Clinical Case Study

Putting an Injured Worker on a Better Path to Recovery

Case Synopsis
A female employee sustained a lower leg injury. She was diagnosed with right peroneal nerve and tibial nerve neuropathy in her right leg. Surgery was recommended, and involved several nerve procedures, removal of hardware and revision of subtalar fusion from previous surgeries.

The patient remained in-patient post care as she did not have help at home and needed to be non-weight baring for six weeks. Home health care was arranged by CorVel upon her release from the rehabilitation center.

Patient Engagement for Better Care
After receiving a report that the patient was not complying with treatment. CorVel responded immediately by assigning a field case manager due to the complicated nature of the case.

During a home visit, CorVel observed several red flags including missed medications and depression. In addition to assisting her fill medications, CorVel obtained patient agreement to see a specialist after discussing the patient’s ongoing pain, and reviewing notes from her treating physician, rehabilitation center and home health nurse.

CorVel participated in the appointment with the specialist to ensure appropriate intervention, citing clinical indications including intense swelling and excruciating pain at the cast site. The physician removed the cast to find the heel wound infected. Using CorVel’s proprietary Case Management App on her iPad, the case manager uploaded pictures of the wound to the patient’s claim file, providing immediate visibility to all interested parties.

Due to the severity of the infection, the injured worker was admitted for emergency debridement surgery the same day. Two additional surgeries were performed as well.

Conclusion
Collaboration and intervention are critical to managing a workers’ compensation claim and a patient’s well-being. Far too many times, a patient can slip through the cracks resulting in ongoing pain and misuse of medications, sometimes risking the patient’s life.

Using clinical evidence, CorVel’s push for the patient’s treatment was instrumental in facilitating immediate hospitalization and surgery that the injury required. Because of the timely actions of CorVel, the patient received the treatment she needed, including a new fusion with stem cell transplant. She went back to work to modified duty, and is now on a better path to return to full capacity.