The Dilemma of the Case Manager in Workers' Compensation: Decision-Maker, System Player, Para Legal/Medical Specialist, Mediator or Enemy?

The Australian Journal of Rehabilitation Counselling

2004

Self Cite

This paper promotes the notion that workplace claims/injury management and rehabilitation in South Australia should be a learning process for all stakeholders. It argues that this is often ignored by the system where organisational rigidity and fixed expectations exacerbate problems and reduce the opportunity for change, new ways of learning and reciprocity. This paper asserts that what enables successful cost-effective claims/injury management would be the open operation of the pooled wisdom, experiences and practices of the stakeholders. It upholds the view that the systems involved need to be more flexible in facilitating partnerships and new learning, which would require changes in terms of openness, opportunities for learning and interacting, and establishing common focused goals. In order to study these ‘learning partnerships’, this paper attempts to analyse the dynamic configurations of ‘social power’ in the specific contexts in which the various stake-holders interact.

Section: Research Findings Methodologymentioning

confidence: 99%

Section: Problem Description: the Facts Of Social Power And Their Effmentioning

confidence: 99%

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confidence: 99%

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Promoting Excellence: A Learning Partnership Approach to Workplace Claims/Injury Management and Rehabilitation in South Australia

The Australian Journal of Rehabilitation Counselling

2004

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“…The case managers who were interviewed clearly expected the rehabilitation focus to be process-oriented because of the legislative requirements, although they admitted that these protocols allow for some movement and discretionary action on the part of the rehabilitation provider. Case managers preferred competent, focused, skilled providers who have a clear understanding of their role and are able to professionally manage the escalating emotions evident at various points along the process (see Roberts-Yates, 2002b). In fact, insurance companies have "preferred provider lists" from which the case manager selects rehabilitation counsellors to match the needs and personalities of specific workers:…”

Section: Case Managers' Perspectivesmentioning

confidence: 99%

Examining the Role of Rehabilitation in the South Australian Workers' Compensation System

The Australian Journal of Rehabilitation Counselling

2003

This paper will analyse the provision of rehabilitation to injured workers with a registered WorkCover claim in South Australia. It presents the comments of key parties on the practice of rehabilitation, approaches to service delivery, and contradictions and paradoxes of the reality of the practice. The comments of workers, employers, case managers, medical practitioners, and of the rehabilitation providers themselves give ample evidence of the complexity of the demands placed upon providers in this system. Emphasis is placed upon their role in presenting the realities of the situation honestly to the worker and in effectively communicating to other stakeholders the particular strategies needed to overcome barriers to successful return-to-work outcomes.

“…They complained about poor communication channels where GPs left case managers out of the loop and medical specialists presented as professional strangers with limited involvement, frequently failing to complete medical reports in a clear and useful way. They reported that medical practitioners make too many assumptions about the worker's performance based on opinion and information provided by the worker (Roberts-Yates, 2002b). Their comments include the following:…”

Section: Case Managers' Perspectivesmentioning

confidence: 99%

Examining the Role of Treating Medical Practitioners Practising in the South Australian Workers' Compensation System

The Australian Journal of Rehabilitation Counselling

2003

This paper reports conversational interviews with key stakeholders in order to analyse the critical role of the treating medical practitioner in the management of injured workers with a registered WorkCover claim in South Australia. The comments expose the dilemma of treating general practitioners in their dual roles of “gatekeeper” and service provider against a backdrop of the ongoing demands and pressures from claims agents, vested interest groups, litigation, pervading antagonistic process relationships, inflexible work settings and the preoccupation with containing costs. The study highlights the need for treating medical practitioners to understand the WorkCover system and legislation. It is suggested further that their practice would benefit from holistic management, supportive care, clear language, respectful communication, timely medical updates and helpful professional attitudes. It was noted that many medical practitioners favour some redesign of medical management practice encompassing the development of a leadership role and the provision of progressive medical management plans in order to maximise successful return-to-work outcomes for injured workers.