ConciergeCLAIM Nurse: Helping Injured Employees Return to Work

When an employee gets injured at work, navigating the claim process can be daunting. They can get discouraged and disengage from the workforce, which can have a negative impact on both the morale of the individual employee and the employer. A one-on-one connection between nurse and patient, pioneered by the Travelers ConciergeCLAIM^® Nurse program, is helping injured workers find access to quality healthcare, stay engaged in the workforce and return to work as soon as medically appropriate.

By placing nurse case managers in local healthcare clinics across the country, the Travelers ConciergeCLAIM Nurse program has reduced days out of work by 35 percent.¹ The Travelers nurse case managers help injured employees understand the claim process and what to expect from medical treatment as they recover from their injury. They can also identify and address potential roadblocks to injured employees following their recommended treatment plans, such as language barriers or a lack of transportation to medical appointments.

“That face-to-face interaction helps build a relationship with the injured employee,” says Sarah Grace, a registered nurse and ConciergeCLAIM Nurse clinic supervisor. “Education is a huge part of nursing. We can help injured employees understand the importance of following their doctor’s orders, including going to physical therapy and getting their prescriptions filled.”

The Path Back to Work

The longer injured employees stay out of the workplace, the harder it can be for them to return. To help keep them engaged, the nurse case managers can connect injured employees with healthcare providers who understand the workers compensation process and the importance of helping employees return to work as soon as medically appropriate.

In cases where modified or light duty work might be possible during a recovery period, ConciergeCLAIM nurses can help employers brainstorm modified job duties that could help employees return to work with limitations, such as lifting restrictions for a lumbar injury. They can also establish protocols for how long such work restrictions might be necessary.

Lost time from work can create business interruptions for employers, especially if key employees are injured. Modified duty arrangements can allow for business continuity. As an example, Grace, the ConciergeCLAIM Nurse manager, recalls when a critical printing press operator was injured. He was the only employee who knew how to operate the press, which presented a challenge for the business during his recovery. The printing press operator returned in a modified duty program in which he supervised other employees until he could return to full duty.

Streamlining the Process

The ConciergeCLAIM Nurse program can help employers know what to expect after an employee is injured, including understanding the nature of the injury and the anticipated recovery timeline. The program also streamlines the claims process and facilitates communications between employee and employer during recovery.

The program can reduce the time required to file claims, as nurses can report the losses on the employer’s behalf and keep them informed of developments. The nurses can also help expedite access to care by getting approvals necessary for medical treatment. They can notify employees promptly about the initial injury and provide employers with quick updates on employees’ recovery status.

For injured employees, the greatest benefit may be taking the time with them to explain their injury and what to expect with their medical treatment plan developed by the clinic’s physician.

“The biggest thing is having that person there with them to answer questions,” says Grace, who has heard feedback from patients that they needed that extra time to walk through their treatment plans. “We can explain the risks of going back to work too soon or doing nothing. It’s allowed us to connect on a different level than standard telephonic case management.”

In addition to reduced days out of work, the program has also reduced attorney representation by 86 percent and reduced days to closure by 39 percent. For more information, please contact your Travelers representative.

Sources:
¹ Based on a comparison of Travelers ConciergeCLAIM Nurse claims to non-ConciergeCLAIM Nurse claims for accident years 2013-2016.