Selected Case Summaries
Case Summary #1 — Long Term Disability, Return-to-Work
Background:
- D. B. was a 38-year-old heavy line engine mechanic with a new
car dealership.
- Diagnosis: Failed back surgery syndrome. His injury
was from an at-home fall.
- High school educated with formal auto-mechanic training, and he
expressed interest in returning to work.
- The attending physician was reluctant to release D. B. despite
a gradual improving trend.
- Referral for vocational case management was 23 months post injury.
"Clients find him warm, caring, understanding, intelligent, involved
and dedicated to their rehabilitation needs." — t.f.
Approach:
Consultant developed a close working relationship with the car dealership
employer and arranged to perform two on-site job analyses with photography.
Consultant conducted both a job analysis of D. B.’s position at injury,
and an analysis of an alternate position, Service Writer. The purpose
of the analyses was to educate his treatment team, uncover potential
accommodations, and identify alternate employment.
Service Provided:
- Two narrative, on-site job analyses with photography.
- Exploration and coordination of job accommodation, in order to
provide weight-load relief to D. B., at his option.
- In the course of analyzing the heavy line mechanic position, consultant
collaborated with the first-line supervisor and coordinated the availability
of jigs and lifts, for D. B.’s use.
- Then, consultant arranged a rehabilitation meeting with both the
attending physician and D. B.
Outcome:
On-site job analyses raised the employer’s awareness of D. B.’s value
as an employee and that job accommodation was simple and cost-effective.
The physician was provided written and visual documentation of essential
functions and physical demands of D. B.’s position, with weight-relief
strategies. Upon review, the physician released D. B. to work and
D. B. returned to his position the following day. Case closed rehabilitated.
Case Summary #2 — Out-of-State, Long Term Disability
Background:
- T. U. was a 37-year-old Heavy Utility Electrical Lineman, in Florida.
- Diagnosis: Severe ankle fracture, ICD9 824.
- Presented with long-term specialized utility craft skills and was
totally disabled from the required pole climbing of his trade.
- He had high school education and expressed interest in his avocations
of outdoor conservation and wildlife.
- Case referred for vocational services 8 months post injury.
Approach:
After thoroughly exploring all possible return-to-work options with
T. U.’s employer at injury, T. U. and consultant developed a close
working relationship toward suitable, career job placement. Based
on his transferable skills and learned employer approach strategies,
and following a systematic weekly job search plan, T. U. obtained
full and suitable re-employment.
Services Performed:
- All interventions were telephonic and by correspondence.
- Consultant provided full placement services including: Labor market
survey, functional resume’ development, networking skills training,
reference development, employer approach strategies, and job interview
skills training, job development, employer introductions, and post-placement
follow-up.
- Before each interview, T. U. and consultant carefully practiced
answering typical and difficult interview questions.
Outcome:
T. U. obtained career employment with the State of Florida as a Park
Ranger within 6 months of initiation of vocational rehabilitation
services. His base income with the State was $ 2,200 monthly, which
exceeded the LTD wage replacement amount of $ 2,158. New employment
resulted in a total wage-benefit offset, and the case closed successfully
rehabilitated.
Case Summary #3 — California Workers’ Compensation
Background:
- B. K. was a 41-year-old rehabilitation nurse, injured in his position
at a California hospital, who relocated to Texas.
- Diagnosis: Status post IDET procedure, chronic pain syndrome—limited
to sedentary work.
- Expressed interest in staying in the nursing field.
- Case referred for RU-102 plan development, 6 years post injury.
Approach:
In support of B. K.’s goal of nursing at the sedentary exertional
level, the consultant collaborated with the medical team, attorneys,
the QRC, and a correspondence school. The consultant helped B. K. identify
and use his acquired transferable skills toward the certified case
manager (CCM) credential.
Services Performed:
- Consultant worked closely with QRC Monitor to develop and submit
an on-time and on-budget RU-102 plan.
- Rehabilitation process involved the consultant meeting with the
claimant to explore fully the field of nurse case management and
to discuss employer approaches and transition strategies. Labor market
research confirmed the viability of the re-employment goal.
- A correspondence school was identified and researched for accreditation.
- As B. K. completed certification-training coursework, consulted
conducted job development, job seeking skills trainings, functional
resume’ development and facilitated employer introductions.
Outcome:
B. K. completed correspondence coursework within plan timeframes and
cost limits. He attended an interview arranged by the consultant,
and was hired as a home health service case manager. Case closed
rehabilitated, within vocational rehabilitation plan parameters.
Case Summary #4 — Texas Workers’ Compensation
Background:
- E.V. was a 33-year-old primarily Spanish-speaking female with
previous experience as a housekeeper in the United States and as
a nurse in Mexico.
- Diagnosis: Status post back surgery, chronic pain syndrome, and
depression. Whole body impairment of 15%.
- She expressed interest in using her acquired skills toward light
nurse assisting and personal attending work, with a career goal of
medication aide.
- Case referred for vocational services 19 months post injury.
Approach:
Consultant utilized a full team approach, collaborating with the physical
therapist, the treating doctor and treating psychiatrist, the claimant’s
attorney and the former Texas Rehabilitation Commission (State rehabilitation)
- to facilitate suitable re-employment for E. V.
Services Performed:
- Initial vocational evaluation
- Meetings with medical providers to help ascertain MMI work capacities
and work tolerance
- Acquired skills analysis, labor market research, collaboration
with State rehab toward sponsorship in a short-term certified nurse
aide training program
- Resume’ development, job-seeking skills training, provision of
suitable job leads, and employer introductions.
Outcome:
After a 4-month certification program, E.V. obtained a new position
as a 3rd-shift nurse aide in a downtown nursing home facility. Based
on the rehabilitation team’s recommendation, she continued in ESL
classes to build her English-language skills and to prepare for GED
High School equivalency. The consultant’s vocational rehabilitation
approach facilitated E.V. overcoming severe physical and mental disabilities
as well as language barriers. E.V. was able to re-enter the workforce
even after a long medical employment gap.
Case Summary #5- Texas Workers’ Compensation
Background:
- O.V. was a 41-year-old English and Spanish-speaking female with
19 years experience as a hotel waitress.
- Diagnosis: Status-post right knee arthroscopy and minescectomy.
Whole body impairment of 17%.
- Case was referred for vocational services during the Impairment
Income Benefit phase, 18 months post injury.
Approach:
Consultant worked closely with O.V. and her attorney to establish
rapport and develop a suitable re-employment plan. Consulted re-focused
O.V. on her acquired skills to plan for new employment with a sit-stand
option. The plan also involved an on-site job analysis to set measurable
rehabilitation goals for O.V.’s treatment team.
Services Performed:
- Initial vocational evaluation
- On-site job analysis, acquired skills analysis, labor market research,
job-seeking skills training in regular meetings with O.V.
- Provision of suitable job leads, employer introductions, and post-placement
follow-up.
Outcome:
Ultimately, O.V. successfully interviewed with another restaurant
and obtained a new full-time cashier position, which allowed a sit-stand
option throughout the workday. Placement was made within the one-year
Impairment Income Benefit Period resulting in no (0) Supplemental
Benefit exposure. The vocational rehabilitation approach focused
on a supportive placement partnership with O.V., assisting her with
the confidence and skills needed to approach employers effectively.
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