Team approach gets injured man back to work
Team approach gets injured man back to work
Case study illustrates integrated approach
At CIGNA, disability nurse case managers often partner with nurse case managers from the health care side of the company to facilitate getting an injured worker back on the job.
This case study illustrates how the company’s integrated approach to disability management works.
A 48-year-old employee at a manufacturing company was stricken with kidney failure, complicated by diabetes and hypertension. He later experienced kidney failure that required dialysis. After nearly 30 years of experience on the job, he was hospitalized and filed for short-term disability benefits. His disability nurse case manager partnered with the claims adjustor to determine the patient’s condition and assess his ability to return to work.
"He was a good employee who had been on the job for 29 years. When he applied for disability, we saw that he was motivated to return to work. We began coordinating and facilitating the process for that to happen," says Lynette Dean, RN, CCM senior nurse case manager.
The disability nurse case manager partnered with CIGNA’s health care nurse case manager to coordinate the care until the member was well enough to get back to work, calling in a vocational rehabilitation counselor to work on job accommodations as the patient’s condition improved.
The nurse case manager on the health care side already was involved with the five physicians providing care for the member when he filed his disability claim. She worked with the physicians on the treatment plan, kept the disability nurse case manager apprised regarding his condition, and provided the records they needed to determine his return-to-work status.
"The health care nurse case managers were able to get his medical information quickly because they already had a working relationship with the physicians. By working closely with these health care nurses, I was able to get timely information and a good assessment of what was happening on the case. There were so many changes in his condition based on his treatment and the multiple comorbidities," Dean reports.
The team followed the patient for three months, eventually getting all five physicians to certify that he could return to work.
The vocational rehabilitation counselor worked out job accommodations with the employer after the case managers received approval from the providers for the member to go back to work. At that point, the health care nurse case manager arranged for the member to get dialysis in the evening so he could work almost all day.
"We worked as a team to get him to the point that he could go back to his primary care physician and we were able to keep him from going into long-term disability," adds Angelica Greene, MHS, CRC, manager of the medical and vocational resources at CIGNA.
At CIGNA, disability nurse case managers often partner with nurse case managers from the health care side of the company to facilitate getting an injured worker back on the job.Subscribe Now for Access
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