Client-based case management for injured and sick workers in a publicly funded New York State occupational health clinic.
Workers compensation carriers have utilized registered nurses to serve as case managers to monitor the medical treatment of injured workers and to reduce delays in diagnostic and treatment services and early return to work. While it may seem to be in the workers'best interest, these nurses often aggressively attempted to dominate injured workers' physician visits, pressuring physicians to release patients to work prematurely. The insinuation of the comp carrier into the relationship between the worker and the treating physician of his or her choice should not be permitted. In this presentation, we will describe how delays in resolving comp claims can be reduced while still protecting the rights of the injured worker. For the past 8 years, the Central NY Occupational Health Clinical Center (CNYOHCC, a part of the NYS Occupational Health Clinic Network), has operationalized and refined a client-based case management program that advocates and empowers sick and injured workers seen at the clinic. The CNYOHCC case management model can be adapted to serve all NY State workers with workers comp claims. The presentation will include a description of elements and methods in the development of the client-based case management model.
Learning Objectives: At the end of this session, the participant will be able to: 1. List at least 2 potential adverse consequences for workers comp patients accompanied to physician visits by insurance company case managers. 2. Describe at least 3 elements used in the client-based case management approach used at the Central NY Occupational Health Clinic. 3. Discuss what changes in the NYS Comp system would allow expansion of the client-based approach to case management.
Keywords: Occupational Health Care, Case Management
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Central New York Occupational Health Center
New York State Workers Compensation Board
Disclosure not received
Relationship: Not Received.