Challenge
*Clarence was working as a truck driver for a concrete company and performed daily duties such as maintaining and cleaning his truck. One day while doing so, he was in the company parking lot, cleaning his truck’s exterior using acid and a long-handled brush. While cleaning off grease and concrete, the rotating drum unexpectedly spun clockwise.
As Clarence went to step around to the opposite side of the truck, he did not realize the brush was caught, resulting in his arm being forcefully jerked back. The sudden motion caused his shoulder to dislocate, resulting in immediate pain and a striking fall to the ground. This is where Clarence remained in severe pain for 15 minutes until a colleague found him and called for help.
Although Clarence initially believed his condition might improve, medical evaluation at an emergency facility was required. An MRI was ordered, and care was transferred to an orthopedic specialist. Clarence was diagnosed with a right shoulder Bankart lesion with dislocation of the right shoulder joint.
Surgical intervention was recommended and initially scheduled for February. However, the procedure was unexpectedly canceled the day prior without explanation, resulting in significant delay. Though Clarence’s frustration was building, his surgery was ultimately completed in August. During the first post-operative appointment, the physician explained that Clarence had sustained a 360° labral tear requiring repair with eight anchors.
Solution
After the surgery was completed, the file was subsequently assigned to *Marissa, a Careworks field case manager, so she could assist with re-establishing care and moving the claim forward.
Upon assignment, Marissa attended an appointment with Clarence, conducted a comprehensive review of the treatment history, and acknowledged the frustration caused by the lengthy delay. Clarence was assured that Marissa would advocate for timely care moving forward.
Marissa also met directly with the treating physician to address the lapse in treatment and reinforce her commitment to maintaining consistent communication and preventing further disruptions. Given the delay, the physician agreed to proceed promptly with care.
Marissa then coordinated the rescheduled surgery, ensured all logistics were confirmed, and proactively arranged post-operative physical therapy with prior authorization for all sessions. She also maintained close communication with the provider to ensure timely follow-up appointments and continuity of care throughout Clarence’s recovery.
Following his second surgery, Clarence was released on light duty with restrictions, including no commercial driving. However, his employer was unable to accommodate light duty or transitional work placement opportunities. Although a work-from-home option was explored, it was not implemented. Once medically cleared to drive personally, Clarence demonstrated strong motivation by independently securing income through driving for a food and grocery delivery company during the recovery period.
Result
After Marissa joined his file, Clarence remained highly engaged in treatment, consistently attending physical therapy and maintaining open communication about his progress. Despite the initial delay in surgical treatment, his determination, combined with Marissa’s proactive care coordination and the provider’s collaboration, resulted in an excellent recovery outcome.
Six and a half months later, Clarence successfully returned to full-duty work.
This case highlights the importance of strong advocacy, timely communication, and coordinated care in overcoming barriers to treatment and supporting successful return-to-work outcomes
*Names changed for privacy purposes