Forensic Case Management after Brain Injury

Case Managers Key after Brain Injury

By Patricia Jackson, C.B.I.S. and Michael Davis, C.B.I.S. – C.E.

Case management over time

Since the 1960’s, the case manager has been a key organizer of services in traditional rehabilitative settings.  Case management has evolved over the years from a simple cost containment focus to a well-coordinated, systematic, comprehensive approach to quality cost-effective care.  Case managers today are routinely and almost universally involved in organizing and coordinating rehabilitative services and resources to maximize a person’s functional recovery after an injury.   

Most recently, the case manager has been recognized as a catalyst in the field of forensic or medical-legal rehabilitation.  Therefore neurolawyers are increasingly using professional case management services to ensure that their clients receive well-coordinated, quality care and treatment during the often lengthy process of litigation. Lawyers have a duty to provide comprehensive legal services, but they typically do not have the time to oversee the medical and rehabilitative aspects of a personal injury case. The provision of case management can have a direct positive impact on addressing the myriad of needs in a serious injury case.

Case managers, attorneys and personal injury claims

As more case managers are being employed by attorneys to oversee their clients’ case, it is important to clarify the role of a case manager in this specialty field of medical-legal rehabilitation.  A case manager is capable of wearing many hats.  This article describes how case management may be involved in a personal injury claim.   

The attorney weighs the benefits of involving a case manager right from the start.  Time is typically of the essence in catastrophic injury claims.  By using professional case management services to coordinate care that will maximize the client’s physical, cognitive and emotional functioning, the attorney can focus on the litigation process. 

The many roles of case managers

Case management assumes various roles throughout the different stages of a client’s recovery from an illness or injury. 

Hospital

In the acute medical arena, the case manager serves as a discharge planner and helps move an individual from the hospital to rehabilitation, home health care or outpatient therapies.  

Insurance Company

The insurance case manager serves mostly as a cost monitor to ensure that health care dollars are expended wisely.

Rehabilitation Program

Facility-based rehabilitation case managers usually serve on a team within that facility to guide therapies toward maximum potential recovery for the patient within the confines of their facility.

Forensic case manager

None of the case managers above are typically involved in the legal aspects of a patient’s case. The forensic case manager is concerned with every aspect of the above.  At the same time, the forensic case manager assures that the legal perspective is being addressed to maximize client recovery.  The personal injury attorney who utilizes the services of an experienced case manager is in fact assuring the client’s access to quality treatment and medical care.

Case manager as liaison

The weeks and months immediately following a traumatic injury are full of day-to-day stressors.  As a result, families usually are overwhelmed with information and decisions they may not be equipped to handle.  All too often, families do not feel fully informed or supported by many of the medical professionals whose expertise has preserved the life of their loved one in trauma.

If the attorney who has been retained in a personal injury case involves a case manager immediately, the family will benefit.  By using the expertise of an experienced rehabilitation professional, the case manager can assume a guiding role in the care of their loved one.

The attorney also benefits by identifying the case manager as the primary contact person for the family.  The case manager is able to field numerous questions and run interference.  This gives the attorney valuable time to proceed with the intricacies of the litigation process.

Families in trauma have special needs.  They can appear to be demanding at times.  But they may simply need someone to listen to their concerns, their ideas or even more importantly, their fears.  So first and foremost a case manager is a liaison for not only the client, but for the family, the rehabilitation team and the attorney, as well.

Case manager as advocate

cutting red tapeOnce given the opportunity to review medical records, discuss the case with all parties involved, and determine the priorities, the case manager can oversee a treatment plan, monitor progress, advocate as necessary and create a clear pathway through the rehabilitation maze.

The forensic case manager can objectively oversee the provision of services from a more holistic and client-centered approach.  The forensic case manager works in conjunction with the clinical case manager and the insurance case manager, but does not have their internal pressures or external financial obligations.

Attorneys who assign a case manager to their personal injury cases are assured that the:

  • appropriateness and effectiveness of therapies and programming will be monitored, and
  • care will be coordinated in the best interest of their clients’ long term needs.

If long term rehabilitation is necessary, the involved case manager has the ability to explore and identify possible funding sources early on.  Through their experience, case managers are familiar with federal, state and local resource systems available to the client.  The attorney may be a novice or have limited experience in that particular arena. Understanding the systems of Medicaid, Social Security, vocational rehabilitation, workers compensation, and the public schools is complex.  Gaining access to their services is a time-consuming process.  Rather than assume that task and breaking new ground, the attorney can rely on the case manager to fulfill this area of responsibility.

Case manager as negotiator

It is important for the client and family to have a skilled negotiator throughout the course of recovery.  The case manager is capable of creatively negotiating a proposed plan of care, length of stay, rates of service and when necessary, identifying appropriate vendors.  Negotiating services to develop a continuum of quality care is crucial as well as time consuming.  Whether it is acute care, outpatient rehabilitation or in-home care, the involvement of a case manager can make a difference.

Taking the long view or seeing the big picture

Where expert life care planning is necessary, identifying service providers and ensuring the implementation of the life care plan is a long term commitment.  The attorney who utilizes the expertise of a case manager is cognizant of the fact that a client’s needs continue long after the litigation process has ended.

There is no easy road to recovery following a catastrophic injury.  Recovery from traumatic injury can be a long arduous process, not only for the injured party but for the family as well. The family’s emotional needs can frequently be overlooked unintentionally while professionals focus on rehabilitation of the client.  The case manager functions as a support system for the family and as an educator and guide through the maze of rehabilitation.  

One of the most valuable tools a case manager brings to the table is the ability to listen.  A skilled case manager listens to concerns from all parties involved, pulls the information together, develops a plan and ultimately directs the implementation of that plan.  The case manager works closely with the rehabilitation team, medical consultants and the family.  By bringing forth the clinical perspective, the case manager helps the attorney strategize throughout the litigation process.

It is the attorney’s duty and obligation to provide clients with the best possible means available to ensure successful resolution to their case.  Financial recovery is only one aspect of a case.  Personal injury attorneys should also concern themselves with the more critical aspects of a case, i.e., emotional and physical well- being.  

An experienced forensic case manager is an asset to the plaintiff attorney’s case for many reasons, some of which have been described here.  Each personal injury case presents itself with a unique situation, specific needs and a vast range of priorities.  In collaboration with the attorney, the list of priorities can be defined, responsibilities delineated and an initial plan set in motion by the case manager.

Whether acting as liaison, advocate, negotiator or educator, the role of a forensic case manager is key in litigating personal injury claims in today’s legal arena.  Ethics dictate diligence by the plaintiff counsel.  Morally speaking, this diligence would serve the client equally as well in the pursuit of quality services, thus facilitating improved quality of the life for the client.

Patricia Jackson is a Case Manager and Michael Davis is the President and Senior Case Manager with Neurological Case Management Associates, specializing in the field of neurological rehabilitation, in Charleston, WV.
 
References:

Bee, C.M.(1996) Damages/Running The Gauntlet From Soft Tissue to Head Injuries/From Chiropractor to Neurosurgeon. A non-published presentation.

Burke, W.H. (1995). The Rehabilitation Expert: Analysis and Management of Brain Injury and Other Neurologic Disorders. In Burke, W.H. (Ed.) The Handbook of Forensic Rehabilitation, Houston, TX: HDI Publishers.

Burke, W.H. (1995). The Forensic Analysis of Costs in Head Injury Claims. A non-published presentation. Insurance Defense network, Las Vegas, NV.

Evans, R. & Watke, M. (1995). Catastrophic Neurologic Injury: Improving Outcomes Through Case Management: The Case Manger, July/August / Sept. 83-88.

Fawber,H.& Zorger Orstein B. (1995). Case Management in Forensic Rehabilitation. In Burke, W.H. (Ed.) The Handbook Of Forensic Rehabilitation. Houston, TX: HDI Publishers.

Howe, R. (Ed.) Inside Case Management. 1 (11), 1 (12), 2 (6). 1995.

Mullahy, C. (1995). The Case Manager Is the Catalytic Collaborator in Managed Care. The Journal of Care Management. 1(1), June 7-9.

For more information from Lash and Associates Publishing/Training, Inc., see:

 

Brain Injury It is a Journey

By Flora Hammond, M.D. and Tami Guerrier

This brain injury book for families explains consequences of traumatic brain injury and gives strategies for coping with changes in the survivor’s physical abilities, memory, attention, thinking and emotions.

 

Head Cases

By Michael Paul Mason

Book on brain injury, blast injury and PTSD features chapters on adults, children and veterans discussing changes in memory, self-image, violence, suicide, family stress and war in Iraq.

 

Lash Blog Permission

4 responses to “Forensic Case Management after Brain Injury”

  1. Hi to every one, the contents present at this website arre really awesome for people knowledge, well, keep up the nice work fellows.

  2. Lynchburg Realtors says:

    Hello to every body, it’s my first visit of this weblog; this website
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  3. You really make it appear so easy with your presentation but I find this topic to be actually something that I feel I might never understand.

    It seems too complex and very extensive for me.

    I’m having a look ahead to your subsequent put up, I
    will attempt to get the hang of it!

  4. Doretha says:

    Our trustworthy legal services have always attracted the interest of numerous clients.
    Have copies of your tax returns to determine how much money may have been lost because of the injury.
    If I was the client, I would surely protest against it.

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