6 Things to Address When a Field Nurse Case Manager Attends the Doctor Appointment With Injured Worker

When nurse case managers attend a physician appointment with a claimant there are several items which must be addressed each and every time. Most physicians who handle a heavy workers’ compensation case load, will be familiar with our needs and address these without being asked. Other physicians may not be so familiar and feel that the nurse “always needs something and is never satisfied.” By understanding these needs, the staff is better prepared to assist us.

At EVERY Visit: Do these six things.

1. Work Note– A work status form of some kind is needed after each visit. It does not matter if the recommended work duties have changed or not. The best work note provides written recommendations regarding sitting, standing, lifting, pushing, pulling and makes notes for any special instructions such as wearing a splint or brace. Physicians should not consider the job when determining whether the patient can work. They should consider their restrictions solely on medical issues. It is the employer’s job to determine if they can accommodate the restrictions.

2. Estimated length of disability– At the initial visit we need some kind of idea as to how long treatment is expected to last. We understand this may change upon each visit, but a general idea is needed. At each appointment this length of disability should be readdressed. Are the goals being met? No, then why not? What changes need to be made?

3. Treatment plan– What is the treatment plan and how long is it expected to last. If you know what the next step will be, be sure to document this as well. i.e. “We will try an ESI at L5-S1 and if this does not resolve her complaints we may consider a facet injection.”

4. MMI– Is the claimant at MMI? If not, let us know when it is expected (if known). If yes, then provide us with the rating at the appointment if able.

5. Copies– As case managers we will request copies of prescriptions for medications, therapy, return appointment date if applicable.

6. Office Dictation– We request fast turnaround on dictation because it allows us to more quickly obtain authorization for tests or procedures. It also helps us to close our file for those claimants who have reached the end of their healing period.

Victoria Powell is the President of VP Medical Consulting, LLC located in Central Arkansas. VP Medical Consulting is a nurse consulting firm providing services to employers, insurance companies, attorneys and the general public. Services include case management, life care planning, legal nurse consulting, ergonomics and patient advocacy. Ms. Powell holds specialty certifications in a variety of nursing specialties. She can be reached through the web at http://www.vp-medical.com by phone at 501-778-3378.