Why has a nurse case manager been assigned to my case?

Once your workers’ compensation case is accepted and payments have started, it is very common for the insurance company to assign a nurse case manager to your case. The role of the nurse case manager is to monitor your medical treatment and report back to the insurance company. While the nurse case manager may tell you he or she will be assisting with your medical care, you must remember that the nurse is working for the insurance company, not for you.

male nurse case manger

How to protect yourself if you are assigned a nurse case manager

After a nurse case manager is assigned, there are things you should do to protect yourself:

  • First, if the nurse shows up to your doctor’s appointment always insist that you be examined by your doctor alone. Do not let the nurse back into the exam room with you. If the nurse attempts to enter the exam room, tell your doctor that you want privacy during the examination.
  • Second, tell your doctor that you would prefer it if he or she did not talk to the nurse. If your doctor does talk to the nurse, be sure that you ask to be present during those conversations.
  • Lastly, be mindful of what you say to the nurse as it will be reported straight back to the insurance company.

nurse case manager helping a patient

Be mindful of your nurse case manager’s role

The main goal of the nurse assigned to your case is to try to get your doctor to release you to return to work. Many times, the nurse will talk to your doctor after your exam to convince the doctor to change your work restrictions. You may leave an appointment with an out-of-work note only to find out later that the nurse convinced the doctor to release you to return to work. This is why it is so important that you insist on being present when your doctor communicates with the nurse.

Another thing the nurse may do, is to try to convince you to change treating doctors. Do not agree to change your treating doctor. Even if the nurse tells you that your doctor cannot see you for several months, do not agree to see another physician. Simply tell the nurse that you will ask to be put on the cancellation list to get an earlier appointment.

The nurse may also present your doctor with a description of your pre-injury job. These job descriptions are often incomplete or misleading. Make sure you give your doctor a complete breakdown of all the physical requirements of your pre-injury job. This will help ensure that your doctor is not duped by an inaccurate job description from the nurse.

If you have been hurt on the job and are dealing with a difficult nurse case manager, call the experienced workers’ compensation attorneys at Allen and Allen. We are here to help protect your rights. Call for a free consultation today at 866-388-1307.