Has the Workers’ Compensation Insurance Company hired you a Nurse Case Manager or a Field Case Manager?
Workers’ compensation insurance carriers will often hire registered nurses to oversee an injured workers’ medical treatment. These nurses are referred to as “nurse case managers” or “field case managers.”
If you have a workers’ compensation case and were given a nurse case manager—watch out! Nurse case managers work for the insurance company and they are looking to save the insurance company money at your expense.
You should immediately contact our workers’ compensation lawyers if you have experienced any of the following situations with nurse case managers:
The nurse case manager has asked me to sign medical authorizations.
Nurse case managers will use signed medical authorizations to obtain and review your medical records unrelated to your work injury. Nurse case managers will share your unrelated medical records with the insurance company. The nurse case manager and insurance company will then use any and all information contained in these medical records as an excuse to refuse paying you the workers’ compensation benefits to which you are entitled. You should never provide a nurse case manager a medical authorization without first consulting with our attorneys.
The nurse case manager attends my doctors’ appointments.
You have a right to obtain your medical treatment and speak to your treating doctor without the intrusion of a nurse case manager. You should never permit a nurse case manager to be present while you are being examined by your treating doctor. It is important that you have an open line of communication with your treating doctor. While the top priority for and your doctor is your recovery from your work injury, the top priority of the nurse case manager is saving the insurance company money and denying your workers’ compensation benefits. Doctors know the nurse case manager’s motives and the obstacles they create. Your doctor will thank you for not allowing the nurse case manager to interfere with your medical care.
The nurse case manager talks to my doctor outside of my presence.
When you are injured at work, you do not give up all rights to medical privacy and HIPAA rights. While the insurance company has certain rights to your medical records, a nurse case manager does not have a right to your private medical information without your approval. When a nurse case manager talks to your doctor outside of your presence, the nurse case manager is simply trying to pressure your treating doctor to take action that will result in savings to the insurance company regardless of whether such action is in your best interest. For example, nurse case managers will attempt to pressure your doctor to release you back to work before you are ready or to delay important medical testing (e.g. MRIs and EMGs). Make sure it is clear to your doctor’s office that your private health information should not be shared with a nurse case manager.
The nurse case manager chooses the doctors I go to see.
Nurse case managers are familiar with the workers’ compensation system and they know the doctors that are on the side of the insurance companies. If a nurse case manager is selecting the doctor you see, they are likely referring you to a doctor that is on the side of the insurance company. These doctors, just like the nurse case managers, are more interested in saving the insurance company money than they are with your well-being and medical recovery. The Workers’ Compensation Act outlines the rights an injured worker has in selecting their treating medical providers. Know your rights and select a doctor who cares about your health and recovery.
The nurse case manager schedules or cancels my doctors’ appointments.
A nurse case manager has no right to delay or cancel your needed medical care. This is a blatant example of a nurse case manager caring more about the insurance company saving money than you obtaining your necessary medical care. Often times nurse case managers will reschedule your physical therapy or doctor’s appointments to coincide with insurance companies efforts to conduct video surveillance of your activities. This allows the insurance company’s private investigator to know exactly where you are going to be at a specific time. This makes recording you very easy. Typically the private investigator will arrive at the appointment before you do so that they can begin recording you upon your arrival. They will then follow you in their vehicle after the appointment to video your activities until you have returned to the comforts of your home.
If you have a workers’ compensation injury and your medical treatment is being sabotaged by a nurse case manager, our workers’ compensation lawyers can protect your rights and prevent the nurse case manager from interfering with your recovery. From our offices in Erie, PA, and Smethport, PA, we protect injured workers throughout Pennsylvania.