Rosie Moore – JRM Nurse Consultants

July 07 2025

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

July 07 2025

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

April 04 2020

Nurses In Telehealth and Why It is Important

Our technology through the years has been advancing to provide patients with nurses that can manage their care through the telephone and through field visits in their homes. With the recent pandemic that has spread throughout the globe, more than ever the field of nursing doing telehealth has become important.

Through my job as an independent nurse consultant, I am able to provide much needed and sought after medical information to my patients and their family caregivers via telephone and telehealth. In order for me to do this, I must be able to have good communication skills and if I am providing telemedicine a good eye for what may be concerning my patient. In the past few years, telehealth has grown. According to the American Academy of Ambulatory Care Nusring (AACN). “Telehealth practice originally began when registered nurses (RNs) were available to patients by telephone to ensure they had access to health care. The RNs triaged patients to appropriate levels of care. ”

Many people lately since the pandemic occurred ask me what do you do for work? My answer is, as a nurse consultant, I educate and assess my patients about their medications, symptoms, and chronic disease processes. I ensure that they are making follow up appointments with their primary care doctors or their specialist. Together we develop a plan of care that will best suit their current situation. Now I also have injured workers that are seeing their doctors and anxious to get back to work. They sometimes have chronic conditions that through my assessment they may or may not know about. These are the moments when as a nurse consultant, I can educate them, provide best practices, and refer them to their primary care doctor to get the help that they need. As for their injuries, I help them to get the right treatment ordered and coordinate their visits to another specialist that can help them when a referral is needed. My job does not end there though, coordinating light duty work for the,m with their employing agency is another aspect of what I do.

Having a telehealth nurse allows doctors the ability to follow up with patients that are not able to come to the office as frequently by carefully monitoring the medications that they are on after they are reconciled with their pharmacist. It also allows for a team approach in managing their healthcare with their caregiver and the patient to provide autonomy, a willingness to participate, and be involved in their own healthcare.

One important time that my patients benefit from is pre and post-surgery. These are scary times for patients and knowing that they have a nurse to contact them and review their instructions before surgery, plan for their needs after surgery, and contact them afterward, assures them that they can manage their needs while waiting for the follow up with their doctor.

This year with Hurricane Dorian almost hitting Florida, there was preparation to plan ahead for patients especially those that were in need of a special needs shelter due to compromised health. It takes preparation at the beginning of the hurricane season to assess all your patient’s needs and plans for disaster. I usually start this around June 1st right when hurricane season starts so that if one should happen, we are prepared with the patient’s plan of care. Once the warning is issued that we need to prepare, then I contact each one of my patients and put their emergency plan into place. I visit each patient and make certain that they are prepared. Once the danger is over, I follow up with each patient by phone and when it is safe to go out, I will visit them in their homes to ensure that they are safe.

Most all my patients receive an in-person visit from me at their home or doctor’s office but they also receive phone calls to maintain the communication lines open about their care. Usually, I have flexibility in my schedule to take time off to spend it with my husband and my son or catch up on housework to free up my weekends. However, during this pandemic of COVID-19, my short days have turned into 16 plus hour days almost 6 days a week and somedays 7 ( although I try to not let that 7th day happen). Many ask what happened to your comfortable hours? Well COVID-19 changed that !! My patients are scared, they have more questions, I have more telehealth visits at doctor’s offices with patients because I am not able to go per my contracted client accounts; it is for their protection and mine. So although tiring, I am grateful that I can still provide the care that they need through telehealth.

So today someone dropped off a sign at my door that says they are praying for healthcare heroes and first responders. I am honored to be among the professions that help support our patients at home to keep them safe during this pandemic. Every telehealth visit that I make with each patient has a COVID-19 question and answer session and they know that if they have a question, they can contact me.

So today, find a healthcare worker and honor them with a kind word of encouragement. We are here working for the health of our country.

This is the sign that was left on our front yard today( Pardon the garden we were going to start planting flowers in it until COVID-19…times are too busy for gardening)

Rosie Moore, DNP, RN

Follow Rosie’s Nurse Corner

Website: Windermere Baby and Family

March 03 2020

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.

March 03 2019

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

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Years of experience in Work Comp, Case Management, Disease Management, Utilization Review and Prior Authorization.

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