The Balance Between Return to Work and Finding Safe Accommodations

Case Management Focus

I hope you had a great Labor Day weekend. As we return to work this week, we are reminded of the important role Nurse Case Managers play in workers' compensation and helping injured workers return to gainful employment after an injury or illness.  

Our main goal is to assist injured workers in receiving the care they need after a workplace injury so they can return to gainful employment. Workers injured on the job benefit from medical care at no cost to meet their needs. They also are paid if they cannot go back to work. This combination can lead to overutilization and other issues that can derail the process. Nurse case managers who take the time to educate and work with the injured worker, the employer, and the adjustor and utilize the resources are successful.  

Nurse Case Managers meet the injured workers where they are. They meet face-to-face with the worker, the doctor, and all healthcare team members. This allows them to have a unique understanding of the process and all invovled. They work collaboratively with the claims adjustor and the employer.  

Nurse case managers often advocate for the injured worker to return to work, even when the worker does not feel ready. It is essential to explain the purpose and benefits of returning to work and that accommodations can be made to ensure the worker's restrictions are considered so they are safe and allow them to work in ways that will not cause a setback or re-injury   

Here are some of the ways Nurse Case Managers can do this:  

Working with the employer early on to understand the job description of the injured worker. Suppose the employer does not have a job description. In that case, nurse case managers observe other workers who do the same type of work to understand and document the expectations of the employer/worker. Sharing this with the rehab team and the physicians involved so they have a clear picture of the type of work the injured worker is expected to do upon their return allows them to evaluate the worker realistically. This picture also will enable them to determine the accommodation(s) needed to ensure a safe return to work. 

Educating the employer about the benefits of returning an injured worker to work is a critical part of the process. Many do not realize the implications of not bringing an injured worker back to work. Explaining the benefits and the repercussions lets them have a better understanding of the process. It can also help them put safety processes in place that can avoid future injuries.  

Bringing team members into the return-to-work process is a good idea so the injured worker transitions through the system as smoothly as possible. Nurse Case Managers look at all aspects of the case to ensure a safe transition to gainful employment.  

It is important to share the job description with the treating physician and specialist called in to evaluate the patient so they can realistically assess the injury and the recovery process.  

 They are sharing the job description and having them explain how recovery will progress to the injured worker and his family. Setting realistic expectations is essential. We also have them explain that recovery is possible, even when it is slow, when the injured worker is an active team member. When the injured worker commits to the process, follows the plan of care, and does their part to recover – we all win.   

The rehabilitation team treating the injured worker is an important partner in the process. They will map out a therapy plan and concentrate on areas that need work. They will make suggestions on what accommodations could be used to meet the individual needs. Most of the time, accommodation(s) are simple and doable for the employer to implement, and they help the injured worker see what is possible vs. what is not possible. It gives everyone hope. 

Working with the employer so the nurse case manager understands the mechanisms of the job is essential. By understanding the actions needed to perform the job: sitting, standing, bending, kneeling, climbing, and other motions are important to be aware of. The rehab team can work with the injured worker to overcome barriers and find new ways to do things safely.  

At times, an injured worker cannot return to the original job. In this case, a vocational counselor should be called in to work with an injured worker to find out what type of work the injured worker and the employer need to do to meet those needs. Sometimes, an injured worker may need to be retrained to do something else as their injury restricts them from returning to their original job.  

The more complex the case, the more the nurse case manager needs to work on keeping the injured worker motivated, helping them stay positive, and using the resources to help them return to work. Nurse case managers do this by asking questions, doing research, and improving communications with all involved.  

Our jobs are not easy, but it is important to look for the resources that can help us retrun an injured worker return to work. Don't give up; as when the system works, it works well!  

Please take the time to share your stories of how you helped the injured workers you work with return to gainful employment.  

Thanks for all you do!  

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