Understanding Serious Injury - Program Modules

Module 1 - Getting to Know the Injury: Medicine for the Non-Medical
Module 2 - Sociological and Psychological Impacts
Module 3 - Community Resources
Module 4 - Understanding Opportunities for the Future
Module 5 - Applying the Tools

Module 1 – Getting to Know the Injury  

Medicine for the Non-Medical Person 

Participants will be able to do the following:
• Identify basic human anatomy using medical terminology relevant to injury identification by claims adjusters, including the classification of minor or catastrophic
• Use the Minor Injury Guidelines (as defined by SABS regulations) to identify an applicable injury
• Differentiate between minor, non-minor and catastrophic injuries
• List and explain the elements of various medical reports for the purpose of effective injury management and case resolution
• Examine the needs of the injured parties and the knowledge provided by the medical community through diagnosis, prognosis, causation and impairment and identify next steps
• Select the appropriate medical or personal assessment for a specific injury type and client need
• Communicate effectively with health care professionals

Module 2 – Sociological and Psychological Impacts  
The Person Behind the Injury: Sociological and Psychological Impacts 

Participants will be able to do the following:
• Analyze pre- and post-accident impairments and functionality by identifying and extrapolating gained information
• Recognize different levels of functional recovery as the person moves through the recovery process
• Identify and analyze the impact of the person’s cultural background, family dynamics, and social norms on their recovery, and then determine how to best provide appropriate support to help guide the claimant and their “circle of influence” towards recovery
• Define choices and examine appropriate treatment options for different levels of recovery and provide meaningful guidance in consideration of policy coverage
• Differentiate the relevant stages of grief, the healing process, and the impact of the injury on the claimant’s mental health and potentially changing roles
• Assess the person’s expectations of return to pre-accident function despite a potential prognosis of reduced functionality

Module 3 – Other Contributors: Community Resources  

Participants will be able to do the following:
• Identify local community services and describe their roles in the person’s rehabilitation
• Identify and describe the types of rehabilitation evaluations used in a serious injury AB file
• Describe the vocational rehabilitation services used to enable people to overcome barriers to accessing, maintaining, or returning to employment
• Describe the benefits and risks of different approaches to disability management
• Select the appropriate resources to facilitate cost-effective claimant rehabilitation and develop a sample plan for a serious injury AB case that employs the appropriate service
• Identify strategies for accommodations in a person’s workplace to customize for post-injury needs
• Apply a series of industry best practices to different case files

Module 4 – Understanding the Opportunities for the Future and Managing Expectations   

Participants will be able to do the following:
• Differentiate between acute/chronic injuries and effectively interpret this difference to relate to future results
• Differentiate between subjective and objective injuries and define appropriate course of action for future rehabilitation
• Examine medical data to appreciate the need for a holistic understanding of the person’s injuries
• Define the settlement strategies of impairment ratings, annuities and life care plan and explain the reasoning behind proposed settlement plans
• Integrate medical information with other pertinent actuarial information to establish the claimant’s life expectancy and then apply this information to generate a life care plan

Module 5 – Applying the Tools   
Case Study: Group Application Work  

Through a final exercise of case study work, participants will be able to practice as a case manager of a major injury as well as recommend a strategy that will maximize the claimant’s future potential. As adjusters, participants will know how to develop a comprehensive injury management plan. 

Participants will be able to assess all medical information that contributes to the overall management of the claimant and the insurance coverage available to them. This will be accomplished through the interactive simulation exercise that reviews and applies all the resources and tools learned.

Schedules and Registration

The program is re-commencing in its new, enhanced format in September 2015. To see schedules when they are confirmed, please visit your local institute or chapter webpage, and click on 'Seminars'. If nothing has been scheduled, be sure to register your interest by contacting the manager at your local institute or chapter.