A Case Manager is Appearing for
My Medical Appointments

The Nurse Case Manager assigned by the workers' compensation insurance company is not your friend. The case manager is not involved in your case to make things easier for you or to help ensure you get the medical treatment you need, even if that's what she told you. Her job is to save the insurance company money in the long term, and to act as a spy in the short term. She may try to convince you she is on your side, playing "good cop" when the adjuster is "bad cop" -- but all the while she will be reporting to that same adjuster and working with the insurance carrier, putting in place a strategy to hold down the costs of your case, even if that means stabbing you in the back.

When an insurance "Case Manager" starts showing up at your medical appointments, the fix is in. Their role is to try to limit how the doctor writes up your visit, influence how he documents your work limitations, and to send the doctor a signal reminding him to play nice with the insurance company if he wants to see his bills paid or wants to get more insurance-referred patients. A case manager may appear early, for an injury that is documented as serious very early in treatment, or may appear as the case begins to approach ninety days of captive treatment, where the insurance company wants to increase pressure on doctors to release you back to work or to increase work capacity clearances if you are on light duty. Sometimes, the insurance company will introduce a case manager only after the injured worker has gone beyond ninety days with a disabling work injury, either to inspire the injured worker to continue with "panel" doctors under the insurance carrier's control even when that is no longer required, or to add some pressure upon any outside doctor who is not seen as helping the insurance company's cause. The nurse case manager works with the insurance adjuster to limit your rights by influencing the medical evidence and documentation in your claim. You need someone on your side to counter these moves so that your rights can be secured and so the value of your claim will not be undermined when you have a serious work injury. Call us, and we can explain how to:

  • Keep the nurse case manager assigned to your case from unfairly influencing how your doctors handle your injury or how they document your claim

  • Avoid unfair "case management" practices that work against your interests

  • Turn the tables on a case manager and have THEM help YOU spy on the adjuster in your case

Like it or not, your rights are at odds with the insurance carrier handling your employer's workers' compensation liability once you have suffered a work injury. The insurance company has a staff of people and outside contractors, as well as pet doctors, to do their bidding and work to downplay your injury and limit the value of your claim, to restrict your rights, and to reduce their own potential liability for the effects of your injury. Their biggest goal is to press you back to work, whether you are ready or not, and without regard to whether that may leave you working in pain every day or unable to compete with fully fit and healthy co-workers as you struggle with long-term effects from a work injury.  You need sound, savvy advice and guidance on your side of the claim to help secure and advance your rights, to overcome the intended harmful effects of even seemingly "well-intentioned" case management. Call us to learn more.

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Don't Wait for Trouble Before Contacting Us

Getting us involved early costs you nothing. We work on a contingency, and we only get paid when we win for you in court or negotiate a lump sum settlement you approve. We can help position your claim so that you may avoid a fight in court, while at the same time strengthening your position for a large lump sum settlement. Call us now to find out how.
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