Return to Work Program Through the Utilization of Medical Management and Vocational Rehabilitation Services Sylvia Rolison, BSN, MPH, CCM Pete Mills, M.Ed., CRC, CCM Bruce H. Brawner, M.Ed., CRC, CCM.

Definition of Case Management Collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet the clients health and human service needs. It is characterized by advocacy, communication, and resource management, and promotes quality and cost-effective interventions and outcomes. (CCMC website) Collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet the clients health and human service needs. It is characterized by advocacy, communication, and resource management, and promotes quality and cost-effective interventions and outcomes. (CCMC website)

The Role of the Case Manager Assesses, plans, implements, coordinates, monitors, communicates, facilitates, motivates and evaluates Assesses, plans, implements, coordinates, monitors, communicates, facilitates, motivates and evaluates Through medical treatment & rehabilitation to return to work Through medical treatment & rehabilitation to return to work Graduate to the highest level in the most efficient manner Graduate to the highest level in the most efficient manner

Considerations that Affect RTW Nature of the injury Nature of the injury Employees attitude Employees attitude Physician quality and attitude Physician quality and attitude Employers return to work program Employers return to work program Other medical factors not related to the work injury but may affect the outcome….diabetes, living conditions, culture, legal issues and support system Other medical factors not related to the work injury but may affect the outcome….diabetes, living conditions, culture, legal issues and support system

In Summary The Case Manager is the communication highway The Case Manager is the communication highway A motivator and a mediator A motivator and a mediator Keeps everyone on the same page Keeps everyone on the same page Keeps everyone's eye on the prize (successful return to work outcome) Keeps everyone's eye on the prize (successful return to work outcome)

Vocational Rehabilitation Services Vocational evaluation Vocational evaluation Vocational/educational testing Vocational/educational testing Vocational counseling Vocational counseling Labor market survey Labor market survey Job placement services Job placement services

Vocational Rehabilitation Services (continued) Consulting with the treating physician Consulting with the treating physician Performing job analysis Performing job analysis Rehabilitation/life care planning Rehabilitation/life care planning Vocational expert testimony Vocational expert testimony

Vocational Evaluation Age Age Education/training Education/training Previous work experience Previous work experience Other life experiences Other life experiences –Military history, hobbies, social and civic activities Vocational/educational testing Vocational/educational testing Information regarding post-injury, physical/psychological capabilities Information regarding post-injury, physical/psychological capabilities Transferable job skills Transferable job skills

Analysis of Past Work Physical demands Physical demands Skills Skills Aptitudes Aptitudes Worker traits Worker traits

Physical Demands of Work Sedentary Sedentary Light Light Medium Medium Heavy Heavy Very Heavy Very Heavy

Job Skills Unskilled Unskilled Semi-skilled Semi-skilled Skilled Skilled

Vocational Expert Services Vocational evaluation Vocational evaluation Vocational testing Vocational testing Job analysis Job analysis Job accommodation Job accommodation Job placement Job placement Labor market surveys Labor market surveys Wage earning capacity Wage earning capacity Vocational testimony Vocational testimony

Determine Post-Injury Employability Comparing the wages earned or capable of being earned by that same worker following their injury Comparing the wages earned or capable of being earned by that same worker following their injury –Age –Education –Access to the labor market –Economic conditions of his or her area of residence –Placeability –Labor force participation

Return-to-Work Process Placement with previous employer is first priority Placement with previous employer is first priority Placement with different or new employer is second priority Placement with different or new employer is second priority On-the-job training On-the-job training Formal training Formal training

Conclusion The primary goal of vocational rehabilitation is return to work The primary goal of vocational rehabilitation is return to work The secondary goal is to provide information to our referral source and to the Administrative Law Judge The secondary goal is to provide information to our referral source and to the Administrative Law Judge

Barriers & Solutions for Return to Work Communication Communication Disconnect between the FCE and the job Disconnect between the FCE and the job Supervisor/employee relationship Supervisor/employee relationship Medication and job placement Medication and job placement Accurate job descriptions Accurate job descriptions Planned light-duty program Planned light-duty program

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