The NHADA Workers’ Compensation Trust (WCT) is composed of an amazing team with a combined experience of over 148 years in the workers’ compensation industry! Our professional, experienced staff has made our number one job to train our members to do the right thing when it comes to managing workplace injuries. Because of this goal, our members “do the right thing.” When we train new members on the workers’ comp process, one of the first topics to cover is: call the nurse. Unfortunately, once a member knows what to do, the call to the nurse part of the process is often the thing they get away from … thinking, “We know what to do, so why do we call?” The call to the nurse is about more than just assistance with referrals and a heads up on a claim, and it’s those reasons we want members to continue with the call to the nurse. WHY CALL? • The call to the nurse is similar to triage with a medical provider. We will cover the basics and gather some important information that will be beneficial to us when we set up and manage the claim: ⊲ Injured worker’s name ⊲ Employer name ⊲ Position at the employer ⊲ Date of injury ⊲ Description of the injury ⊲ Has treatment occurred yet ⊲ Referral for care ⊲ Work status • As a member of the NHADA — WCT, you are part of the mandatory managed care program. This is a huge benefit to our members and helps us in so many ways, from management of a claim to cost containment. The call to the nurse assists the member and injured worker in navigating the managed care process. ⊲ We use the Windham Managed Care Network of Providers. As part of the managed care program, injured workers are required to treat for their injury within the network. There are a few unique situations where this is not the case; these would be discussed during the call if applicable. The network is built of specialists and gives us the ability to refer the injured worker for specialized care right out of the gate and without the need for a referral from another provider first. Calling the nurse ensures that the best choice for medical care in a specific specialty occurs. • A common misconception by those that have been injured or those assisting someone that has been injured is “I have to go to the emergency room” or “Let’s get you to the emergency room.” Emergency rooms are for “life-threatening emergencies.” Most occupational injuries that occur do not fit these criteria and, in fact, can be better managed at an occupational medicine clinic, urgent care or a specialist’s office. When minor/acute injuries present in an emergency room, they are not the first to be seen; patients that are more critical jump to the front of the line. An injured worker may be at the emergency room for hours before being cared for, and if another employee went along, then you are now missing two people from the workplace. Non-emergency visits to an emergency room also clog up the system; you do not want to be the reason there is no bed available for someone that needs it more than you. The other huge factor is cost. A simple laceration treated in the emergency room may bill out at over $3,000.00 and, in some cases, over $5,000.00. This same injury managed at an occupational medicine clinic may not even bill out at $500. The call to the nurse will help you make the decision as to where the most appropriate place for medical treatment should occur. • Employers’ First Reports of Injury need to be filed within five days of the notice of the injury to avoid a fine from the NH Department of Labor. The call to the nurse starts a paper trail. We keep a record of the calls and take notes. When the First Report of Injury arrives INJURY AT WORK… Take a Minute and Call the Nurse BY MARTA SILAKKA RN, BSN, CCM, COHN-S NURSE CASE MANAGER NHADA — WCT 12
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