Tag Archives: Rosie Moore

Florida Workers’ Compensation: Clarifying the 30-Day Work Status Update Requirement

By Rosie Moore, DNP, RN, LNC, LEHP
Functional Medicine Nurse Consultant & Workers’ Compensation Case Manager

One of the most common questions I receive from providers is whether they need to see an injured worker every 30 days to update their work status. While Florida Statute § 440.13(2)(c) is often cited, there tends to be confusion surrounding its interpretation.

Here’s what the statute actually says:

“The physician shall release the employee to return to work with or without restrictions, and such release shall be reported to the employer and the carrier. The physician shall reevaluate the injured worker at intervals not exceeding 30 days, unless the carrier authorizes less frequent visits.”

But what does this really mean in practical terms?

It does not mean the provider must physically see the patient every 30 days. Rather, they must ensure that updated work status documentation is issued at least every 30 days. If the worker has not been seen in person but continues under care with no change in status, the provider may issue a note or DWC-25 indicating that the work status remains the same and that it is being continued based on previous clinical findings.

This clarification is essential, especially for providers managing high caseloads or patients with chronic injuries who may not require in-person follow-up that frequently.

Best Practice Tip:
Document clearly that the extension of restrictions or duty status is based on prior clinical evaluation, and indicate the date of the last in-person visit. This keeps the employer, insurer, and injured worker all aligned.

If you’re a provider navigating Florida workers’ compensation cases and want help streamlining your documentation while remaining compliant, I’m here to help.

Contact Rosie Moore, DNP, RN, LEHP, LNC, BC-FMP
Email: rosie@jrmnurseconsultants.com
Phone: 407-760-1662
Website: www.jrmnurseconsultants.com

Clarifying 30-Day Reassessment and Work Status for OWCP Providers

By Rosie Moore, DNP, RN, LNC, LEHP
Functional Medicine Nurse Consultant & Workers’ Compensation Case Manager

If you’re a provider treating a federal employee through the U.S. Department of Labor (OWCP), you may be wondering how often you need to see the patient in person in order to address work status and provide documentation such as the CA-17.

Here’s what you need to know:

There is no OWCP rule that requires an in-person visit every 30 days.
While many case managers or employers prefer monthly updates, OWCP allows for completion of the CA-17 and work status documentation based on chart review, as long as your determination is based on recent clinical documentation and your professional judgment.

Can I Complete a CA-17 Without Seeing the Patient?

Yes. If the injured worker is stable and there is no new clinical change, you may complete a CA-17 indicating that work status remains unchanged. You must clearly document that your opinion is based on a review of existing records and that no in-person visit occurred.

Best Practice Language to Include in Your Note:

“Work status extended based on review of existing medical records. No in-person evaluation was conducted at this time.”

This protects you and clearly communicates the basis of your decision.

Reminder: OWCP Forms Are for Administrative Use

The CA-17 and similar forms are tools used by the employer and claims examiner to track capacity for duty. OWCP does not regulate a strict timeline for follow-up unless medical necessity or case complexity requires it.

Final Thoughts

As always, clinical judgment comes first. If the injured worker’s condition changes or you need to reassess capacity for work, schedule a visit. But if nothing has changed, chart review may be appropriate — and acceptable to OWCP — when updating paperwork.

Need Help Staying Compliant Without Extra Work?
As a nurse consultant, I help providers stay on top of OWCP documentation, functional evaluations, and return-to-work protocols—without unnecessary visits.

rosie@jrmnurseconsultants.com
 jrmnurseconsultants.com
 407-760-1662

COVID-19 Should I Be Concerned

There is a lot of stress and fear globally regarding the COVID-19 and what we are supposed to be doing to protect ourselves.  The media, friends and family, popular theme parks, businesses including airlines, cruises, and places of attractions, all have something to share about the COVID-19.  This is a household word that gets used in households on a daily basis probably more times than we want it to be.  Should we be concerned? That is an outstanding yes!! Why?  Well, first of all, let’s dissect what is happening, fear ( false evidence appearing real).

There is a lot of things that we are uncertain of and many times people will provide us information that may not be accurate.  They are not telling us to be mean, but they themselves are scared because they do not have all the facts.  Our healthcare professionals are leaning on the Center for Disease Control (CDC) and the World Health Organization ( WHO) to provide them the latest facts.  I am sure there are doctors who specialize in microbiology ( that famous petri dish that I hated in college) to do a battery of tests on this organism.  They learn something new each day.  There is not a specific cure as the virus has not been here long enough to develop a vaccine against it.  This is what causes the fear of not having a cure, not knowing if you contract it what will happen to you, your family, and your job, not to mention your friends.  So now that we dissected what the real issue here is fear, let’s see if we can put your mind at ease while we let the professionals figure out how to eradicate this virus.

“First of all Coronavirus disease 2019 (COVID-19) is a respiratory illness
that can spread from person to person. The virus that causes
COVID-19 is a novel coronavirus that was first identified during
an investigation into an outbreak in Wuhan, China.”

“The virus is thought to spread mainly between people who
are in close contact with one another (within about 6 feet)
through respiratory droplets produced when an infected
person coughs or sneezes. It also may be possible that a person
can get COVID-19 by touching a surface or object that has
the virus on it and then touching their own mouth, nose, or
possibly their eyes, but this is not thought to be the main
way the virus spreads.”

The symptoms are Fever, Cough, and Shortness of breath.  Pretty common symptoms that can be overlooked for many upper respiratory infections.  These symptoms can manifest themselves at any time in the 2-week window after becoming infected.

The way to protect yourself and others from catching the COVID-19 is to practice washing your hands for 20 seconds with antibacterial soap before eating, after eating, after using the bathroom, after touching your nose, eyes, or mouth.  You should also wash your hands after coming from the grocery store or any other public place that is not your home.  If you do not have access to soap and water right away uses the antibacterial right away.  If you shake hands with someone, do not be afraid to use your antibacterial.  I know people may frown at that and think you are germophobic, but really it is okay if questioned a simple explanation stating that you want to practice good infection control and want to be certain that you do not compromise them or your family is enough stated.

Always wash your hands after preparing food and serving or taking care of others ( no matter age).  Avoid contact with people that are sick and if you feel sick, stay home.  do not try to go to church, restaurants, activities, school, or any public spaces with multiple crowds and pawn it off on allergies. Everyone knows allergies are not contagious so many people who cannot afford to stay home because they do not get paid for being out, tell everyone that they have allergies.  Yes someone may have allergies but until this is verified by a doctor or nurse practitioner, stay home!

Be sure to clean surfaces with antibacterial wipes or household disinfectants as the virus can live on surfaces and if touched it can cause someone to get the virus.  When you come home from the outside, take your shoes off outside clean the bottom of the shoe and do take a shower at night before bed or if possible as soon as you come home from work.

I know this all may sound excessive, but if you follow good infection control, it will help decrease the stress that the media is causing you by playing the news 24/7.  Limit the times that you watch the news so that you are able to function on a day to day basis.  Have a cup of chamomile tea for bed to allow your mind to relax and get rest.  Start your day with something positive such as a daily devotion, prayer, or if you do not do any of the latter, watch a tv show that brings laughter to you.  Listen to the news midday or afternoon, this will give you at least what happened in the evening and the morning and not bombard you.

Sick Woman Cold

 

I hope that this has brought you some comfort.  For specific updated information go directly to one of these sites:

CDC/Center for disease control

WHO/World Health Organization

OSHA/Occupational and Safety Health Administration

As a nurse, I have to practice above and beyond the CDC, WHO, and OSHA rules so that I can protect myself and my patients.  So I understand and get everyone’s concerns right away.

Be blessed and be safe.

 

Comparison of Theories in the NICU

The Roy Adaptation Model was known to focus on spiritual matters and promoting health amongst a family-centered type of care.  In the Neonatal Intensive Care Unit (NICU), this especially holds true, because of the situation of critical illness faced daily, The Roy Adaptation Model helps families adapt to a changing environment and deal with the quality of life or in some instances death.  In the NICU, Roy’s model would work well as the nurses acclimate to the parents and what is happening to their baby. With Roy’s model, she indicates that health and illness are part of a person’s everyday life, this, in turn, will cause the environment to change in which they live. If the parents are to respond in a positive way and come out of it stronger, they will need to adapt to the change (DeNisco & Barker, 2012).

People will often adapt to a change in their life when they can respond positively to the changes that are happening around them.  An example would be the early premature birth of a baby, unexpected changes in the life of a mother and those immediately around her in the family are affected.  This will include other children, spouse and anyone else part of the family’s nuclear family, which in some cultures can be a very extensive family. That mother and father will use whatever coping mechanisms they learned in life to cope with the stress and the changes that they are facing.

There are three kinds of stimuli considered in Roy’s Adaptation Model, these will all affect the subgroup of premature parents in the NICU, because of the type of unit it is, a unit of uncertainty running high with emotions that go up and down.  In a different culture, the role of the nurse will differ.  For example, think about a mother that speaks a different language and is unable to get clear communication to and from the nurse.  A translator would have to be used to explain what was happening to her as a mother and then what is happening to her baby in the NICU.  For example in one article, there was a baby born early, with a mother that did not speak the language and the family did not fully understand what was happening in the NICU.  The family asked for their “Curandero” a community healer in their culture to clean the baby with an egg (Peterson-Iyer, 2008). The nurse needs to be able to use cultural sensitivity in explaining why this cannot be done, without offending the family but still including them in the baby’s care.

Jean Watson’s theory on caring can also be applied to the NICU because it is nurturing and will be needed in a critical location like the NICU. Jean Watson’s theory of human caring focuses on giving as an extension of self.  It is about instilling faith and hope in a person.  When a person is sensitive to another person’s feelings, it helps to build a trusting relationship.  It is important to acknowledge the positive and negative feelings that a person puts out to another person.  Jean Watson believes in her theory that we experience personal growth through teaching and learning as well as spiritual and socio-cultural well-being.  Jean Watson’s theory emphasizes spiritual and nursing practice, which in turn will promote caring and love to the patient.  This will then develop into a caring relationship.  The theory allows the nurse to understand the other person’s perspectives on things and form a mutual bond.  It also promotes growth when a caring environment is formed allowing the patient to be who they are and be accepted for it (Alligood, 2013).

The role of the nurse in Jean Watson’s theory is to instill faith and hope as well as build a trusting relationship.  In the article about the Mexican Indian family, Jean Watson’s theory would apply.  The mother in this instance speaks a different language that may be unique to the translation company that the NICU uses causing a barrier.  The mother, as in the article may be young and not have received prenatal care.  Their faith is going to be different from our own, as when the father of the child, wanted to use a “Curandero”, but as nurses, we must be able to provide culturally competent care.

References

Alligood, M. (2013). Adaptation model. In Nursing theorists and their work (8th ed., pp. 303-327). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

DeNisco, S. M., & Barker, A. M. (2012). Theory-based advanced nursing practice. In Advanced practice nursing: Evolving roles for the transformation of the profession (2nd ed., pp. 361-377). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

Peterson-Iyer, K. (2008). A difficult birth: Language and cultural differences. Retrieved from http://www.scu.edu/ethics/practicing/focusareas/medical/culturally-competent-care/difficult-birth.html

 

A Theory for Post Partum Moms

Betty Neuman’s theory will work well with visiting post-partum moms in their homes after they have had their babies.  One of the things that I have seen while working in labor and delivery, is that the mothers come in with preconceived ideas on what breastfeeding is or is not, based on what their mothers and grandmothers know.  The family will say that back in the day, there was not any teaching on breastfeeding, you just did it. This can cause stress with the newly delivered mother and the family.    However, I most recently read an article and it spoke about a 17-year-old girl that came in with a complicated pregnancy and she delivered early sending her baby to the Neonatal Intensive Care Unit.  She was from Mexico but spoke a language called Mixtec.  This would make explaining about breastfeeding difficult and frustrating to the family and the nurse (Peterson-Iyer, 2008).

However through Betty Neuman’s model, if the nurse takes out a book that talks about breastfeeding, even if it is not in her language, she can point to the pictures and demonstrate what she needs to do.  Initially, this mother will be pumping her milk, since the baby may be too sick to drink at the breast, however, once the discharge is planned, she will need assistance breastfeeding and bonding with the baby.  It is through home visiting nurses, that these cases of mothers that are learning and have language barriers can have support for proper breastfeeding.

Betty Neuman believes that nursing should be approached from a holistic standpoint; physical, psychological, mental, social, cultural, developmental, and spiritual well-being.  As a person, Neuman’s theory considers the patient as an individual family member, community or society. The environment that the patient lives in can be external or internal.  Stressors that Jean Watson speaks of in her theory, produces tension in a person’s life (Alligood, 2013).

 

References

Alligood, M. (2013). Systems model. In Nursing theorists and their work (8th ed., pp. 281-301). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

Peterson-Iyer, K. (2008). A difficult birth: Language and cultural differences. Retrieved from http://www.scu.edu/ethics/practicing/focusareas/medical/culturally-competent-care/difficult-birth.html

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