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| Q:
What types of injuries require case management?[Top] |
Any
claim with the estimated duration of 6 plus weeks, and:
- Knee Injuries
- Amputations
- Spinal Cord Injuries
- Head Injuries
- Vision loss
- Cumulative Trauma disorders
(carpal tunnel syndrome, tendonitis etc)
- Shoulder injuries
- Neck Injuries
- Back injuries
- Extensive burns
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| Q:
What is a case manager?[Top] |
| The
Case Manager coordinates the health care services, vocational
rehabilitation and claim management activities in a caring and
cost effective manner, according to the injured worker’s
needs, and with a focus on returning the injured worker to work
in the shortest time possible. The Case Manager oversees the
delivery of services of the claim, until it is closed or there
is an LTD established, thus ensuring service continuity and
a primary point of contact for injured workers, service providers,
employers and unions.
Specifically, the Case Manager is responsible
for:
- acting as a liaison between
the case management team, the injured worker, the employer,
the union and the health service providers
- with the assistance of the
Commission’s Medical Advisor and in communication with
the family physician and other health service providers,
setting out the expectations the medical management plan
- coordinating and expediting
medical referrals and related treatment activities
- establishing initial RTW activities
with the injured worker, the employer and appropriated team
members (e.g. Occupational Therapist, Rehabilitation Specialist)
- ensuring that the injured
worker and employer are appraised of their respective roles
and responsibilities
- coordinating the efforts of
the employer and service providers in the return to work
plan.
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| Q:
What is a case management team?[Top] |
| The
Case Manager is supported by an internal team of professionals
dedicated to the rehabilitation of the injured worker. The team
includes the Case Manager, the Occupational Therapist, the Rehabilitation
Specialist and the Medical Advisor. The team is lead by the
Case Manager who is responsible to act as a liaison between
the injured worker, the other members of the team, the employer
and all service providers. |
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| Q:
What is the medical advisor's role in
case management?[Top] |
| The
team’s Medical Advisor provides case managers with medical
analyses of claims including clinical objectives, estimated
recovery and disability periods, probable and possible outcomes
of the treatment plan, and the impact of the current condition
and residual impairment on fitness for work.
The Medical Advisor also:
- consults with treating physicians
as needed to discuss the medical management of cases and
submits recommendations to case managers with respect to
the necessity, character and sufficiency of medical aid
as required
- reviews the medical management
of a case and to approve payment for surgeries and other
treatment modalities
- reviews the progress of a
case, as part of a case management strategy and submits
recommendations for any additional interventions as necessary
- performs medical examination
for the assessment of permanent physical impairment. (PPI)
which is a one-time award for physical impairment resulting
from the accident.
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| Q:
How can I get help expediting the referral,
test and/or procedure?[Top] |
| The
Medical Advisor and Case Manager can help you expedite referral,
test and/or procedure. A network of specialists is available
within New Brunswick, as well as in Quebec, Ontario, Nova Scotia
and Maine. Specialized tests like MRI can be obtained with a
few days in most regions. By expediting medical services we
ensure that the impact of inactivity on the worker’s functional
capacities is being reduced. |
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