Return To Work
WSI has teamed up with six of the larger medical facilities in
North Dakota to have registered nurses on site to assist injured
workers seeking medical attention at their facilities. RTW case
managers will open case management services when their initial evaluation indicates:
- A wage-loss claim has occurred (time loss from work for five or more consecutive calendar days)
- Work restrictions prevent the injured worker from returning to the pre-injury position
- Claims adjuster requests assistance
- Extended medical treatment is anticipated
The RTW case managers assist in coordinating care and
evaluate proposed medical treatment for appropriateness
and medical necessity. They also assist with transitional
work and work restrictions, act as a liaison between the
injured worker, employer, medical provider and WSI claims
adjuster, and provide recommendations for care. They do
not make decisions on compensability of claims.
The RTW case manager will continue to follow the care until:
- The injured worker has returned to work in their pre-injury position
or a modified position (the injured worker’s pre-injury job that is
modified to accommodate restrictions imposed by the physician) and
further impact by the case manager is not expected
- Employer will not be returning injured worker to work
- Employer or adjuster do not feel RTW case manager is necessary (Some employers have detailed RTW programs)
- Adjuster feels comfortable following the RTW process
For injured workers treating in facilities who do not
have an On-Site RTW case manager, the claims adjuster,
employer or medical provider can request assistance from
WSI medical case managers.
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