Drug seeking employees, ER visits, and unexpected injuries are budget and reserve killers. Most of the time the clues are obvious, behaviors truth telling. Is there an ethical way to let an injured worker (IW) know that you suspect they are not telling the truth about medications? Glancing in the locker room from the hall the supervisor saw the IW with a prescription container, later the IW was falling asleep at the workstation. How does a carrier or employer address this issue? Drug addiction is at an all-time high and many guidelines have been put in place to try and address the epidemic, however employers, carriers, and healthcare providers deal with the side effects. Working under the influence is more common than you think, and a risk for all involved.
Medication reconciliation is key to addressing medication management, a task completed, every visit in the doctor’s office. IW’s may not be providing full disclosure. As a field nurse case manager medication reconciliation is an ongoing task. During the initial interview we asked the IW to provide all medication bottles and pharmacy bills, writing down all the names of the prescribing providers. Home visits give us the chance to look around the room and make note of medical supplies, braces, bottles or receipts. Other sources of clues are pharmacy and medical bills, PCP notes, hospital and past surgical records. Red flag diagnosis are fibromyalgia myalgia, RSD/CRPS, spinal surgeries, migraine headaches, anxiety and depression. Home and family dynamics are also vital. Recent divorce, death, or caregiver needs are often uncovered. In home RN CCM field case management visits can provide a clear picture of the many factors influencing and driving your claims. This vital information can in turn solve the mysteries, focus the treatment and management plan to bring about return to work and MMI.
Reference: Nursing 2016 June – Unauthorized Drugs