How Insurance Companies Try To Rip Off Injured Workers: A Series – Volume 3: The Nurse Case Manager

Our Workers’ Compensation Law allows and even encourages insurance carriers to hire ‘nurse case managers’ to handle and direct an injured worker’s medical care in a claim.  Although many nurse case managers are generally good people, make no mistake – they are paid agents of the insurance company, making it heavily debatable whether the nurse could ever really be a ‘neutral’ party in the case.  In a typical scenario, and as discussed in previous blogs, the nurse case manager will contact the claimant in one way or another, often times almost immediately after a work injury occurs, to say that she’s been asked to appear in the case in order to make sure the injured worker gets proper medical care.  The problem with a statement like this is the definition of “proper” medical care.  When the nurse case manager begins directing the medical care in a claim, it is fairly routine, for example, for her to shuffle the claimant away from physicians who are viewed by the insurance company as “claimant friendly”; and to start making appointments for the claimant to see doctors who are well-known in the industry to be “insurance friendly.”  The hope is that by the time the injured worker figures this out, the medical evidence in the case will have already been terminally impaired past the point of no return.  One protection against this is a treating physician who will tell a nurse case manager “no” when she tries to manipulate the claim; but doctors with this kind of backbone are few and far between.  It’s exponentially more helpful for the claimant to be able to rely upon an experienced workers’ compensation attorney who will aggressively tell the nurse “no,” if necessary, which is exactly what Hart Law does.

Have a question about your nurse case manager?  Give us a call, anytime.

Neal L. Hart, Attorney at Law