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Return to Work

Insurance Carrier/Third-Party Administrators (TPAs)

Insurance Carriers and Third-Party Administrators (TPAs) have a role in helping injured workers return to work. Not only is it beneficial to the injured worker, but it also helps the bottom line for employers.

Insurers and TPAs can:

Nurse Case Management Services

Most insurance carriers and TPAs employ nurse case managers. Here are some ways they can help an injured worker return to work.

Nurse Case Managers should follow these best practices.

Claims Adjusters

Claims adjusters play a crucial role in helping injured workers return to work. Adjusters can ensure that injured workers are receiving proper medical care by promptly authorizing treatment and prescriptions that fall under the Medical Treatment Guidelines and Drug Formulary. Denying or delaying recommended treatment and medication will also delay an injured worker’s recovery and ability to return to work.

Claims adjusters must always check the Board file or medical portal to see if the injured worker has a legal representative. If so, the claims adjuster should only communicate with injured workers through their attorney or licensed representative.