What "best practices" would you recommend to Case Managers?
1. Three point contact. If there is one practice that is mentioned more than any other, it is this one. It is often modified and expanded to mean, “Case managers should review the file and, within three days of receiving that file, establish contact (preferably personal) with the treating healthcare professional, employer and worker.” In practical terms, the treating healthcare professional contact may have to be indirect. Don’t let that stop you from making personal contact with the worker and employer. (Many jurisdictions put this practice in their required procedures for agents and adjudicative staff. See South Australia WorkCover Claims Operational Guidelines Chapter 6 page 4 as an example applied to agents and New Your State Insurance Fund Global Case Management for one that applies at an insurer team level).2. Facilitate personal contact with decision-making employer and worker. The vast majority of injured workers return to their “at injury” employer. The timeliness of that return and its long-term success often rest with the case manager. Often, the manager or supervisor will be the key person mediating the timing of a return to work. Keeping the worker connected to the employer and the employer actively engaged in thinking about RTW for this person may well lead to improved outcomes. ( I really like the CCOHS document Best Practices for Return-to-Work/Stay-at-Work Interventions for Workers with Mental Health Conditions FINAL REPORT [May 2010] because it is authoritative and well referenced. I think the personal contact practices identified are widely generalizable to most Case Management situations).3. Think mid-week this week, not Monday next week. Case managers can influence the timing of a graduated RTW, light-duty RTW or work trial. For most Monday to Friday jobs, there is a tendency to set a Monday start date a week or two in hence. Research tells us that more injuries occur on a Monday than any other day of the week. This “Monday Effect” phenomenon alone is reason enough to consider a different approach. Why not consider the Wednesday, Thursday or Friday before as the RTW date? Not only will this allow a returning worker more time to adjust to a regular work week, it may shorten duration and reduce costs overall.4. Identify barriers…and how to overcome them. I recently reviewed a case management system where the insurer and staff had developed a new “tab” that required the case manager to identify barriers to RTW. Case managers themselves had helped design this part of the systems with drop-down menus of the most common barriers raised or identified in case management. If the barrier source was identified as “employer” and the reason “wants worker to be 100%,” the course of action might be “case conference with employer” generating an actionable item in the system. If the source was “worker” and the reason “fear of re-injury” then the action might be “arrange work conditioning” or “set up light duties with employer.” The point here is not that you need a new case management system but that identifying barriers and ways to overcome them can be an effective technique in case management.
Terry says of himself: I am a student of workers’ compensation systems. Many years ago I discovered two things about this area. First, workers’ comp and OH&S are of vital importance to people. Protecting, caring for and providing compensation to workers are important, noble and morally responsible endeavors. The second thing I learned was that no matter how much I knew about workers' comp/OH&S, there was always so much more to learn. This is an endlessly challenging area of study. My purpose, therefore, is not to lecture, but to reflect on the ideas and issues that are topical in this area... and to invite others to share in a learning experience. By adding your knowledge and insights, others with similar interests can participate in the discovery and study of this important domain.
His blog is "Workers' Compensation Perspectives".