The Fundamentals - Case Management

Case management is a goal-oriented approach that aims to help employees remain at work and facilitate a safe and timely return to work. It is best accomplished with a multidisciplinary team.

At the heart of case management is a dedicated resource, such as a disability management advisor, who coordinates discussions between the employee, the manager and all partners in the process. Working collaboratively with the employee and the manager, this resource person ensures that any work-related functional limitations or restrictions are identified and incorporated into a remain-at-work or return-to-work plan. The ideal outcome is for appropriate accommodations to help an employee remain at work or facilitate a safe and timely return to work.

Case management is not always required, for example, if the accommodations are simple and straightforward. A manager can make arrangements on an informal basis, purchasing adaptive equipment or making work schedule adjustments or space allocations. However, in more complex cases, an interdisciplinary team is beneficial, and the case management model provides structure. In all instances, document the arrangements made.

The employee is responsible for providing the manager with medical information specifying work-related capabilities, functional limitations and restrictions that might be required for accommodation within the workplace. A remain-at-work or return-to-work plan will need to be agreed upon by both the employee and manager. Successful outcomes need early intervention and effective case management, including:

  • Case definition/profile;
  • Case analysis;
  • Understanding of the shared responsibilities of the employee and the manager to actively communicate;
  • Timely decisions on benefits: eligibility and entitlement;
  • Efficient, accurate and timely administration of claims;
  • Integrated teams to identify and manage workplace issues in a coordinated manner; and
  • Proactive discussions.

Case Management and Reporting

Costs for workers' compensation claims are lower when occupational injuries and illnesses are reported early (source: Glen-Roberts Pitruzello, “The High Cost of Delays: Findings on a Lag-time Study,” The Hartford Financial Services Group, NCCI Issues Report, Summer 2000, (article not readily available without subscription):

  • Claims reported two weeks after occurrence had average settlement values 18 per cent higher than those reported in the first week.
  • Claims reported in the third and fourth week after occurrence had average settlement values approximately 30 percent greater than those reported in the first week.
  • Claims reported after one month of occurrence had 45-per-cent higher average settlement values.
  • For certain types of injuries, there is a positive relationship between the time a claim is reported and the amount for which the claim is settled.

Promising Practices

Correctional Service Canada (CSC)

The CSC has a graduated case management approach with joint case discussions. The process begins at the work site and then, if employees have not returned to work after a 6-month absence, the case is reviewed regionally. Nationally, the Committee members meet on average 6 times per year, reviewing cases of correctional officers who are away for more than 1 year; they review about 100 cases annually. Its National Joint Return-to-Work Advisory Committee, which includes union partners, meets twice per year to discuss general return-to-work issues, trends, and associated issues. The CSC also has joint case discussions with union representatives.

Public Works and Government Services Canada (PWGSC)

PWGSC's Labour Relations and Case Management have jointly set up a working group, including bargaining agents, to create a protocol to clarify the roles of all stakeholders, for example, how the employee might come back to another job and who needs to get involved in the process.

Human Resources and Skills Development Canada (HRSDC)

HRSDC's disability management advisor plays a leadership role in collaboratively supporting and assisting managers and employees by providing advice and guidance. When required and advantageous, the advisor engages applicable stakeholders within the disability management process.

Essential Activities

  • Assist the manager and employee in understanding the legislative interpretation of benefits.
  • Provide managers with applicable resources and tools for maintaining ongoing communication and feedback with the employee.
  • Educate and support managers regarding their responsibilities throughout the entire process in order to keep the employee informed about options.
  • Support the manager and employee in establishing stay-at-work or return-to-work plans.
  • Help the manager and any employee deemed permanently unfit or medically incapable of returning to work to understand their options.
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