Case Managers: What is their role and how to find the right one for you

Many clinical negligence cases involve litigating for clients with extremely complex needs. Our aim is to obtain damages that compensate clients for their suffering and enable them to rebuild their lives. Where people have been left with long-term disabilities, the focus is rehabilitation; which clinicians, what equipment and what adaptations are required to help this client develop their independence and support their needs. Many of our clients have enormous levels of support from their family and partners. However building the correct team, finding the right equipment and assistive technology and securing an appropriate property is no small order.

How a case manager can help me?

A case manager is someone with knowledge of these areas, who works to meet the therapeutic and educational needs of the client. Often they have previously worked as occupational therapists, physiotherapists or nurses and bring this insight to their role. They identify suitable treating therapists and act as line managers for support workers, who provide families with day-to-day assistance in caring for their loved ones. The case manager should be up-to-date with developments in technology and equipment, and can organise trials to see what is right for the client. They often work with property finding agents to secure appropriate accommodation, and obtain the input of occupational therapists to determine which adaptations need to be made. Where the client is of school age, the case manager should assist in finding an appropriate school and helping the child obtain a place. Additionally, organising a holiday where a family member has extensive needs can be a Herculean task. A case manager should be able to assist the family in having time away together, in a setting where all family members can enjoy themselves, whilst ensuring that the client’s care needs continue to be met.

The costs of meeting the needs of someone with a severe disability can be enormous, but once liability is established (i.e. it is accepted by the Defendant that they caused the disability through their negligence) these costs should be recoverable from the Defendant, as long as they are reasonable and for the purpose of rehabilitation. In cases of this size, any money obtained for the client will usually be held on trust by a Deputy, who ensures that it is spent on the client’s therapeutic and educational needs. In response to suggestions by the family and by the treating therapists, the case manager will obtain quotes for the Deputy to approve and will work to deliver them.

How do I choose a good case manager?

The case manager will ideally be involved for several years and will be the family’s first port of call for numerous issues. As such, it is critical to ensure that they are the right fit. My recent experience supporting a family in their search for a case manager highlighted a number of key areas to bear in mind when going through this process:

• Has the candidate ever managed a case similar to yours? If the client is a child, have they worked with children of a similar age? If their injuries are quite specific, again, do they have experience in this area, and if not, are you confident that they have other relevant experience that they can bring to the role? No two clients are the same, so evidently there will never be a ‘perfect match’, but a certain amount of similar experience is necessary.
• How much contact do you require? Some families will need daily contact with their case manager. This tends to be the case where the client has particularly complex needs and they are at a relatively early stage in the process. The need for very regular contact tends to decrease as the therapeutic team, adaptations and schooling becomes settled. Ask whether the candidate has capacity for the contact that you current require.
• Do you get on? This may sound obvious, but you will be working together closely. It is important that you feel this is someone that you can sustain a working relationship with.
• Do you think the candidate is someone who can coordinate a team of clinicians and support workers? Will they be able to recruit effectively and address problems that might arise, efficiently and professionally?
• Will this candidate be managing the case in person, or will they delegate work to less experienced colleagues? It is key that the family know who they will be working with. Some companies propose a more experienced case manager but much of the work is done by a trainee. Evidently we all have to learn (I am a trainee myself!) but if this set-up is envisioned it should be absolutely clear. In very complex cases it is unlikely that this would be appropriate.
• What are the arrangements for when the case manager is on leave or away from work due to sickness? Who will you contact during this time?
• Do you prefer someone who is very hands-on, who will be very active, or would you prefer someone whose role is a facilitator of the family’s suggestions? Different families have different needs. Some will know exactly what they want, and simply require someone to make it happen. Others will appreciate a much more dynamic case manager.
• Does the case manager have the connections and knowledge to expand upon the family’s existing set-up?
• Can this person advocate on behalf of the client? There will be times where the case manager needs to make the case for the client or their family, whether to an equipment company or to the local authority. Do you feel comfortable at the prospect of this candidate speaking on your behalf?
• Outline your expectations to the potential candidate and ask them how they would meet these. Perhaps ask them to set out broadly how they might plan the next 6 months with you, and how they would work with you to prioritise various goals. The initial meet and greet does not tend to be an extensive interview, but it might be helpful to see the candidate’s approach.
• Finally, do you feel comfortable that they will work to achieve the best for your loved one? The role of a case manager is to ensure that their client is given the best possible chance at rehabilitation and to develop their potential. You should feel confident that the person you choose to work with prioritises this.

It can take some time to find the right case manager, but it worth persevering. Our team of medical negligence experts see the enormous progress made by clients for whom we obtain interim and final damages to fund their care, and it is important to ensure that the person coordinating this is the right fit for them and their family.