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Talk to Terrie: The DOL Case Management Changes

May 21, 2019

May 21, 2019

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I don’t think the Department of Labor (DOL) put in a lot of thought when they decided to limit the time that a Target Case Manager can spend with sick nuclear weapons workers covered under the Energy Employees Occupational Illness Compensation Program to a mere 15 minutes per week.  It’s hard to fathom that DOL would willingly jeopardize a worker’s health and well-being by reducing the time the case manager can spend with the worker.  Most people spend more time than that in a week brushing their teeth.

Discussions with Deb blog provides a more detailed description of what the responsibilities are for a case manager but, basically, they monitor the worker’s medical treatment plan and ensure that everyone involved with that plan are doing a proper job for the worker.  DOL requires case managers to be Registered Nurses.

Imagine what it would be like for both the case manager and the worker if a visit to manage the care could only last 15 minutes:

Case Manager (CM) enters the home.

CM, “Hello Mr. Smith.  How are you today?

Mr. Smith, “Ok, I guess.  I’ve been having…” (Approximately, 1 minute has elapsed.)

CM, “Well, let’s get to taking your vitals.” CM pulls out the thermometer, blood pressure cup, stethoscope and proceeds to take readings. CM retrieves medical binder, finds the proper file and jots down readings. CM notes that Mr. Smith’s blood pressure is elevated.  (Approximately 5 minutes have elapsed.)

CM, “So, Mr. Smith you mentioned something that is bothering you?  Can tell me what the problem is?”

Mr. Smith, “Yeah, I was prescribed a new medicine and I don’t think it’s right for me.  I get dizzy and have to lay down.  It also makes me shaky and upsets my stomach.” (Approximately 1 minute has elapsed.)

CM searches medical binder for new prescription. CM doesn’t recognize the symptoms reported by worker as being a side effect of the medication.  CM does a quick search and confirms that the symptoms are not listed as a possible side effect of the medication.  (Approximately 2 minutes have elapsed.)

CM realizes that eight more pages of the assessment needs to be completed in 6 minutes. Under this new policy, the CM must make the difficult choice of pursuing the cause of the symptoms in minutes or complete the required paperwork.  The obvious choice is to determine what is causing the serious symptoms.  But can that be done in 6 minutes?  I don’t think so.  Is the CM supposed to do this without being compensated for the time spent?  It is wrong for DOL to expect them to do that.  Does this jeopardize the sick worker?  Most definitely.

Cold War Patriots (CWP) has once again taken the lead to stop DOL from decreasing the health care to the workers who dedicated their lives protecting the United States during the Cold War.  I urge you to read CWP’s Letter to Supporters to find out how you can help.