What Does a Telephonic Case Manager Do in Workers’ Comp?

Telephonic case management is a core service in Workers’ Compensation and disability programs, designed to guide injured employees through recovery while helping employers and insurers control costs. Instead of meeting face-to-face, the telephonic case manager works primarily over the phone, allowing for fast engagement, consistent follow-up, and support that spans multiple locations.

The Role of the Telephonic Case Manager

A telephonic case manager is typically a registered nurse with clinical experience who understands injury recovery, medical guidelines, and return-to-work best practices. Their job is to keep the file moving forward, remove barriers to care, and make sure the injured worker gets the right treatment at the right time.

Early Outreach & Initial Assessment

One of the most important parts of telephonic case management is early contact. As soon as a claim is assigned, the case manager reaches out to the injured worker, usually within the first few days.

During this call, the telephonic case manager:

• Confirms the injury details and diagnosis
• Reviews the initial treatment plan
• Identifies any red flags, such as unmanaged pain, comorbidities, or psychosocial barriers
• Sets expectations for the recovery timeline
• Provides reassurance and education

Early involvement is strongly linked to better outcomes. A public risk pool in Texas reported that when claims were referred to case management within 7 days of injury, more than 50% of employees returned to work within 90 days. This shows how impactful early telephonic outreach can be in preventing delays and complications.

Coordinating Medical Care

Telephonic case managers act as the central communicator for the claim. They stay in continuous contact with:

• Treating physicians
• Physical therapists
• Specialists
• Adjusters
• Employers

Their job is to ensure treatment stays on track and matches evidence-based guidelines. They confirm appointment attendance, follow up on missed visits, and help the injured worker understand medical instructions that may be confusing.

Because the interaction is telephonic, communication can happen more frequently. This frequent contact helps identify issues early, such as setbacks, medication concerns, or the need for referrals, before they become major complications.

Supporting Return-to-Work Planning

A major responsibility of telephonic case management is helping employees return to work safely and at the right time.

A telephonic case manager does this by:

• Monitoring functional improvement
• Reviewing work restrictions with medical providers
• Coordinating modified duty or light duty roles with the employer
• Setting realistic recovery milestones
• Re-evaluating work plans if the recovery stalls

This structured approach keeps everyone aligned and often shortens the time an employee remains out of work. Telephonic case management is especially effective because the case manager can maintain regular check-ins without the travel delays that come with field visits.

Ongoing Monitoring & Problem Solving

Throughout the life of the claim, the telephonic case manager conducts periodic follow-up calls to assess:

• Pain levels
• Mobility
• Adherence to treatment
• Progress toward return-to-work goals
• Any new complications or concerns

If the case becomes more complex, such as an upcoming surgery, a hospitalization, or a breakdown in treatment, the case manager can adjust the strategy or recommend escalation to field or catastrophic case management.

This ongoing oversight helps detect problems early, which can prevent prolonged disability and keep costs from escalating.

The Value of the Telephonic Case Manager

Telephonic case management is often more cost-effective than field case management because it eliminates travel time and allows nurses to work more efficiently. A study by Carlisle Medical of 2,000 Workers’ Compensation files found that telephonic case management resulted in 40% lower nursing-hour costs compared to field-based case management, while still meeting file objectives.

Additionally, telephonic programs are not limited by geography. One telephonic case manager can manage more files across multiple locations because there is no travel time or geographic barrier. This scalability allows organizations to support more employees with fewer resources while still maintaining strong clinical oversight.

Overall, telephonic case managers play a vital role in bridging medical care, communication, and return-to-work coordination. They help injured workers feel supported, ensure providers stay aligned on treatment goals, and keep claims moving toward resolution. With lower nursing-hour costs, strong early-intervention outcomes, and the ability to manage a larger caseload across wider regions, telephonic case management has become an essential component of modern workers’ compensation programs.

Explore how early clinical involvement and consistent follow-up can help keep claims moving and support timely return-to-work outcomes.

Check out our sources:

Carlisle Medical, Inc. Telephonic Case Management in Workers’ Compensation. White paper, prepared in collaboration with Louise Moore, RN, Nurse Case Manager Supervisor, Carlisle Medical, Inc., Oct. 2021, https://www.carlislemedical.com/wp-content/uploads/2021/10/CAR-21-Wht-Paper-Telephonic-Nurse-Case-Mgmt-in-Work-Comp.pdf.

Texas Comptroller of Public Accounts, Fiscal Management Division. “Note 17 – Risk Management: Public Entity Risk Pool.” Reporting Requirements for Annual Financial Reports of State Agencies and Universities, Texas Comptroller of Public Accounts, https://fmx.cpa.texas.gov/fmx/pubs/afrrptreq/notes/index.php?menu=2&section=note17&page=entity.