Challenge
Not all claims are the same. Injured employees are all vastly different and have gone through varying situations. They can be young or old, confident or nervous, and knowledgeable or unknowledgeable about workers’ compensation. For *Theo, he was only 18 years old when he had his first interaction with the workers’ compensation system. This put him in a position where everything was unfamiliar, and he didn’t know what to do or expect.
While working for a food service employer, Theo was unpacking their daily truck delivery. As he opened a box of food with a knife, an incident occurred, resulting in a laceration to his leg. After reporting this to his employer, Theo got initial treatment for the injury, though the story didn’t end there.
Noticing that the path toward recovery was progressively getting longer, Theo’s employer filed a claim, which landed with *Melissa, a Careworks case manager. From Melissa’s perspective, the primary objective of this referral was to secure a maximum medical improvement statement and address various obstacles hindering the progress of the claim. Among these challenges were Theo’s lack of transportation, his daytime class schedule, and his limited understanding of the workers’ compensation system.
Solution
Following the assignment of the case and resolution of the identified barriers, Melissa initiated contact with Theo through test messages that he was able to respond to in between and after classes. Then, an in-network provider within walking or biking distance from his residence was found. After Theo confirmed that he would be able to travel to the provider on foot, Melissa and him were able to arrange all his medical appointments to accommodate his class schedule.
Taking it from there, Melissa contacted the provider and gave them a comprehensive medical summary and facilitated a prompt referral for immediate scheduling. She also kept Theo in the know at every step of the way, prioritizing his ability to understand what was going on and not be afraid about any next step. To Melissa, it seemed as though a big part of Theo’s hesitancy to an active recovery was his misunderstanding about the workers’ compensation process including his role versus his employer’s role with cost and scheduling. Taking these concerns seriously, Melissa answered every question Theo had and took the time to explain his recovery plan thoroughly.
Result
Through dedicated time, effective communication, and coordinated efforts, Mellisa helped Theo successfully achieve maximum medical improvement within eleven business days of receiving the referral. Theo was able to return to work happy and healthy, thankful to Melissa for not only guiding him, but educating him through a once scary process.
*Names changed for privacy purposes