What is the function of case management in Workers Compensation?

• A. To follow individuals receiving care under WC to ensure timely return to work.
• B. To approve every medical procedure without review.
• C. To manage payroll and billing unrelated to care.
• D. To deny claims to reduce costs.

Answer: (A)

Case management in Workers Compensation centers on coordinating medical care and the return-to-work plan. A case manager works with the injured employee, treating providers, the insurer, and the employer to develop and monitor a treatment plan that supports healing while identifying safe, feasible work activities or accommodations. They help schedule appointments, verify that care aligns with medical guidelines, and remove barriers—like access to services or transportation—that could delay recovery. The goal is a timely, safe return to work with appropriate medical care, not to approve every procedure automatically, handle payroll, or deny claims to cut costs. Those administrative tasks or forceful denials are outside the primary role of case management.