You suffered a work injury and the workers’ compensation insurance company tells you they assigned a Nurse Case Manager (or NCM) to your claim. Is this a good thing?
A NCM can be helpful in setting appointments, referrals, and arranging transportation to appointments. But never forget: insurance companies employ nurse case managers to minimize costs.
Some NCMs have been known to advocate against the best interests of the injured worker. In our practice we have seen nurse managers:
- argue with a physician to change a diagnosis or lift restrictions prematurely.
- “Trash talk” against an injured worker, such as nurse case managers telling the doctor the patient doesn’t want to work, or is just seeking drugs.
- urge a provider to use x-rays for diagnostic purposes instead of an MRI, or to substitute a less expensive treatment protocols.
While the insurance company has the right to assign a NCM to your workers’ compensation claim, you have the right to safeguard your treatment and recovery.
You are not required to allow the NCM into your doctor’s appointments, and we advise against it. Also, you are allowed to be present during any meetings between the NCM and your doctor.
At Putnam Law, we send all nurse case managers an agreement outlining our expectations for their involvement in your care. We insist that any communication between a nurse case manager and a client go through our office. That way, any inadvertent comment made at a doctor’s office cannot be used against you in your claim for benefits.
While a nurse case manager may sound like a good idea in theory, they are one more reason you need an attorney to protect your rights in your workers’ compensation claim.
If your employer or insurance adjuster has assigned a nurse case manager, you should talk to a work injury attorney to discuss your rights.