that scenario is case
management. Serving as a liaison among the employee and other family
members, the employer, the workers' compensation insurance carrier,
health care providers, and possibly others, the medical case manager
will do everything possible to improve the quality of health to the
worker while controlling the cost and monitoring outcomes.
Case management has become more accepted among employers,
physicians and insurance companies, with the prevalence of managed
care. More and more companies realize that having an individual
whose sole purpose is to monitor those injured workers' care and to
expedite their return to work will translate into ultimate savings.
A good case manager looks at all aspects of each case. An
effective case management process will include these steps:
* Case Identification -- For case management to be effective,
early identification is critical. By collaborating with the worker,
the employer, and the health care provider, the case manager
the return to work process with cost effectiveness and quality of
* Assessment -- The goal of assessment is to identify the worker's
physical and functional status, as well as resource and service
needs. Experience and judgment play a large part in the evaluation
of the amount of case management needed. …