Case Studies
As experts in the field of occupational healthcare for more than 25 years, WorkCare has experience in managing a variety of employee related issues. With this in mind, we offer a selection of colorful, real-life case studies that help to outline our holistic approach to healthcare and provide you with a portrayal of our client's experiences and the results of our intervention.
The Case of the Fuzzy Foot Condition
The Patient: A 38-year-old forklift driver suffering from a chronic orthopedic problem.
The Diagnosis: The treating physician (not a WorkCare physician) requested weekly doctor visits, but did not specify the frequency of leave or duration of incapacity - simply marking that section of the medical certification form “Unknown.” The provider noted that he could not state if the foot condition would affect the employee’s job because he did not know the nature of the employee’s work, essentially granting the employee a blank check for absences.
WorkCare’s Intervention: The ambiguity of the certification warranted a call from a WorkCare physician. A letter was sent to the treating physician requesting medical clarification and included a copy of the employee’s job description. The treating physician responded that ambiguous leave was not his intent. He revealed that he had only seen the patient once and was frustrated with the situation to the point of considering dropping the patient from his caseload. WorkCare’s physician convinced him otherwise and presented work restrictions and job modifications as an alternative.
The Solution: The employer had sedentary forklifts available that were hand operated – eliminating the need for the employee to use his feet. The treating physician agreed to the modification and the employee began working with new equipment.
Case of the Anxious Office Worker
The Patient: A forty-year-old female customer service representative suffering from mental illness (anxiety), resulting in intermittent work absences for more than one year.
The Diagnosis: The employee claimed that each time she made an effort to return to work, her anxiety returned. As a result, her medical leave was continually extended by her treating physician.
WorkCare’s Intervention: WorkCare’s consulting medical physician contacted the employee’s treating physician to inquire about the employee’s ability to go on modified duty instead of dealing with customers; perhaps she could focus on computer work. The treating physician was open to the idea and was sent the employee’s job description. After a review, the treating physician agreed that she was capable of going back to work and in fact, mentioned that it would be beneficial to her.
Conclusion: The employee was sent back to work with a revised job function and the treating physician was educated on the concept of modified duty. Employees with chronic issues must learn to cope with their illness, and getting them back to work can help. A combination of medication, modified duty and psychotherapy is typically the most effective treatment.
Case of the Lethargic Mechanic
The Patient: A 33-year-old tire mechanic employed by a large service company was found in a state of lethargy on several occasions after performing certain job tasks such as changing out tires. It was later determined by the worker’s treating physician that the employee suffered from diabetes and his instances of lethargy were a result of his low blood sugar levels. If ignored, low blood sugar levels can cause severe symptoms such as confusion, behavior changes, stupor and unconsciousness.
Clarification Needed: Due to the employee’s medical condition, the employer had concerns about possible workplace hazards and wanted clarification on the employee’s fitness-for-duty.
WorkCare’s Intervention: A WorkCare physician called the employee’s treating physician to clarify possible work restrictions and job accommodations required by the employee.
Conclusion: The treating physician confirmed that the employee’s condition would necessitate work accommodations, including a pre-work break and a break every four hours to chart his blood sugar levels and a snack. A WorkCare physician helped to set parameters, such as allowing the employee to work only if his blood sugar levels remained above 70 – if below 70, he would not be able to perform his job duties.
The Case of the Overly-Dutiful Husband
The Patient: Forty-two-year-old employee charged with providing care for his ill wife.
The Diagnosis: The employee turned in a request for intermittent medical leave to care for his ill wife who suffered from migraine headaches and kidney stones. The wife’s illness required frequent doctor visits and the employee was responsible for her physical care and transporting her to appointments. The physician noted that the patient would need assistance “as needed” and would require doctor visits “sometimes.” The situation essentially granted the employee carte blanche for medical leave.
WorkCare’s Intervention: The ambiguity of the terms “as needed” and “sometimes” warranted a call from a WorkCare physician to the treating physician for clarification. WorkCare’s physician contacted the treating physician to clarify the need for leave “as needed” and “sometimes” and discussed the amount of time off needed for the employee to care for his wife.
The Conclusion: The treating physician confirmed that the employee needed intermittent leave to accompany his wife to doctor visits no more than once per quarter for a half day. By clarifying the employee leave requirements, WorkCare was able to curb excessive and unnecessary days away from work.
The Case of the Safety Sensitive Sheriff
The Patient: A 33-year-old sheriff from a Los Angeles, California suburb underwent surgery for an orthopedic problem.
The Diagnosis: During his surgery, the treating physician (not affiliated with WorkCare) discovered that the sheriff suffered from an arrhythmia – a condition that causes abnormal heart rhythms and can lead to fainting. Confronted with the diagnosis, the sheriff declined treatment. No questions asked, the treating physician released the patient back into the field.
WorkCare’s Intervention: Back at work, the sheriff’s medical chart arrived on the desk of a WorkCare nurse case manager who identified the arrhythmia as a red flag. WorkCare’s assistant medical director was contacted and she found that the treating physician made a common mistake typical of doctors with little or no occupational healthcare experience: He failed to look at his patient’s life from a holistic standpoint. If he had, he would have realized that the sheriff’s job is considered “safety sensitive” and due to the nature of his work and responsibilities – including carrying a firearm - the arrhythmia could prove to be life threatening.
The Solution: At the suggestion of the assistant medical director, the sheriff was placed on modified duty until he underwent surgery for the arrhythmia.