On the move

One of the first things I do in the day is triage claims, which means I review claims and documents, and determine whether they need mobile case management intervention. I’m looking for claims where things may have stalled and where mobile case manager intervention is going to speed up the recovery process and ultimately deliver more efficient return to work outcomes.

Then, like a ‘regular’ mobile case manager, I engage with workers, employers and treaters to facilitate face-to-face meetings and I attend those meetings to expedite treatment approvals. I also help plan for return to work and ensure that when workers return to work it’s safe and sustainable for them to do so.

We meet with the worker and employer first to get up to speed on a claim and part of that is to assist the employer with return to work planning. Then I’ll often go with the worker to the GP to discuss the return to work plan, with the aim of getting timeframes locked in.

I see this as having two benefits – workers have light at the end of the tunnel, and employers can plan their business by knowing when they can expect their worker back at work.

Yes, it is different from regular case management. My experience is that mobile case managers can be more proactive. This means going out and identifying issues before they have occurred and solutions before obstacles have popped up, which means a smooth trajectory for the claim.

Another difference is that my role is autonomous. I am able to meet with employers, workers and treaters and I can be a lot more responsive and get things happening for people which is beneficial. We can do on-the-spot approvals for different services, which is another key differentiator.

We work in conjunction with case managers – we are a support service that assists a case manager with getting the best outcome for the worker.

Workers love that aspect of our role because it means their recovery is quicker and they are not in pain for as long. Employers love it because the worker gets back to work, and the treating health practitioners love it too because we are able to cut through the red tape associated with claims. On-the-spot approvals means that the process is simplified.

Yes. For most workers it’s their first claim, and employers can go a long time without having anyone injured, so it can be hard to know how to navigate the system.

We’ve had feedback that employers who have had mobile case management once, they feel so well educated and confident to do things themselves that they don’t need us the second time around if they have another injured worker. We really are making it easier for people.

I really enjoy having that face-to-face interaction and building rapport. It’s easier for workers because there’s a real person in front of them, not just a voice from an insurance company talking to them on the phone.

I get to see the smile on their face when they go to doctor and the doctor says they can return to work. I enjoy that people put trust in me to do what’s needed to help people get back to work.

There are some negative perceptions about workers compensation but my experience is that an overwhelming number of people want to recover from their injury. They want their lives back and to go back to work. We can steer people through that process to ensure it’s a smooth ride.

I remember working with a 61-year-old landscaper who had a run of the mill injury and then surgery, but he had a severe reaction during the operation and got a significant infection.

I’ve approved lots of different treatments and rehabilitation on the spot for this man. I was able to approve surgery on his shoulder that will eventually restore enough function to get him back to work. When I informed him that the surgery had been approved, he broke down in tears for about 10 minutes. He was so thankful that he was on the path to recovery.

Another worker I supported had been off work for 15 months and was stifled by lack of planning on behalf of her employer. I visited the workplace with the worker, who hadn’t been back in 12 months, to meet with all the parties. We devised a plan and presented it to her doctor and she commenced modified duties with reduced hours, but she was back at work. She sent me a follow up email and said it had saved her life. She didn’t know how long she was able to keep going and going back to work had made the difference.

We are constantly evolving what we do, so I’m excited to think where we can take things next.

I work with a great team who are open to everyone’s ideas. It feels like we are leading the scheme with what we are doing. I want to make sure we stay ahead and keep evolving to stay a scheme leader and make a difference in people’s lives.