I. Communication
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Possesses the knowledge and interpersonal skills necessary to make an accurate assessment and evaluation of condition and needs. |
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Able to establish a sense of trust with the IW and their family as well as the employer and physician. |
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Willingness to keep the employer and/or claims person informed and updated in a timely manner. |
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Understands the “TEAM” concept and functions as an integral member of the TEAM. |
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Has knowledge of the type of work being performed at a particular company, and is willing to learn as much as possible through onsite visits. |
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Able to meet with the physician and other caregivers (PT, OT, etc.) to discuss and implement a proper treatment plan. |
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II. Documentation
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Writes and submits accurate, timely, reports containing valuable information such as:
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Current diagnosis and treatment. |
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Prognosis regarding achieval of MMI. |
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Work status with projections regarding whether or not the IW will ever be able to return to his pre-injury occupation (project dates for RTW, if possible). |
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Dates of last and next physician appointments. |
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List of all diagnostic testing performed (to include results). |
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Surgeries performed and/or anticipated. |
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Summary of events (only the facts). |
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Recommendations/Plan. |
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Monitors IW's progress and compliance with the treatment plan established by the physician. |
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Obtains and submits physician and therapy reports. |
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III. Resolution
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Willingness to initiate immediate onsite intervention at the ER, doctor's office, jobsite, IW's home or wherever necessary. |
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Makes appropriate recommendations to assist with recovery and has an established resource network in the community at large. |
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Able to problem-solve quickly and be creative. |
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Has established good working relationships with the various medical providers and their office staff to ensure quick scheduling of appointments for the IW as well as prompt communication. |
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Collaborates in bringing the “TEAM” together:
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IW and family |
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Treating Physician |
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PT's, OT's, etc. |
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Employer/Claims Handler |
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Enables Attorney (plaintiff and defense) involvement especially when the IW is unable to return to his pre-injury occupation as
well as helping to interpret medical information. |
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Contains cost of medical care coordination services through performance of pro-active, task-oriented activities only. |
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IV. Integrity
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Respects the rights and dignity of the IW as well as the employer and/or referral source. |
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Possesses a “working knowledge” of state and federal laws (Worker's Compensation, Longshore, Jones Act, ADA). |
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Operates within the medical-legal framework by functioning as a Nurse at all times. |
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Remains neutral in claims or company issues by referring the IW to the appropriate person or persons necessary to assist them. |
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Reports facts truthfully and assesses the IW's condition accurately. |
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Practices under the “Code of Professional Conduct for Case Managers” as well as the Code of Ethics for Professional Nurses. |
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