Employer's Guide
to Managing On-the-Job Injuries
The Role of University Hospitals CompCare Case Managers
- Monitoring the course of treatment
after a work-related injury
- Initiating the employee’s
return-to-work
- Facilitating communication among the
parties
Q. What is a case manager?
A. A University Hospitals CompCare case manager is a highly trained
professional whose job is to help guide the employee’s recovery
and successful return-to-work. All of our case managers are
registered nurses and/or certified case managers. Our customer
service representatives and case managers are assigned to work in
teams with specific employers, which means you will always receive
knowledgeable, personalized service. Furthermore, our case management
program has received Case Management Organization full accreditation
by URAC, the premier organization for accreditation of case
management services.
Q. Why is URAC accreditation so important?
A. URAC accreditation signifies that University
CompCare has all of the necessary policies and procedures in place
for medical case management and that they are applied consistently.
We create individualized case management plans for injured workers
that set short- and long-term goals, and we are committed to the
confidentiality of client-specific information.
Q. What is the case manager’s involvement in an injury case?
A. If you have an employee injured on the job, a case
manager will be assigned to oversee the employee’s progress after
initial treatment has begun. The case manager monitors the employee’s
medical needs, helps guide him or her along an appropriate course
of treatment, and coordinates a successful return-to-work program.
Q. Can the case manager suggest a return-to-work program that
includes transitional work?
A. Yes. The case manager can arrange for the employee to
return to work with limitations determined by the physician, for
a limited period of time. This arrangement is appropriate only if
the employer can accommodate a transitional, or modified, position
that fits the employee’s functional capacity.
Q. How can a period of transitional work benefit the employer
and employee?
A. By returning the employee to the work environment sooner,
transitional work helps avoid re-injury, reduces gaps in experience
and training, controls lost-time costs, and makes the employer part
of the support network for employees recovering from injuries.
Q. How long will the case manager handle the employee’s case?
A. The case manager will coordinate and monitor the
employee’s medical services until he or she is able to return to
work and/or the case is closed according to BWC guidelines.
Q. What if the employer or employee disagrees with the case
manager’s decisions regarding medical treatment or rehabilitation?
A. Anyone who disagrees with a medical treatment decision
made by a case manager can appeal that decision directly to
University Hospitals CompCare via the Alternative Dispute Resolution process.
After a thorough review of the decision and the case in general,
University Hospitals CompCare will issue its final decision on the issue
within 21 days from the date of receipt of the appeal. The
opportunity to appeal University Hospitals CompCare’s final decision to BWC
is available if needed.
Q. What if the employer or employee has complaints about the
level, timeliness or courteousness of University Hospitals CompCare’s
administrative service?
A. University Hospitals CompCare is committed to a high level of
customer service and teamwork. If you ever have questions about
the service you or your employees are receiving, contact your
University Hospitals CompCare customer service representative at
1-800-818-7273. If you are seeking a more formal response,
please direct your concerns to the Director of Operations at
University Hospitals CompCare.
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