Why you don’t want a nurse case manager assigned to your workers’ comp case

I’m often asked the above question from a workers’ compensation adjuster or from a nurse case manager (NCM) assigned to one of my workers’ comp claimants after I’ve asked the adjuster or defense counsel to cease sending an NCM to medical appointments with my client.  Why do I do this?  Look at the below note sent by an NCM to the authorized treating physician (ATP) on an accepted workers’ comp claim:

 

The NCM’s name is Kim Williams.  If you can’t make out the language above, she’s telling the patient’s doctor that the patient is “doing everything she can to not have to work” after her surgery.  This is a lie.

Ms. Williams goes on to beg the doctor “NOT [to] take her out of work” and then explains that despite the fact that she has been “removed from her case” she is “working the file on the backside.”

I hope you find this appalling, as I do.

Here is a woman with a legitimate, accepted workers’ compensation injury.  She’s had surgery.  She’s supposed to be recovering.  But what does the nurse assigned her case want her to do?  Stop getting treated and be sent back to work, so that the insurance company can save the money it would otherwise have to pay in benefits while the patient recovers from her surgery.  I hope Ms. Williams loses her nursing license over this and that the insurance adjuster (if he/she is “in on it”) does as well.

I release NCMs from my clients’ cases because they lie about my clients to their treating doctors, try to manipulate the medical care delivered by the ATP, and consistently show zero interest in helping the client recover from his/her injuries.  Instead, as Ms. Williams is attempting to do “on the backside” in the note above, they actively work to deny the patient’s progress in healing, even after the NCM has been released from the case.

If you’ve been hurt at work, and the insurance adjuster has assigned a nurse case manager to accompany you to your medical appointments, fire the nurse.  She is not attending your appointments to help you get better.  She is not acting as a medical provider, but rather an agent for the insurance company that wants to cut off your medical care and benefits.  Make sure your doctor also knows that he/she should NOT communicate with the fired NCM, too, in case your NCM is as sneaky and dishonest as Ms. Williams from Integrated Care Management appears to be while “working the file on the backside.”

Feedback

  Comments: 3