Fulfill the employer’s obligation for appropriate and effective
medical intervention for an occupational injury
Respond to the critical need of earliest return to work
Responsive to curtailing unnecessary costs of ineffective,
prolonged or inappropriate medical care
Ensure that apportionment issues are addressed appropriately
and clearly defined in the treatment process
For the Injured Worker:
Actively assists and guides the injured worker in the complex
process of obtaining optimal medical care that restores his/her
previous level of health
Assists in the prevention of untoward medical outcomes by
timeliness of intervention and education to the injured worker
Supports the injured worker by a “high touch” service with
face-to-face contact and accompanying injured worker to
physician appointments to ensure his/her concerns are addressed
Promotes and reinforces the injured worker’s accountability to
participate in his/her medical plan of recovery
For the Claims Examiner:
Through knowledge and experience of medical providers,
ensures that all providers develop and implement the agreed
upon medical plan of recovery
Provides excellence in care coordination and keeps the claims
examiner informed of all developments and progress via timely and
consistent verbal and written communications
Interfaces collegially with the physician to monitor judicious
utilization of medical services
Provides medical interpretation and medical technical support to
the claims examiner for necessary decision making
For the Physician:
Provides collegial support for developing and implementing an
appropriate plan of recovery
Creates vital linkages among a team of diverse interests to work
towards a common goal of medical recovery and early return to work
Provides key clinical updates, employer accommodations, and
legislative information to the physician for the plan of recovery
Creates a positive experience to the physician and his/her office
staff for the acceptance of the worker’s compensation case
