Mercer Marsh Benefits

Case Management

Best practice support for sick and injured employees to recover and return to work 

Four of the top 10 people risks reported by New Zealand HR and risk managers, fall in the category of health and safety (work and non-work related), which can ultimately manifest as employee sickness or injury absence. The cost to a business of lost time due to employee illness and injury is significant, and is often overlooked in strategic and resource planning as a driver of business success.

What does proactive case management look like?

Let’s look at a real example of recent return to work case our Wellnz case management team looked after in New Zealand. The patient was a middle-aged male working in a storage yard for a large manufacturing company. Whilst driving a forklift, he accidently hit a pothole in the storage yard, causing our patient to incur sciatica type symptoms. As part of our proactive case management approach, our team contacted the patient as soon as possible to discuss their symptoms, how the event happened and what the best return to work strategy would look like based on their symptoms and personal situation.  Proactive case management of sick and injured individuals centres on preparing for future recovery, return to work and is always forward facing.

The Assessment phase - Proactive case management starts with a thorough assessment conducted by a professional with expertise in supporting recovery and return to work. Open, honest and empathetic communication is key to developing rapport and understanding the true barriers to a successful return to work. The initial assessment will gather information about injury or illness but also about the person as a whole, their daily living activities, and their work activities.  In the case of our forklift injury, we prioritised them to attend six physiotherapy sessions to try and alleviate the pain and build back muscle and strength in the affected lower back areas. However, after six sessions, the claimant was still not able to put their own socks on without going through pain. Based on these results, our case manager quickly intervened as they could see the patient was not improving.

The Skilled Intervention phase - Central to case management services is the expertise of the case manager / injury management consultant in coordinating the right services at the right time.  This requires reasoning and regular collaboration with the employee to achieve a shared commitment to the strategies and the goals for recovery. Planning, facilitation and coordination of services and strategies are developed, aiming to address the barriers to recovery identified in the assessment phase.  This phase will also include collaboration with the employer to aid the re-introduction of the employee into the workplace. In the case of our patient, who was still suffering from sciatica pain after his originally arranged treatment plan, we referred him to a specialist in this area. After a MRI scan, the patient was diagnosed with a pro-lapsed disc that required surgery and would require a two to three month recovery period with follow-up physiotherapy treatment.

The Evaluation phase - Employees with illness or injury benefit from ongoing support from their case manager and their employer. Recovery and return to work journeys are rarely linear and it is important the plan is agile and able to pivot to address new barriers as they arise.  Objective evaluation against the agreed goals will ensure that the strategies employed are effective and that the case is moving forward, remains proactive and ultimately achieves the recovery outcome best for the employee and the workplace. In our sciatica case example, their operation was a complete success and they were back at work on light duties approximately three months after the surgery. The employer was kept in contact with updates and recovery timeframes throughout the entire process, and was able to work around the temporary loss of the employee by contracting a skilled temporary worker to work in the yard whilst our patient was recovering from their surgery. It is all about getting the right treatment, transparency of communication, building realistic recovery timelines and showing empathy.

Poorly handled injury management not only negatively impacts the absent employee and the success of their return, it can also have a flow-on effect to other business risks identified in the Five Pillars of People Risk report. For example, an extended unmanaged absence can negatively impact Workforce Exhaustion (risk ranking #3 for HR) and in the worst case scenario, this can have a knock-on effect on Talent attraction, retention and engagement (risk ranking #2).

To make sure you are protecting your people and your business through employee sickness or injury absence, professional assessment, intervention and evaluation is key. Our team of experts and allied health professionals are here to help. Contact your broker at Mercer Marsh Benefits or contact us here to learn more.

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The Five Pillars of People Risk Report - New Zealand

This webpage is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. The information contained herein is based on sources we believe reliable, but we make no representation or warranty as to its accuracy.  Marsh shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein.

Any statements concerning actuarial, tax, accounting, or legal matters are based solely on our experience as insurance brokers and risk consultants and are not to be relied upon as actuarial, accounting, tax, or legal advice, for which you should consult your own professional advisors