What is a workers comp nurse case manager?
A nurse case manager is a registered nurse who works for the workers comp insurance company. In theory, she is supposed to implement individualized patient care plans and coordinate medical care and treatment. In reality, these nurses are hired by the insurance companies to oversee your case, so you can bet that they're working to reduce your benefits and medical treatment needs with every move.
And, we don't say this willy-nilly, either. During our over 20 years of experience, rarely do we come across workers comp nurse case managaers that are beneficial to our clients. Clients with severe injuries, who need complex medical care coordination with several surgeries, could often use a real nurse case manager - one that's on their side, helping along their recovery process.
BUT, that never happens...
Like many things in the workers comp system, nurse case managers sound like a good idea but are just another way for the insurance company to limit your benefits, treatment and the amount they have to pay you (like vocational rehabilitation).
The workers comp nurse case manager is not working for you.
Nurse case managers try to get between you and your doctor - meeting with the doctor secretly, telling him the insurnce adjuster won't authorize or approve some test or treatment he has recommended for you, saying your job isn't as physically demanding as it really is, saying you tell her you're feeling "fine" so you don't really need more physical therapy, etc. You get the idea.
A busy doctor just relies on the nurse and believes what she is saying. He doesn't have time to call you to see if what she is saying is true or accurate.
Sometimes, nurse case managers cause delay in the entire process. They do this by pushing your doctor to release you back to work before you are physically able to work, conveniently 'forgetting' to follow up, send and request paperwork, questioning every doctor recommendation for tests and terapy, and a number of other tactics.
And, delay in any form brings you further away from getting the help you need. Like this man, who had to wait 8 years before receiving the benefits OWED to him, Anything that delays the process is probably good for the workers comp insurance company and bad for you.
Don't let this happen to you.
Order our FREE report Managing Your Nurse Case Manager here - it's free to anyone who has been injured in DC, MD or VA and has information you need to make sure you're getting all that you rightfully deserve.
Call us today at 202-393-3320 if you've been hurt at work - all we do is represent people who have been seriously injured.