7.1 Case management process

ase Management

Case management is a structured and collaborative process that ensures injured or ill workers receive timely and appropriate services for return-to-work. It involves:

• Assessment, planning, facilitation, and advocacy for needed services.

• Use of internal and external resources for effective rehabilitation.

• Early intervention following injury/illness.

• Goal-focused and cost-effective approaches.

Case Management Process

1. Initial Medical Treatment

   • Begins at the workplace with first aid or medical evaluation.

   • Ensures early medical intervention to prevent long-term disability.

   • Employers should have policies for early intervention.

2. Understanding Job Demands

   • Job demands analysis (JDA) compares job requirements with worker's abilities.

   • Key job demands include:

     • Physical (lifting, bending, standing)

     • Cognitive (memory, multitasking)

     • Environmental (hazards, PPE use)

   • The National Occupational Classification (NOC) provides general job demand information.

3. Referral to Third Parties

   • Referrals are made based on client needs with their consent.

   • Can include specialists, therapists, or vocational counselors.

4. Return-to-Work (RTW) Determination

   • Based on physician’s evaluation of job demands vs. worker’s medical limitations.

   • Work is classified into limited, light, medium, or heavy exertion levels.

   • RTW options include:

     • Gradual RTW (reduced hours, increasing over time).

     • Modified duties (avoiding tasks beyond medical restrictions).

     • Alternative work if unable to perform primary job tasks.

5. Documentation

   • Case records should include:

     • Client’s signed consent for information release.

     • Initial & periodic assessments.

     • Vocational rehabilitation plan with goals & timeframes.

     • Referral records & outcomes.

     • Case closure summary.

Quiz: Case Management & Disability Management

Multiple Choice Questions

1. What is the primary goal of case management in vocational rehabilitation?
   a) Reducing employer costs
   b) Ensuring worker productivity
   c) Supporting safe and timely return-to-work
   d) Preventing all workplace injuries

2. When does case management begin?
   a) When the worker submits a compensation claim
   b) As soon as the injury or illness occurs
   c) After the first medical consultation
   d) When the employer approves return-to-work

3. What is the purpose of a Job Demands Analysis (JDA)?
   a) To determine how long an employee can stay off work
   b) To assess whether a job needs modification based on a worker’s condition
   c) To ensure all employees perform the same tasks
   d) To create a medical treatment plan

4. Which of the following is not a key aspect of job demands analysis?
   a) Physical requirements
   b) Cognitive and psychological demands
   c) The worker’s personal preferences
   d) Hazardous exposures

5. Why should a physician be provided with a job demands analysis?
   a) To determine if the worker is fit for their original job
   b) To reduce insurance claims
   c) To persuade the worker to return to work quickly
   d) To help the employer decide on wages

6. In case management, when should referrals to third parties be made?
   a) Only when the worker requests them
   b) Whenever an employer thinks it's necessary
   c) When a worker’s needs require specialized services
   d) After the return-to-work process is completed

7. What does a gradual return-to-work (GRTW) program involve?
   a) Returning the worker to their original job immediately
   b) Adjusting job duties to match medical restrictions
   c) Assigning all light duties to injured workers permanently
   d) Avoiding any workplace modifications

8. Which document provides general job demand information across occupations?
   a) The Vocational Rehabilitation Handbook
   b) The National Occupational Classification (NOC)
   c) The Employee Rights Act
   d) The Workplace Safety Manual

9. Why is documentation important in case management?
   a) To track the employer’s spending
   b) To maintain a record of decisions, referrals, and progress
   c) To keep workers from filing complaints
   d) To prevent employees from requesting additional medical leave

10. What is the most important factor in a return-to-work determination?
    a) The employer’s business needs
    b) The worker’s current medical limitations
    c) The availability of alternative positions
    d) The cost-effectiveness of rehabilitation

Answer Key

1. c) Supporting safe and timely return-to-work

2. b) As soon as the injury or illness occurs

3. b) To assess whether a job needs modification based on a worker’s condition

4. c) The worker’s personal preferences

5. a) To determine if the worker is fit for their original job

6. c) When a worker’s needs require specialized services

7. b) Adjusting job duties to match medical restrictions

8. b) The National Occupational Classification (NOC)

9. b) To maintain a record of decisions, referrals, and progress

10. b) The worker’s current medical limitations