Workers' Comp

Rising from the Fall

2 MIN READ

Catastrophic Case Management

Meet Carolyn Lau, MBA, RN, CCM

Carolyn Lau is a seasoned catastrophic case manager who has successfully managed numerous complex cases over the past 30 years. This case exemplifies not only her nursing expertise, but her communication skills in building rapport with all parties to benefit her claimant.
 

The Case

A 60-year-old, recently widowed laborer experienced a traumatic brain injury (TBI) after falling off a truck resulting in loss of consciousness, intracranial injury and bleeding. The man was rushed to an ICU where he received immediate care. Though the injured worker healed quickly from his physical injuries, he continued to experience psychosocial issues including anxiety, depression, agitation, speech and compulsive disorders. His primary goal was to return home, and through collaboration with the case manager, treatment team, his daughter and the adjuster, a discharge plan was developed to promote independent living.
 

Case Management Impact

To meet this goal, Lau quickly utilized her TBI knowledge to address the claimant’s significant medical issues. This included coordinating the man’s discharge needs with the rehab facility to ensure a timely referral for inpatient rehabilitation at a network facility specializing in treating brain injuries. Following rehab, the injured employee was discharged home with companion services and nursing care for medication management and blood pressure monitoring. Though he was initially resistant, Lau worked tirelessly with the injured employee to encourage compliance with the plan and ensured he received quality outpatient rehab services directed by a specialized neurologist. The claimant continued with speech therapy to work on cognitive issues and received treatment for his anxiety which helped improve compliance with the treatment and return-to-work plan. Lau then worked with home care providers and the man’s daughter to manage behavioral issues and stay on course.
 

Outcome

Lau continued to work closely with outpatient providers and review work capacity and job demands at every appointment. As a result, the claimant successfully returned to full-duty work three days a week, just five months after incurring a life-threatening TBI. He has now progressed to four days a week and is being evaluated for driving capability. As a result, Lau not only helped return the injured employee to function, but her efforts resulted in total cost savings at $222,295 for an ROI of more than 9:1.

 

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