Field medical case management is best used for the following types of workers’ compensation claims:
- Medically complex or catastrophic injuries
- The recovering worker has not been released to return to work or the employer is unable to accommodate light duty
- Treatment plan is outside standardized criteria
- The treating physician does not have a clear plan for treatment, rehabilitation or return to work
The CompAlliance workers’ compensation Medical Case Manager provides in-person biopsychosocial assessment, identification of any barriers and co-morbidities that may impact a medically appropriate and timely resolution of a claim, and develops a case plan to address these barriers and co-morbidities. The recovering worker’s teaching needs are assessed and implemented, to facilitate adherence to the treatment plan.
Ongoing evaluation and communication with all stakeholders on an existing claim assures quality managed care services are received and return to work is successful, resulting in decreased claim cost.