Honoring Those Who Drive Injured Employees’ Return to Work

National Case Management Week is a time to thank those who advocate for injured and disabled employees

Return to work is a term widely used in the P&C industry, but how often do we consider its true meaning? Think about the amount of effort, skill, coordination and compliance it takes to reach that goal, especially for those overcoming the most severe injuries or illnesses. Suddenly, the power of those three words is massive.

Those same factors that make for successful return to work also describe the duties of the case manager—a vital, but often unheralded professional in the P&C space. Over the past nine years, Enlyte has set out to change that through its Heart of Case Management Awards. The program, which runs in conjunction with National Case Management Week (Oct. 13-19), showcases the top four Enlyte case managers who have made the greatest impact on the injured and disabled employees they serve.

In this edition of Enlyte Executive Insights, Tim Howard, SVP, Field Case Management, explains the value of case management and what those in the P&C industry may not know about these trusted professionals.

What is the Heart of Case Management?

Tim Howard (TH): This award is really what we consider to be the “MVP of Case Management.” It’s a national program recognizing Enlyte’s case managers who go above and beyond their traditional job duties to improve the lives of thousands of injured employees each year. We award the top cases from more than 2,000 case managers across the country. This includes field, catastrophic, telephonic and disability case management.

Why an awards program for case management?

TH: I consider case managers the life-changing forces of our industry. These professionals are charged with ensuring thousands of American employees who sustain an injury on the job receive the care and resources they need to reach their highest level of functioning. Still, many in our industry might not realize the important work they do because case managers aren’t ones to brag about the difference they make on a daily basis. That’s why we created the Heart of Case Management Award, to celebrate these professionals and the vital role they play in workers’ compensation and disability management.

Tell Us About This Year’s Winners

TH: Well, first I’d like to express the difficulty judges face in choosing our Heart of Case Management Award winners. The nominations we receive are all worthy of recognition, and the four winners selected truly represent the excellence of Enlyte case managers.

This includes Donna Chestovich, RN, BSN, CCM, a catastrophic case manager assigned a case involving a medical transport pilot who survived a plane crash but sustained critical burn injuries that left him with a 5 percent chance of survival. Not only did the pilot survive, but with Donna’s care coordination, he returned to the cockpit.

Field case manager Sarah Gifford, CCM, CRC, CEAS, truly utilized her critical thinking skills in managing the care of a 42-year-old female ice carver who accidentally amputated three fingers on her left hand while on the job. This injured employee is a single mother caring for a young child, and now she had to learn to function with a disability. It was a scary proposition for this employee, but Sarah addressed her mental and physical issues in the care plan, insuring the woman relearned the daily life skills necessary to return to a productive lifestyle.

An interesting facet of case management that some may not be aware of is the role it plays in helping companies stay compliant with the Americans with Disabilities Act. Disability case manager Alyssa Tease, MS, CRC, CPWIC, recently worked with an employer to accommodate an employee with attention deficit-hyperactivity disorder. This allowed the man to resume employment at his “dream job” and the employer to retain a valuable employee.

The most vital attribute of case managers is their ability to establish trust with injured employees, who often are initially skeptical about and overwhelmed with the workers’ compensation process. Telephonic case manager Elizabeth Lebron, MHA, BSN, RN, CCM, is a great example of this. On first contact with a pilot who sustained a shoulder injury, the injured worker initially dismissed Elizabeth, and rejected her assistance. Undeterred, Elizabeth quickly won the pilot over by advocating for surgery that was initially deemed unnecessary. She then closely monitored his progress to ensure there were no lapses in his care continuum, which led to him quickly returning to full duty.

To get the full picture, I suggest everyone visit the Enlyte Heart of Case Management Award website where they can access videos of the case managers describing these cases in their own words.

What are a few other things P&C professionals might not, but should know about case managers?

TH: They’re on the front lines of stopping opioid abuse. Case managers are experts in observation and follow best practice guidelines to help injured employees best manage pain. They work to ensure other pain management protocols are being utilized and, if prescribed, opioid guidelines are being followed.

They keep claims out of the courts. Case managers help educate injured employees about their injury, which facilitates a more proactive role in their recovery. Studies show an empowered and respected injured employee is also unlikely to seek legal action, and that case management involvement can significantly reduce claim litigation.

They’re best at earning the most valuable asset in workers’ comp: the injured employee’s trust. That attribute can mean everything to an injured employee struggling to navigate a complicated workers’ comp system. Case managers provide that critical connection to help guide injured employees toward their goals.

They’re experts at stopping RTW delays in their tracks. The trusting relationship case managers develop with injured employees makes them more aware of issues outside of the injury that could delay return to work. This often includes uncovering psychosocial factors such as fear of job loss, income, potential disability and even post-traumatic stress from the injury itself.