COHN Occupational Case Management 5 — Questions and Answers
Question 1: When conducting a telephonic case management call with an injured worker, which action is MOST important at the start of the call?
- Immediately ask about fraud indicators
- Identify yourself, your role, and explain the purpose and voluntary nature of case management services (Correct answer)
- Request a recorded statement for the insurer's file
- Inquire about the worker's attorney contact information
Correct answer: Identify yourself, your role, and explain the purpose and voluntary nature of case management services
Ethical case management requires transparency: identifying yourself and explaining your role and the voluntary nature of services protects worker rights and builds trust.
Question 2: A case manager is reviewing a treatment plan for an injured worker that includes procedures with questionable evidence of effectiveness. The MOST appropriate response is to:
- Approve all treatments to avoid conflict with the treating physician
- Apply evidence-based guidelines to evaluate appropriateness and communicate concerns through proper channels (Correct answer)
- Contact the employer directly to deny the treatment
- Immediately refer the case for an Independent Medical Examination
Correct answer: Apply evidence-based guidelines to evaluate appropriateness and communicate concerns through proper channels
Occupational case managers apply evidence-based clinical guidelines to assess treatment appropriateness and raise concerns professionally and through appropriate channels.
Question 3: An injured worker is cleared for return to work but refuses due to fear of re-injury. Which intervention is MOST appropriate?
- File a report with OSHA about the worker's non-compliance
- Coordinate a graded exposure or work-hardening program and address fear-avoidance with behavioral support (Correct answer)
- Terminate case management services immediately
- Advise the employer to discipline the worker for non-compliance
Correct answer: Coordinate a graded exposure or work-hardening program and address fear-avoidance with behavioral support
Work hardening and graded exposure address kinesiophobia and fear-avoidance behaviors that impede return to work following occupational injury.
Question 4: What does the 'impairment rating' assigned at MMI primarily determine in the workers' compensation system?
- The worker's eligibility for unemployment insurance
- The degree of permanent physical loss, which is used to calculate permanent disability benefits (Correct answer)
- The worker's classification for future job applications
- The employer's OSHA recordkeeping obligation
Correct answer: The degree of permanent physical loss, which is used to calculate permanent disability benefits
An impairment rating quantifies the degree of permanent physical loss using standardized guides (e.g., AMA Guides) and is used to calculate permanent disability benefits.
Question 5: Which of the following best illustrates the principle of 'least restrictive environment' in return-to-work planning?
- Keeping the worker off work until full recovery to prevent any risk
- Returning the worker to the closest possible approximation of their pre-injury job with minimal modification (Correct answer)
- Assigning the worker to a completely different department with no physical demands
- Requiring the worker to complete 12 weeks of work hardening before any job assignment
Correct answer: Returning the worker to the closest possible approximation of their pre-injury job with minimal modification
Returning the worker to the highest functional level with the least restriction possible promotes faster recovery and workforce integration.
Question 6: A case manager receives pressure from an employer client to document findings in a way that minimizes the worker's injury severity. The COHN should:
- Comply to maintain the client relationship
- Refuse and document findings objectively in accordance with professional and ethical standards (Correct answer)
- Omit the injury details entirely to avoid conflict
- Consult the employer's legal team before completing documentation
Correct answer: Refuse and document findings objectively in accordance with professional and ethical standards
COHNs are bound by professional ethics to document accurately and objectively; falsifying or minimizing records violates ethical and potentially legal standards.
Question 7: Which of the following is a KEY difference between the COHN and COHN-S credential?
- COHN-S requires a higher level of clinical nursing education but no occupational health experience
- COHN-S requires a BSN or higher degree and demonstrates advanced education in occupational health nursing (Correct answer)
- COHN-S is only valid for nurses employed in manufacturing industries
- COHN-S focuses exclusively on case management, while COHN covers all occupational health domains
Correct answer: COHN-S requires a BSN or higher degree and demonstrates advanced education in occupational health nursing
The COHN-S (Specialist) designation requires a baccalaureate or higher degree in nursing, distinguishing it from the COHN credential which has a more flexible education requirement.
COHN Occupational Case Management 5
When conducting a telephonic case management call with an injured worker, which action is MOST important at the start of the call?