With more than 2, employees and 55 service locations throughout North America, the company delivers case management, utilization management, medical bill review, preferred provider organizations, Social Security representation, information management, Medicare Set-Aside, and related cost-containment solutions. Injured workers often aren't directed to top performing providers.
It's estimated that less than 20 percent of work comp injuriesiii are treated by the best-performing doctors in the network by outcomes, RTW, medical efficiency, and other criteria. That's the difference between several days delay in RTW and several thousand dollars in unnecessary costs. Look for programs that use analytics to identify and direct workers to the best providers in the network.
There's little recognition or accommodations made for comorbidities, such as obesity or depression. It's estimated that more than 50 percent of American workers are obese, have diabetes, heart disease, or other illnesses.
Poor utilization of case management programs. Good case management requires a range of skills and attributes, ranging from clinical and vocational credentials and experience, to a strong knowledge of state and federal regulations. Medical case managers must be engaged in every step of the care process to facilitate a more robust exchange of information between the employer and the treating provider.
Look for programs that provide optimal and proven case management strategies and outcomes. There's often a lack of a formalized written return-to-work policy. When it comes to getting workers back on the job, it's important that everyone is on the same page. It is important to have clear written RTW polices to ensure that the employer and vendors are clear on the process that needs to happen to bring injured workers back to full-time duty.
It is the role of the return to work coordinator and joint labour-management committee to identify and eliminate these personal and environmental barriers when possible, or to diminish their effect. Archived News Select Year Member Login.
Some of the barriers and examples of how they might negatively impact return to work include: Design, delivery and entitlement of benefits: Some benefit programs do not permit maintenance of benefits during partial return to work, thereby forcing disabled workers to stay off work until fully recovered, possibly increasing the length of recovery time. Others do not permit a trial return to work or penalize the worker if a trial return to work was not successful. Corporate policies: Some companies may discourage or ban communications with injured or ill workers, thereby disconnecting workers from their social ties in the workplace and eliminating discussion of possible accommodations that would allow the worker to return to work.
Other policies may charge the cost of accommodations or modified return to work to the specific Collective agreement issues: Some provisions of collective agreements may make it difficult to return the worker to a modified or different job, either temporarily or permanently.
These may include clauses on call back after layoff, seniority provisions or job classification. The worker may be reluctant to return to work, fearing reinjury. If workers have been off work for a long period of time, they may have adjusted their lives to a pace and structure that makes is difficult to return to regular employment. In addition, they may have become isolated from their coworkers and lack the social connection to the workplace.
Smaller organizations may have more limited resources, and may lack experienced and trained labour and management representatives familiar with the health care and rehabilitation issues related to effective return to work.
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