April 20, 2019

Insurance Adjuster Attempts to Use Nurse Case Manager Against Injured Worker’s Interests

illegal actions by workers compensation adjusterThis past July, I discussed on this blog issues related to the participation of a nurse case manager in a Georgia Workers’ Compensation claim.   In that post I pointed out that insurance adjusters sometimes assign a nurse case manager to a particular claim.  The nurse case manager is not an adjuster, and they do not deal with issues related to wage benefits.  Instead, they deal with the medical component of your case only and a nurse case manager can be helpful in setting up medical appointments, coordinating transportation to and from doctor’s visits and working out issues with prescriptions.

Issues arise when the nurse case manager tries to influence your doctor about signing off on a return to work release or suggesting to the doctor that he include in his reports statements which say that your pain has subsided and that you are doing better.  Some nurse case managers even try to influence the drug prescriptions written by the doctor.  Others appear at each one of your appointments and try to stay in the room when your doctor examines you.  You have the absolute right, by the way, to insist that your nurse case manager step outside during your examination and conversations with your doctor. [Read more…]