WorkCare’s Clinical Accommodations & Leave Management program has an acronym – CALM – that aptly describes this innovative delivery model featuring four primary services:

 

  • Accommodation
  • Clinical Exams
  • Physician Consultations
  • Leave & Disability

Solutions

The Clinical Accommodation & Leave Management (CALM) delivery model uses an early detection system and features a combination of:

Accommodation

A WorkCare occupational physician acts as a liaison with treating providers to help them navigate the accommodation process. Related tasks include:

  1. Educating treating providers about essential job functions.
  2. Obtaining clarification on return-to-work restrictions and limitations.
  3. Clarifying specific functional limitations..
  4. Negotiating reasonable accommodation options for safe return to work.
  5. Recommending appropriate equipment and/or workplace modifications.
  6. Determining whether there is a need for additional clinical review.

Physician Consultations

Physicians review medical documentation to support clinical decision-making for leave and disability in accordance with the client’s short-term disability and leave-of-absence plans. Qualified physicians:

  1. Obtain medical documentation clarifications.
  2. Consult with case managers to help clarify next steps.
  3. Determine appropriateness/need for Clinical Exams.
  4. Provide clinical education for major diagnostic areas.

Leave & Disability

A WorkCare physician serves as a liaison with the treating provider to help the employer/client navigate the Leave & Disability process. Activities include:

  1. Review of essential job functions and the treatment plan.
  2. Clarification of restrictions, limitations and medical documentation.
  3. Determining the need for additional clinical review.
  4. Authenticating medical documentation.
  5. Conducting quality assurance on all aspects of the process.

Clinical Exams

We collaborate with best-in-class vendors for physical and mental health clinical exams in the following categories:

Fit for Duty – for complex cases that require  assessment of an employee’s ability to work safely.

Independent Medical Evaluations – physical or mental health evaluations  performed by a physician in the same specialty as the treating provider.

Peer-to-Peer Matched Specialty Review – comprehensive medical record review and discussion with the employee’s treating provider conducted by an impartial physician in the same specialty.

Functional Capacity Evaluation – objectively measures functional abilities of an employee across a broad range of simulated job tasks.

We also provide medical translation services.

We apply predictive analytics and evaluation techniques to flag cases at risk for prolonged work absence, disability and the need for early intervention vocational services.

Value

  • Improving access to medical and return-to-work information to promote case resolution
  • Keeping employees working on full, transitional or modified duty
  • Avoiding “medicalization” of non-medical issues
  • Ensuring timely referrals to nurse case managers, vocational counselors and medical providers, as warranted
  • Accurately tracking results based on risk indicators, case specifics and services provided
  • Reducing rates of absence and long-term disability to promote retention and productivity
  • Supporting enterprise-wide, scalable injury prevention and management systems