Tuesday, November 10, 2009

Let's Reduce Lost Time --- Medical Case Management

As mentioned in my last posting, Oklahoma gets a low ranking compared to other states in the category of lost time. How can we improve our standing and get workers back to work quickly?

At the Court we think we are doing our part. Time to trial for nearly every judge is six to eight weeks, just the right amount of time for the attorneys to be prepared. So what else can we do?

I believe that much of the delay outside the courtroom can be ameliorated by judicial appointment of medical case managers.

What criteria should we use to decide when appointment is appropriate? Based on my experience dealing with cases ranging from the mundane to the tar-baby, certain events or circumstances are red flags that in the future will trigger consideration of case manager appointment. They include:
  • Claimant has missed work for more than thirty days
  • Injury to multiple body parts
  • Claimant has drug problems or is predisposed to them
  • History of missed appointments
  • Presence of comorbidities, such as obesity, diabetes, heart disease or heavy smoking, that potentially mask symptoms or impede recovery
  • Insurance carrier uses out of state adjusters or multiple PPOs
If my readers have suggestions to modify or expand this list, please contact me with your ideas at by posting a comment to this item or replying to your email notification.

1 comment:

  1. In the "olden days" the Claimant's bar always objected to Nurse Case Management, as they saw it as spying. I am convinced the majority of the population can not remember and follow doctors orders, and need an advocate to assist them in completing the physicians orders. If the Claimant Attorneys would see this as a way of moving the cases toward finality, rather than a hinderance, we would all win. The quicker each Claimant reaches MMI, the more cases they can handle, the more money they make. For the Respondents, there is always another claim, and there is no financial incentive to reach MMI quickly, only closure of the claim. I'm glad to see this post, as it is a reminder that Nurse Case Management is a tool we need to use wisely in claims handling