Since the beginning, Paradigm has had a singular goal: improve the lives of severely injured workers as they and their families face incredible health and life challenges. Our case management teams are on the front lines working tirelessly to support injured workers with the highest levels of clinical expertise and resources available, which is critical as we navigate through the COVID-19 pandemic. 

During this time, we have implemented additional training, tools and support for our Complex Care Solutions Field Case Managers to assess injured worker risk of COVID-19, as well as established new protocols for how to best support injured workers throughout the COVID-19 situation. As part of our responsibility to the injured workers we serve, as well as our clients, colleagues, and communities, we are sharing an overview of the Paradigm best practices our case managers will use to support injured workers during this challenging time. 

Overall Injured Worker Support & Wellness

It’s vital for case managers to remain informed on the latest information and guidance provided by the federal and local governments. If a case manager is asked questions from injured workers or their families regarding COVID-19 that fall outside of treatment concerns, our case managers will utilize the CDC website as an optimal reference point.

Paradigm Case Managers will:

• Schedule a weekly call/touchpoint with the injured worker and their family.
• Listen with empathy. These times are stressful and challenging for all.
• Advise injured workers to inform their employer (if currently working) if there is any exposure risk or if they are symptomatic.

Physicians & Appointments

Paradigm case managers will work to stay informed of the status of physician and provider offices in order to provide injured workers and their families up-to-date guidelines regarding upcoming appointments and treatment options. They will remain in close contact with injured workers regarding any changes or updates to facility policies. 

Paradigm Case Managers will: 

• Routinely check with provider offices on policy of non-urgent appointments for both injured workers and case managers.
• Report to the injured worker consistently on provider office/facility policy regarding visits.
• Obtain a tentative reopen date for closed offices or facilities, inform the injured worker, and follow up on the tentative date to confirm a successful reopen. 
• Explore work-around options if a physician office will see the injured worker, but not the case manager (due to a non-essential appointment, office policy, area restrictions, etc.) For example, we are increasing our use of telephonic and video channels to minimize disruptions to care management. Our channels are consistent with the U.S. Department of Health and Human Services guidelines and utilize HIPAA compliant tools as much as possible.

Medication

Paradigm case managers will work to ensure that injured workers do not experience disruptions in their medication regimen.

Paradigm Case Managers will:

• Confirm the injured worker’s current medication regimen (duration and dates) and establish a continuity plan.
• Determine if it is necessary to follow up with a provider sooner than normal due to medication needs. Some customers are approving early renewal of prescriptions due to COVID-19.
• Determine a provider’s plan for addressing medications if they are closed or not seeing patients.
• Determine together, with an injured worker, if they have an adequate supply of necessary medications to carry through periods of canceled appointments.
• Determine if narcotics or opioids will need to be extended due to delayed treatment/appointment/surgery.

Surgery

It is inevitable that some surgical procedures may be delayed while physicians and facilities are meeting the demands of the COVID-19 situation. If a Paradigm case manager finds one of their injured workers with a delayed or rescheduled surgery, they will communicate the changes quickly and clearly so that all parties understand the altered treatment plan.

Paradigm Case Managers will:

• Determine whether an injured worker’s surgery is delayed or rescheduled.
• Proactively follow-up with providers as service begins to return to normal. Surgery may be challenging to schedule once a facility is serving injured workers again. 
• Determine what, if any, alternatives the physician is recommending for the injured worker during their surgery delay to avoid deconditioning.
• Communicate all information and plans to both the injured worker and the customer. Continue with on-going follow-up and plans for rescheduling.
• Determine if a narcotic or opioid extension has been prescribed due to the delayed surgery and report the recommendation to the injured worker and the customer.

Return-To-Work

Some employers will experience extreme changes to their business during the COVID-19 crisis, which may impact an injured worker’s return to work situation. Paradigm case managers will explore alternate options if an injured worker is affected. 

Paradigm Case Managers will:

• Confirm if an injured worker is currently released to light duty, that their light duty work will continue under the current circumstances.
• Determine if the COVID-19 situation can create new opportunities for light duty work options with their employer. 
• Explore how COVID-19 is affecting injured workers currently working full duty. 

Physical Therapy

An injured worker in physical therapy might experience a disruption in therapy services due to COVID-19. If an interruption in physical therapy occurs, Paradigm case managers will determine how their recovery may be affected, and if any alternate options are available.  

Paradigm Case Managers will:

• Consider virtual or tele-rehabilitation services as an alternative if normal services are disrupted.
• Check if a home exercise program (HEP) is available for the injured worker. If it has been provided, the Paradigm case manager will routinely monitor the weekly progress.

Diagnostics

It is inevitable that regularly scheduled diagnostics may be cancelled or postponed, due to the lack of available providers and/or facilities. 

Paradigm Case Managers will:

• Confirm if diagnostics are proceeding as scheduled.
• Obtain protocol for the next available date to reschedule any canceled or postponed diagnostics. 
• Proactively follow-up as appointments may be hard to schedule once facilities are back in service. 

Assessment of Injured Workers with High Risk Related Files

Paradigm case managers will proactively review open files to assess if injured workers meet the criteria to be considered a high-risk as related to COVID-19. If one meets any of the high-risk categories, the case manager will initiate a conversation with the injured worker and the customer to determine if essential appointment attendance is warranted versus staying home. 

 As always, our highest priority is to serve injured workers and their families to deliver the best possible outcomes. While we all adjust to our new normal during this unprecedented global health crisis, we are committed to giving our full support to injured workers to help restore their health, their spirit, and their hope for a brighter future. We welcome your follow-up questions, feedback, and suggestions by contacting complex@paradigmcorp.com. We are in this together.