A pending revision to the Chapter 137: Disability Management will see an addition of §137.5. The purpose of the new paragraph is to clarify who will be recognized as Certified Case Managers. It will include certification standards for all case managers used by carriers.

Key Revision Language for the New §137.5:

“Case managers, who are certified, must be certified by an established accredited organization including the National Commission for Certifying Agencies, the American Board of Nursing Specialties, or other national accrediting agencies with similar standards for case management certification.”

Key Credentialing Requirements:

For those who do not have the approved credentials, DWC will call them “skilled, non-certified case managers”. They may provide services when they meet the requirements to sit for a case management certification examination, with the exception of experience; and are working under the direct supervision of an identified certified case manager for the time period of no more than 18 months.

What Credentials Will You See for Certified Case Managers?
(Sorry-Claims Adjusters Cannot Be Case Managers!)

  1. Certified Case Manager: CCM
  2. Certified Occupation Health Nurse: COHN(S), and/or COHN(S)/CM
  3. Registered Nurse Case Manager: RN-CM
  4. Registered Nurses Board Certified: RN-BC
  5. Certified Disability Management Specialist: CDMS
  6. Certified Registered Rehabilitation Nurse: CRRN
  7. Certified Rehabilitation Counselors: CRC

Concerns Expressed At DWC Hearings this year:

  • 18 months may not be long enough for the non-skilled to obtain the specialty certification. Some specialties require 3-5 years to qualify.
  • Other non-medical individuals testified they are just as qualified to provide case management services.
  • Concern that the number of credentialed case managers needed may not be available in the state.
  • Rural areas, for Texas network claims, lack needed CCMs- no options or recommendations in the rule to cover this situation.
  • Hospital case management is not the same as industrial case management.
  • Noted that ODG addresses CCM levels based on severity and complexity of the medical condition.
  • Employers were concerned about a “demand” for higher salaries for CCMs.

Author: Deborah Goza, MS, RN, CCM, COHNS
Editor: D. Perry