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Can I Trust My Nurse Case Manager?

In Tennessee, not every injured worker is going to interact with a nurse case manager, but many do. I can’t count the times a new client has expressed some concern about whose side the nurse case manager is on. I tell people to be careful who they trust, and remember who hired the nurse case manager.

In theory, a nurse case manager’s job is to monitor the progress of a claim, help coordinate appointments, act as a middle-man between the injured worker and the insurance adjuster, and help educate and assist an injured worker through their claim. Many nurse case managers do this and are patient advocates, making sure things run smoothly for the injured worker.

Unfortunately, there are also nurse case managers who turn out to simply be advocates for the insurance company. Recently, a client told me that he only decided to hire an attorney because his doctor had initially assigned him temporary lifting restrictions of no lifting greater than 10 pounds. The nurse case manager told the doctor to change the restrictions to 30 pounds. The doctor listened to the nurse case manager and changed his temporary restrictions. The client felt like he couldn’t trust the doctor any longer if he was just going to parrot what the insurance company wanted him to say.

In addition to potentially trying to re-direct a doctor’s treatment, nurse case managers might try to steer injured workers to insurance-friendly doctors and try to keep them from researching their full choice of doctors on their own. A nurse case manager might even try to get a doctor to release an injured worker to return to work after surgery, but before they are ready.

Because you never know what kind of nurse case manager you’ll get, it is always good to err on the side of caution and remember that what is in your best interest might not match up with what is best for the nurse case manager and the insurance company. To that end, we routinely tell our clients to tell nurse case managers to waiting outside while being examined by the doctor. The nurse case manager can speak with the doctor after the appointment. It can also be helpful to stick around after an appointment and listen to what the doctor and the nurse case manager talk about.

The best thing you can do with regards to a nurse case manager is talk to your lawyer about how you should handle the situation. Here at Rocky McElhaney Law Firm, workers’ compensation is one of our areas of expertise.  Our team of lawyers has the experience to know how to help you avoid some of the pitfalls that can happen when a nurse case manager is involved. If you’ve been injured and are concerned about a nurse case manager not having your best interests in mind, give us a call.