Case Management Focus: Are Workers’ Compensation Case Managers Disruptors?

13 Feb, 2024 Anne Llewellyn

                               

Sarasota, FL (WorkersCompensation.com) -- Workers Compensation case managers are disruptors! Yes, we disrupt the status quo. We ask questions, put our hands up, and say STOP when something is wrong.

In today’s complex healthcare system, we need disruptors to stop, listen, re-evaluate, and then bring the team together (including the injured worker and their family) to discuss revamping the care plan.

As a worker's compensation case manager, I have often been told I was a disruptor. Thank you, that is my job. If WE did not disrupt when we found something wrong or the injured worker needed to improve on the plan of care, why are we needed?

Think of ways to disrupt for the good of the injured worker, the employer, and the healthcare team. Here are two examples.

The injured worker is not improving, and no one can understand why. It is time for a second opinion. It is time to change therapies. In worker's compensation, time is money, and lost time for the injured worker and the employer is costly. When involved in a case, our role is to make sure there is progression of care. If we do not see it, we must find out why and suggest changes to the injured worker and the team.

The employer does not have light duty available. The injured worker can work, but nothing is available at his place of employment. In this example, we can look outside to see what else he can do or look at the employer’s situation and make suggestions—having the injured worker return to work, even if it is on light duty, is so essential in the recovery process.

If the injury was catastrophic, how will we help the patient return to gainful employment? Case managers can seek the help of vocational rehab to get an assessment done on what the injured worker might be able to do despite their disability. In case management, we think about the abilities vs. the disabilities. What can they do vs. what can they not do? Doing so opens doors, even if the work we find is a volunteer job, which could turn into a paying job with time. Helping injured workers find the resources they need is part of our work. We don't give up on people - we see their value and work to help others see it, too.

We listen. Yes, we listen – to the patient, the family, the employer, the healthcare team, and the adjustor/payer. We listen to understand everyone's point of view and then work to address each stakeholder. Everyone has a place in the system and needs something from it.

Our primary allegiance is to the injured worker and the family. They need our expertise and persistence to navigate the complex healthcare system. We lead by example and show them how to advocate for themselves to get the necessary care and resources.

Disruptors do not settle for the status quo – we want to ensure that all involved in the system participate in raising the bar and ensuring our roles are making a difference.

Are you a disruptor? Share an example of a situation where you used your skills to disrupt a problem going wrong.

I would love to draft an article on case managers as disruptors to show our value to complex situations. Email me if you have a story, and I will use it in a future article. My email is allewellyn48@gmail.com!

Have a good week!


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    About The Author

    • Anne Llewellyn

      Anne Llewellyn is a registered nurse with over forty years of experience in critical care, risk management, case management, patient advocacy, healthcare publications and training and development. Anne has been a leader in the area of Patient Advocacy since 2010. She was a Founding member of the Patient Advocate Certification Board and is currently serving on the National Association of Health Care Advocacy. Anne writes a weekly Blog, Nurse Advocate to share stories and events that will educate and empower people be better prepared when they enter the healthcare system.

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