Case management is “a collaborative process of assessment, facilitation and advocacy of options to assist with an individual’s health needs and return to work. Case management is achieved through communication and use of available resources to promote quality and cost-effective outcomes.”

In a nutshell, case management involves:

• Liaising between the employee and the workplace
• Working with treating practitioners and external service providers such as rehabilitation providers
• Influencing management in the employing organisation
• Liaising with claims or insurance staff

Case Management may be performed by the supervisor or line manager, the RTW coordinator, an external rehabilitation professional, the treating doctor or the human resources manager.

In a smaller organisation, the RTW coordinator may spend much of their time on case management. In a larger organisation, their time may be spent on training, up-skilling and supporting other staff who undertake the day to day coordination of return to work. In larger organisations, RTW coordinators may limit their involvement in case management activities to more complex cases.

Working with Supervisors

Why is training of supervisors needed?

Supervisors play a key role in the successful RTW outcomes. A study has found significant reductions in new claims and active lost time claims when training of supervisors in RTW is provided. The study, A Controlled Case Study of Supervisor Training to Optimise Response to Injury in the Food Processing Industry, discovered that there was close to 50% reduction in new claims and almost 20% reduction in active lost time claims when this occurred.

Training of supervisors in RTW can also help shift perceptions about injured workers. Instead of seeing workers as lazy or entitled for requiring modified duties, supervisors may come to understand the worker’s condition and what they can do to assist. When they said that they can make a difference, supervisors may feel more satisfaction about their role. Furthermore providing assistance to the worker engages the worker and their productivity lifts. This has a positive impact on other workers.

In “Supervisor Competencies for Supporting Return to Work: A Mixed-Methods Study” the key competencies were identified as:

• Managing conflict as it arises
• Being honest
• Communicating sensitive information
• Demonstrating fairness
• Understanding a supervisor's legal obligations
• Respecting privacy and confidentiality
• Knowing the specifics of the worker's tasks and the workload involved
• Understanding what an injured worker can and cannot do
• Speaking in a respectful manner
• Managing how information about a worker's condition is disclosed to others
• RTWC should set out clear procedures and expectations.
• Allow opportunities for communication.

Working with claims managers

The RTW coordinator regularly works with claims managers when an employee injured. Claims managers undertake a variety of tasks in their role. These tasks may include:

• Issuing workplace injury insurance policies to employers
• Calculating and collecting employers’ premium 
• Administering and managing workers’ claims for compensation
• Facilitating and managing return to work
• Assisting employers with injury and claim prevention
• Providing information and educating employers and workers about their obligations 

When working with case managers it’s important to understand the variety of tasks they are required to fulfil. Getting to know each other will help ongoing communication and gaining a better understanding of the system. Talking through issues with them will be constructive, and possible disputes should be discussed. It’s important to be positive in your dealings. Claims managers have a busy job so be polite and helpful, but also address persistent problems. Solve challenges together. Working as a group will help to find a positive way forward.

Working with Senior Management

Senior managers sets the tone for the rest of the workplace. Lower rates of workers compensation costs occur where strong team morale exists, he is work collaboratively, managers behave supportively, formal and informal feedback is provided, there is a strong focus on quality client services, and managers reflect the organisational values of the company. They need to walk the talk.

In Return to Work, it’s important for management to show care for their workers. This might include an early phone call to the injured worker, or an expression of empathy.

RTW coordinators should regularly supply management with reports and analyses, outlining the business case as well as the human case to show all of the benefits of having an effective RTW system in the workplace.

The rules of case management

1. Communicate with injured employees, preferably within the first 24 hours of the injury occurring and continuing throughout the case. The employee should also be briefed on the employers approach, how the system works and what is expected of them. Other topics might include the employee’s pay level over time, the people involved in the system, and what they can contribute towards getting the best outcome.
2. A coordinator should be appointed to oversee each case, ensuring that issues are identified early and addressed.
3. Provide assistance for every employee with a health condition or injury. This assistance might include high quality primary medical care, aids or appliances where necessary, and if required assistance with domestic duties.
4. Provide clear information for co-workers – With the injured person’s permission, advise co-workers of their needs when they return to work. Providing further information to supervisors facilitates collaboration in the planning of meaningful modified duties.
5. Avoid delays – follow up on agreed actions and persist with overcoming the red tape.
6. Regular follow-ups – This might include a five minute weekly meeting with an employee on modified duties or a regular phone call with someone who is off work. Employees should be provided with clear advice on who to contact if there is a problem. 
7. Supervisors and RTW Training – this should include processes, legislation, active listening, basic ergonomics and individual restrictions and health issues. A trained RTW coordinator may spend their time up-skilling others in the organisation.
8. Case managers must have enough time to do their job – in principle, 30 to 60 cases is a full time workload, although much depends on the demands of each case.
9. Documented case management procedures – These procedures are important so that the staff know what to expect if injured.