​Tips For Dealing With Your Virginia Workers’ Compensation Nurse Case Manager

If you’ve been injured on the job, you might find yourself dealing with a nurse case manager.  Nurse case managers are often hired by the workers’ comp insurance company to monitor your medical treatment, progress toward recovery, and your return to work.  Unfortunately, nurse case managers are usually not very concerned about what’s best for the injured worker.  Remember, the insurance company is paying the nurse case manager!  Here are a few tips to help you deal with any nurse case manager assigned to your claim:

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What Does a Workers’ Comp Nurse Case Manager Do?

Often a nurse case manager who works for a workers’ compensation insurance company will be hired to work with an injured worker to various things for the workers compensation insurance carrier. A nurse case manager’s role often includes:

  • Attend medical care appointments with permission from the injured worker
  • Discuss the medical care and a treatment plan for the injured worker with the physician
  • Help with scheduling medical appointments
  • Provide information to the workers compensation insurance carrier about your medical treatment
  • Authorize payment for medical care recommended by the authorized treating physician


Good Nurse Case Manager?

While all nurse case managers are paid by the workers compensation insurance company, that doesn’t mean that all nurse case managers are bad. Some nurse case managers actually try to be helpful to injured workers by:

  • making sure there’s accurate communication between you and the insurance carrier
  • ensuring that you are getting the medical care you need

Unfortunately, in our firm’s experience, the good nurse case manager is relatively rare. Most of the time, nurse case managers try to build a case against you so your workers comp benefits can be cut off, pressure your doctors to return you to work, or talk doctors out of more expensive treatments and surgeries.

Many times a conflict between the injured worker and the nurse case manager arises because the nurse case manager feels the need to try to save the insurance company money. If you are experiencing a conflict with your nurse case manager, be certain to contact a workers compensation attorney right away. If you act quickly, an experienced workers comp attorney can minimize the damage the a nurse case manager can cause.

Nurse Case Managers: Demand A Private Examination

You have the right to a private examination by your treating physician without having the nurse case manager in the room.  A private visit with your doctor will give you an opportunity to discuss your medical issues and questions alone with your doctor.  If the nurse case manager comes into the exam room, you should ask the doctor if you can have some privacy during the appointment.

Often, the nurse case manager will try to talk privately to your treating physician after the appointment.  To prevent this from happening, you should stay until the very end of the appointment.  If the nurse case manager asks to speak to the treating physician privately, you should ask that you be allowed to join in that conversation.

We have seen nurse case managers talk to doctors in private and ask them to change the worker’s restrictions to allow them to return to work.  BUT, the nurse case manager doesn’t tell the worker that they’ve been released to return to work. Then, when the worker doesn’t show up for work, the employer fires him or her.

DON’T FORGET — The nurse case manager is working for the insurance company!

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Don’t Let the Nurse Case Manager Change Your Doctor

Many times, we will see nurse case managers play the “doctor change” trick when the insurance company doesn’t like the doctor who is treating you.  Sometimes, the nurse case manager will say that the doctor you chose isn’t available for a long time but you could see another doctor much sooner.  You should be careful when this happens!  There is a reason why one doctor is suddenly “booked up” but another isn’t.

When this happens, go ahead and take the appointment that’s far in the future.  But, ask if the office receptionist will call you when there are cancellations.  Or, if the office won’t call you, volunteer to call the office yourself on a daily basis.

Unfortunately, there are a few doctors the workers’ comp insurance companies always try to send injured workers to.  A lawyer who’s experienced with Virginia Workers’ Comp cases is going to know who these doctors are and what they will say before the worker even sees the doctor.  Insurance companies pay these doctors hundreds of thousands of dollars each year to give the insurance companies the opinions they want.

Injured Worker: Keep Your Lawyer Updated!

It’s important to keep your lawyer updated about all of your discussions with your nurse case manager, especially if you believe that your nurse case manager is trying to work against you.

Talk To a Virginia Workers’ Compensation Lawyer

If you’ve been injured on the job and are struggling to deal with your nurse case manager, it is wise to talk to a lawyer who is experienced in workers’ compensation claims. At the Ritchie Law Firm, you can talk to us for FREE . . . NO STRINGS ATTACHED! We can give you advice on your claim before you make a decision that could damage your case. Check out our article on “How Much Does a Workers’ Comp Lawyer Cost” here.

For more than 45 years, the Ritchie Law Firm has successfully helped thousands of injured workers navigate the complex workers’ compensation process. The Ritchie Law Firm specializes in serving injury victims. We never represent insurance companies or corporations. If your workers’ compensation case is going to hearing, you will want a trial expert on your side. We are board certified trial specialists through the National Board of Trial Advocacy. The attorney you choose for your workers’ compensation case can make all the difference.

Virginia Workers’ compensation is a complex system that can be very difficult to navigate. Be very careful to make certain that your rights are protected before you sign anything. There is no cost to talk to our workers’ comp lawyers. If we take your case, we don’t get a fee unless we win your case. There is no risk to you to get some information about your case before you make any decision that might negatively affect its outcome.

Choose wisely. . . you can talk to us for FREE.

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