Workers’ compensation cases can be complex and challenging to navigate for both employers and employees. The process involves medical evaluations, legal proceedings, and financial responsibilities, making it essential to have a qualified professional to oversee the case. One such professional is a Nurse Case Manager (NCM), who plays a vital role in ensuring injured employees receive appropriate medical treatment and return to work promptly.
Role of Nurse Case Manager:
The NCM’s role is to work collaboratively with healthcare providers, employers, and employees to facilitate the delivery of quality medical care for the injured worker. They ensure all parties are well-informed of the injury, treatment, and progress of the injured employee. The primary goal of the NCM is to optimize the injured worker’s functional capacity, which translates to an earlier return-to-work outcome. They achieve this by:
1. Coordinating treatment: NCMs are responsible for ensuring that the injured worker receives prompt and appropriate medical treatment. They schedule medical appointments and ensure that the treatment is in line with the workers’ compensation guidelines. This coordination ensures that the injured worker is receiving the right treatment at the right time.
2. Assessing the injured worker: NCMs assess the injured worker’s physical and medical needs and match them with the appropriate medical care provider. They also consider the injured worker’s personal needs, such as transportation and caregiver support.
3. Advocating for the injured worker: NCMs act as the injured worker’s advocate, ensuring that they receive fair and appropriate compensation for work-related injuries. They negotiate with insurance companies, employers, and healthcare providers to ensure the injured worker’s rights and needs are met.
Benefits of having an NCM on a Workers’ compensation case:
1. Cost savings: The services of an NCM on a workers’ compensation case can result in cost savings for both the employer and the insurance company. This saving results from reduced medical treatment costs, earlier return to work, and decreased wage replacement costs.
2. Improved employee outcomes: Employees who have an NCM on their workers’ compensation case have better health outcomes than those who don’t. This improvement results from the NCM’s expertise in coordinating medical treatment, managing progress, and advocating on behalf of the injured worker.
3. Improved communication and compliance: NCMs ensure that all parties involved in the workers’ compensation case are well-informed and comply with the workers’ compensation guidelines. They act as liaisons between healthcare providers, employers, and employees, ensuring that everyone is on the same page and moving forward together.
Eddie Braun, JD, MBA
Vice President & CFO
IW Care Connection, Inc.
13715 Burbank Blvd.
Sherman Oaks, CA 91401
Phone: 818-789-2273
Toll Free: 877-789-2280
Fax: 818-789-2275