A brief guide for case managers, employers, employees, and claims adjusters
The goal of worker’s compensation is to assist the injured worker during their recovery – which may mean monetary assistance, rides to appointments, or a number of other things – and ultimately see them return to work at some capacity. In order to see this accomplished, all the moving pieces need to work together towards the injured worker’s recovery and wellness – doctors and therapists need to diagnose and treat, claims adjusters need to communicate with the claimant and other parties related to cost control and efficiency, case managers need to ensure things move forward smoothly between all parties involved while keeping mental health in mind, employers need to continue to work and potentially cover the injured worker’s position until they return, and the claimant themselves needs to focus on getting better.
This series is designed to give those involved in a worker’s compensation claim some direction on how to handle all the pieces and people involved in a claim from the beginning. I’ve listed several things to be aware of at different levels of the claim and how to combat common problems that arise. This is a starting point that mainly focuses on interactions with the injured worker and their environment.
Tips to Manage Worker’s Compensation Claims Effectively – for Case Managers
First impressions
- Help the claimant understand the process. When this process is efficient and streamlined, claimants will feel a sense of control and forward momentum[i].
- Encourage communication between all parties[ii].
Throughout the claim
- The more in control the claimant feels, the more likely they are to return to work. Help empower the claimant by asking them what it is they want. Help them adjust their wants to fit what they can do based on the law or other restrictionsi.
- Remember, the claimant needs to heal mentally – even if the injury sustained is physical. Encourage the claimant to ask their doctor and other return to work professionals for advice about the benefits of psychological treatment and mind-body therapies such as yoga. Exercise, healthy relationships and hobbies can also improve their well-beingi.
- Encourage the employee to talk with their doctor regarding treatment and medication side effects and downsidesi.
- Hurt does not mean harm. Activity is oftentimes a large part of healing and pain management. Encourage the employee to learn what is normal to feel, and what is abnormal – instead of avoiding painful things altogether[iii].
- Encourage employee to check with doctor about flare-ups and what to do when they happeniii.
Preparing for the employee to return to work
- Ensure a graduated return to work with identified goals is set up with the employeriii.
- Educate the employee about creating restrictions out of needs, not wants. Being too restrictive in duties can lead to boredom, frustration and lack of productivity[iv].
[i] Case Study: Cool, calm and in control
[ii] Manage people, not musculoskeletal symptoms
[iii] The importance of early return to productive and full time duties
About the Author: Jessica Stogsdill has been working in the mental health field for the past 2 years. She earned her Bachelor of science degree in Psychology in 2011 and her Masters of Social Work degree in 2015 both from Grand Valley State University. She completed her internship with Ottawa County Community Mental Health’s Assertive Community Treatment Team in her final year of graduate school. As an intern, Jessica was able to participate in a wide range of experiences with the severely mentally ill population related to improving function, education, assessment, and building rapport in the community. Upon graduating she began working as a telephonic clinician in the Productivity Assurance Call Center (PACC) at R3 Continuum, where she has been since 2015. Jessica has been trained in critical incident response (CIR) and provides telephonic support daily to individuals as well as to groups. She coordinates with other professionals and builds relationships with employees to facilitate their improvement in functioning so the employees can return to work and to their lives.
