We all know by now that Workcover case managers come in many different shapes, sizes and – especially- characters. They can be young and extremely inexperienced, lacking communication and basic people skills; , many are in their forties, divorced and utterly miserable sourpusses, some are male, most are female, some have years of experience and have undoubtedly gone through a “work hardening programme”, some are fresh off the street and so inexperienced and non-educated in the law and in medical terminology it’s frightening, many are, yes, lazy and incompetent, a very few are decent. They are pro-active and re-active case managers. Most don’t give a hoot about the plight of the injured workers, and -perhaps most importantly -and the most frightening part, as most of you know, is that it is our medically untrained, totally uneducated workcover
Case Managers clerks are allowed to make that life or death decision for us, by over-ruling. How cool is that! They actually get to play God!
“…Advice from the most senior Medical Staff in the country can be overruled by Case Managers, and often Orthopaedic or Neurosurgery is delayed or never done on the whim of a Case Manager “who decides that it is not necessary.”The Case Managers, employed by the Insurer, and the Return to Work Coordinators have the right to withhold treatment recommended by specialists, or to over-rule evidence based treatment based on thorough medical knowledge…”
[Professional Health Partners P/L stated in their submission re the NSW workcover overhaul the classic statement of facts]
The role of the all-mighty, non-medically trained workcover case manager
You don’t believe us? Well check out the statement made on workcover SA’s website for example entitled:
The case manager is responsible for deciding if the claim can be accepted for compensation under the legislation. The case manager will work with the injured worker (since when?), employer, health provider(s) and rehabilitation provider to coordinate the return to work process.
Their role includes – and please read and re-read between the lines for it is all there:
- case managing the claim from an administrative, cost and legislative perspective
- developing and approving programs and plans in consultation with all parties
- ensuring information provided to injured workers about their rights and responsibilities is made available in a language or format suitable for the worker
- assessing the requirement for workplace rehabilitation intervention through consultation with the worker, employer and treating doctor
- determining the rehabilitation and return to work objective and goal(s) for the worker if required
- selecting a rehabilitation service provider to provide user services
- assessing the requirement for medical expert and other support services in consultation with the workplace rehabilitation consultant and treating medical practitioner
- reviewing programs and/or plans to ensure they are progressing towards the identified objective and goal.
What does this say to you? Yep: the workcover case manager has TOTAL control over you, the injured worker – even though s/he has never ever seen you, has no medical or allied health knowledge, is not a doctor, not a “rehabber”, and is just a “clerk” really! How bloody frightening is this?
Add to that the fact that all insurers we know of usually have an incentive or bonus program (for case managers) tied to the reducing the number of workcover claims or reducing the benefits paid to legitimate injured workers, even the most seriously injureds amongst us… and yes, it is a recipe for disaster. And so it is that many case managers primary goal is to focus solely on finding an excuse or basis for denial or delay of legit benefits to the injured worker (i.e. surgery, weekly pay, home help, physio, hydro, pain management, counseling etc etc).
You can read heaps more about those bizarre but powerful creatures here :all articles related to case managers
[Original Source kindly shared by co-author Trinny: http://www.workcover.com/%28X%281%29S%28n3txbcnw43hemwqgb03ouual%29%29/health-provider/return-to-work/the-roles-of-return-to-work-professionals/case-managers?AspxAutoDetectCookieSupport=1]
[Post by dedicated by workcovervictim and manually transcribed on behalf of WCV]
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