Tag Archives: nurse case manager

Dirty Tricks Employers Use To Keep You From Getting Benefits

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Tom’s post on how to protect your rights is crucial for every worker to read before they get hurt at work. Know your rights, and beware these dirty tricks that employers use to keep you from getting your benefits.

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Today’s post is by our colleague Tom Domer from Wisconsin.

Over the course of 35 years representing injured workers, I have heard some whoppers – Employers’ questionable tactics that make even my jaw drop.

With all the insurance company generated blather about “employee fraud”, incidences of employer fraudulent tactics abound.

Workers beware of the following:

  • Recorded statements taken by worker’s compensation carrier adjuster while employee is under medication or in the hospital still suffering from the injury. Questions such as “It’s true you had (low back pain, arm pain, fill in the blank pain, etc.) before your work injury, correct? You’ve had lots more pain from (your motor vehicle accident, sports injury, etc.) than you’re experiencing from your work injury, correct?”
  • Employer “channeling” a worker to its “Return to Work Clinic” (doctors on company payroll whose opinion is “like some athletic coaches, ‘rub some dirt on it and get back in the game’.”
  • Telling employees to take sick leave rather than claim worker’s compensation.
  • Telling employees to file medical bills under their group insurance, not worker’s comp.
  • Nurse Case Manager who initially befriends the employee, but later makes every attempt with the worker’s doctor to prematurely return the worker to the job before a healing occurs. Continue reading

Should I trust the nurse case manager for my workers’ compensation claim?

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Some nurse case managers may not be acting in your best interests.

The short answer is, “be careful.”

In many workers’ compensation claims, an insurance adjuster hires someone called a nurse case manager, or NCM. The workers’ compensation insurance adjusters claim that the purpose of the NCM is to help coordinate doctor appointments or work as a go-between with the adjuster and the injured worker.

Simply put, it’s important to remember where the NCM’s paycheck comes from: the insurance company.

Often times, however, the NCM will attempt to direct you to doctors that might not be in your best interest for treatment purposes, or direct you to doctors that are well-known to release patients back to work before they’re ready. Similarly, the NCM will attempt to influence your doctors into signing reports that may be detrimental to your workers’ compensation claim, or worse: your health.

Even the Supreme Court of Nebraska has stated that NCMs hired by the insurance companies are not considered a benefit to the injured employee.

Simply put, it’s important to remember where the NCM’s paycheck comes from: the insurance company. Consequently, a good “result” for a NCM (released back to work with no additional medical treatment) might not be a good “result” for you. So be careful. Just because your NCM claims that he or she is acting in your best interest, that may not actually be true.