Effective case management is the key to safe, speedy and durable RTW. There are three basic rules of case management:

1. Case management procedures should be documented, so that everyone in the organisation knows what to expect.
    
2. Each injured worker should be assigned a case manager to oversee and monitor his or her progress in rehabilitation and RTW, so that any challenges are identified early and addressed.
    
3. Organisations need to ensure that case managers have enough time to do their job properly, including case managers who must juggle case management with other responsibilities, for example supervising. The number of cases that can be handled at one time depends upon the demands of each case and any other workload the case manager is responsible for. In principle, 30 to 60 cases is a full-time workload.

Who makes the best case managers?

Case managers need to be effective and timely communicators, ethical—which includes being committed to maintaining confidentiality as appropriate—and good at fostering collaboration. Most organisations will have a pool of people who might fit the bill.

For example, RTW coordinators may be actively involved in assisting employees after an injury, as the person who communicates with them and coordinates, or ‘case manages’ the return to work process.

Alternatively, the RTW coordinator may train, up-skill and support other staff who undertake the day to day coordination of return to work. In a large organisation the RTW coordinator may spend much of their time training and supporting supervisors to manage return to work, and limit their case management activities to complex cases.

Case management for work injury can be performed by the:

• Supervisor or line manager;
• RTW coordinator;
• External rehabilitation professional;
• Treating doctor; or
• Human resources manager.

What is the secret to successful case management?

Case management works most effectively when the focus is on what is best for the employee.

Some people term this "patient-focused case management" or "client-centred case management." This emphasises that the employee is the key person being helped. Actions are primarily directed towards supporting the employee, both with medical rehabilitation and return to work rehabilitation.

Case managers are responsible for ensuring that the employee has:

• High quality medical care, including primary and specialist care;
• A sound understanding of their condition;
• Any aids or appliances that may be necessary; and, where relevant
• Assistance with domestic services in the early stages. For example, domestic assistance would be appropriate for a person with an arm fracture who is unable to clean the house, or someone with a leg fracture who is unable to drive.

What kind of training does a RTW case manager require?

Case managers should be trained in:   

• Organisational disability management processes;
• The processes and legislation relevant to the jurisdiction/s in which the organisation operates;
• Active listening;
• Dealing with problematic situations;
• Basic ergonomics; and
• Individual health conditions and restrictions as they arise.

What tasks does a RTW case manager perform?

Case management involves:

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

The case manager is also responsible for:

• Maintaining communication with the employee. The first communication should take place as early as possible, preferably within 24 hours of the injury or illness, and regular communication should continue throughout the case.
   
• Providing clear information to coworkers, with the injured employee’s permission, so that they are aware of his or her needs upon return to work. Supervisors should also be informed, so that too they have an understanding of the person's difficulties. Giving supervisors background information about the case facilitates employee-supervisor collaboration in planning productive and meaningful modified duties.
   
• Ensuring that delays are kept to a minimum. In some situations this is simply a matter of following up with simple actions as agreed. In other cases, it can require considerable effort to overcome the many potential obstacles that arise from bureaucratic compensation systems. For example, a number of telephone calls may be required to confirm that liability is accepted for an operation without delay.
   
• Regular follow-ups with stakeholders. Follow-up may comprise a weekly five minute meeting between the employee and their supervisor, or a regular phone call to someone who is off work. Follow-up aims to check on progress and deal with issues as they arise.
   
• Organising a "one week off work" RTW briefing meeting with injured employees, scheduled approximately 7 days after work absence begins. Despite the existence of documented procedures, employees will often not read or take notice of information until they are faced with a situation, so it is sensible to refresh an employee's understanding of return to work procedures after injury occurs. The case manager should organise a meeting with the employee to let them know about the employer's approach, how the system works, and what is expected of them can make a substantial difference. It is pragmatic to make this meeting part of the case management procedures. At the week-one meeting the employee should receive information about:
  • Their pay level over time;
  • Return to work systems and what is expected of them;
  • The roles of those involved in return to work management, such as the supervisor and the production manager;
  • The role of the claims or insurance manager;
  • What is expected in terms of certificates, how they are completed and who they need to be handed to;
  • How to get the most out of the system;
  • How to problem-solve return to work issues; and
  • What they can do to contribute positively and get the best outcome.