Nurse Case Manager Misconduct

Have you been hurt at work and the insurance adjuster assigned a nurse case manager to accompany you to your medical appointments?

A nurse case manager is a nurse who is supposed to take a look at a workers compensation claim from a broad view, considering both the medical and legal aspects of the case. Some of the duties of a nurse case manager include:

• schedule appointments
• act as a liaison between the injured worker, medical provider, employer and workers’ comp benefit provider
• ensure the doctor keeps the employer/insurance agency informed of recommendations including work restrictions
• help facilitate care suggested by the medical provider.

Unprofessional nurse case manager example

We represented a worker who had a nurse case manager attend all doctor’s appointments with him. Before the nurse case manager’s involvement, the injured worker felt like he had a good relationship with the doctor that was treating him. Once the nurse got involved, the client felt that the doctor treated him differently and that the nurse controlled the medical visits. The doctor would defer to the nurse regarding treatment choices, such as authorizing an MRI and even the Permanent Partial Impairment (PPI) rating.

The Indiana Workers Compensation Act does not currently regulate the conduct of nurse case managers. However, if a nurse acts improperly, that can result in sanctions being issued against the insurance company. We have seen nurse case managers that attempt to manipulate the medical care being given to our clients. Instead of helping the injured worker recover from his injuries, the nurse case manager is acting in the best interest of the insurance company to expedite treatment and minimize benefits.

If you have a situation where a nurse case manager is controlling your medical care, we can help. Call us at (317) 569-9644. Don’t let a nurse case manager impact your medical care.  Get the treatment and rehabilitation you deserve.

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