Taking Action: The Role of the Case Manager

The benefits of early action include reduced: (1) client and family stress; (2) recovery complications; (3) long-term costs; and (4) potential for litigation.

In non-industrial cases, accident and health insurance adjustors are the initial contact. If MTBI persists and referrals are made to specialists for evaluation, an uneducated adjuster may question the MTBI and delay or refuse authorization and payment. The prudent adjuster will refer the file to case management. Hopefully, the case manager has experience with MTBI problems. Getting a supportive opinion from the physician or neuropsychologist is helpful.

In industrial injury cases, a claims adjuster, presumably educated about MTBI will refer the case to a pro-active case manager who is knowledgeable about this population. Both individuals recognize the importance of early identification, assessment, and treatment of MTBI. Questionable cases will also be ruled out. This scenario is, unfortunately, somewhat rare; however, it is slowly changing as case managers become more educated and experienced in the potential consequences of MTBI.

The case manager should be an advocate for, and an active participant in, the treatment process.

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