Honorees represent the best of those who make a profound impact on the lives of employees with injuries and disabilities
SAN DIEGO, Oct. 14, 2024 /PRNewswire/ — Four case managers are being celebrated for their exemplary work in helping restore the livelihoods of employees injured on the job or in need of accommodations due to disability.
In conjunction with National Case Management Week (Oct. 13-19), Enlyte has announced the winners of the 9th annual Heart of Case Management Awards, a prestigious honor recognizing four individuals nominated by their managers and selected from a field of more than 2,000 case managers across the country. The national program recognizes Enlyte case managers who have made the greatest impact on injured and disabled employees they serve and go above their traditional job responsibilities to help improve the lives of thousands each year.
“Every day, case managers are charged with helping to keep America’s workforce humming along,” said Helen Froehlich, Senior Vice President, Utilization Management. “It’s not an easy task, considering the severity of injury or illness may not only be mobility limiting, but life-threatening. These professionals not only play a critical role in helping injured and disabled employees get back to work, they also provide services designed to restore lives.”
This was the case for this year’s Heart of Case Management Awards winners, who overcame overwhelming odds to help injured employees meet their recovery goals. This includes a case manager who helped a pilot who sustained critical burn injuries return to the cockpit. Another used her critical thinking skills to accommodate an employee with a chronic mental disorder, allowing him to resume employment at his “dream job.” Two others ensured an employee who accidentally amputated her fingers and a non-compliant injured employee received the education, motivation and resources they needed to reach their highest levels of functioning.
Nominees are judged on a multitude of criteria including expertise, excellence, adaptability, trust, influential communication, critical thinking and outcomes. The following are synopses of the award-winning entries. To hear the winners talk about their cases in their own words, check out these videos.
Catastrophic Case Management
Donna Chestovich, RN, BSN, CCM
A pilot from an air patient transport company was returning from an assignment when he ran into fog and equipment failure. Forced to make a crash landing near the runway, his plane became engulfed in flames following impact. The pilot crawled out of the cockpit but not without sustaining 55% total body surface third-degree burns from head to torso as well as a left forearm fracture. Rushed to a level 1 trauma center, physicians gave the pilot a 5% chance of survival. After numerous surgeries, skin graphs and laser surgeries, the man defied the odds and survived. With a long recovery ahead of him, he was assigned to Enlyte case manager Donna Chestovich, who quickly gained the pilot’s trust and became dedicated to helping him do what was unthinkable weeks earlier —return to work. Donna quickly began coordinating care to help him transition home and receive outpatient rehab services to reach his goal. She collaborated closely with the adjuster and used her critical thinking skills and local connections to help ensure the patient received the best physical and occupational therapy services available and connected him with a psychologist to manage PTSD issues from the crash. The injured employee eventually returned to modified duty and was back flying soon after.
Field Case Management
Sarah Gifford, CCM, CRC, CEAS
A 42-year-old female ice carver was cutting a large ice block with a bandsaw when her hand slipped, resulting in accidental amputation of three fingers on her left hand. The woman’s coworkers reacted quickly, summoning emergency care and placing her severed fingers on ice in hopes for reattachment. The injured employee was taken by ambulance to a level 1 trauma center to stop the bleeding, prevent infection and attempt to reattach her digits. Field case manager Sarah Gifford met the injured employee at her ICU bedside soon after surgery. The woman was a single mom with a young son at home, and aside from her physical health, the employee also expressed concerns about caring for him and maintaining a viable income to support him. Gifford quickly assured the injured employee that her job as a case manager was to help ensure all aspects of her life would be addressed in her recovery. To promote circulation in her newly attached fingers, the employee received a non-traditional, but ancient method of healing, leech therapy. The process allowed the injured employee to regain function of two of her digits. Gifford then collaborated with a prosthetist to ensure the woman received an artificial finger capable of allowing her to return to normal activities of daily living. Gifford’s persistence helped the employee return to her work with her employer at a desk position that was better suited for her skills. The injured employee was released to full duty 71 days prior to the ODG guidelines, which allowed for significant cost savings on the claim.
Telephonic Case Management
Elizabeth Lebron, MHA, BSN, RN, CCM
For a case manager, gaining the trust of an injured employee is often fundamental to the success of the claim. Such was the case for Elizabeth Lebron when she was assigned a case involving a 59-year-old pilot who slipped and fell on the terminal while walking to flight. Unable to move his shoulder after injury, the man sought treatment with his primary physician who suggested an MRI and referral to an orthopedic specialist. Reluctant at first to submit a workers’ compensation claim due to mistrust in the system but realizing the injury was significant, the pilot eventually filed 18 days after injury. His skepticism was evident when case manager Lebron initially contacted him, dismissing her, and rejecting her assistance. Undeterred, Lebron managed to quickly receive the MRI results and then advocated for him when rotator cuff surgery was initially deemed medically unnecessary. She won over the pilot with her actions, who, prior to this, was considering litigation. After successful surgery, Lebron closely monitored the pilot’s progress making sure there was no lapse in his care continuum, obtaining 30 sessions of post-operative therapy and helping ensure he was compliant with his home exercises. Lebron’s efforts paid off with the injured employee returning to full duty, while achieving $28,000 actual savings on the file.
Disability Case Management
Alyssa Tease, MS, CRC, CPWIC
A software application tester with attention deficit-hyperactivity disorder was struggling to adjust to a mandated remote-to-hybrid work setting change. Though the employee enjoyed his job, had a good relationship with his coworkers and was highly regarded by his manager, he struggled to concentrate in an open-concept workspace with no separators to block out noise and other stimuli.
In attempt to manage the situation, the man tried wearing noise-cancelling headphones while in the office but movements of coworkers continued to divert his attention away from tasks. To help the employee adapt to the new work environment, the employer contacted Enlyte requesting an ADA accommodations assessment. The file was assigned to Enlyte case manager Alyssa Tease, who reviewed documentation and collaborated with the employee and employer to develop strategies designed to facilitate both parties’ needs. After the parties assessed the designated workspace, the employer agreed to secure a secluded area for the employee to reduce distractions while also providing opportunities to socialize with coworkers during breaks and team meetings to facilitate a healthy work environment. This resulted in a successful ADA accommodation, allowing the employee to remain gainfully employed at his dream job and the employer to retain an important team member.
About Enlyte
Headquartered in San Diego, CA, Enlyte (www.enlyte.com) is the parent company of Mitchell, Genex, Coventry and Apricus, leaders in cost-containment technology, provider and specialty networks, case management services, pharmacy benefit and disability management. The Enlyte businesses align their joint industry expertise and advanced technology solutions in a combined organization of nearly 6,000 associates committed to simplifying and optimizing property, casualty and disability claims processes and services.
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SOURCE Enlyte
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