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  1. #1
    Join Date
    Oct 2010

    Default Nurse Case Manager Problems

    I have a NCM who has went behind my neurosurgeons back several times to got the doctor from the IME who had not seen me since Jan. 2010 to write orders on me. My neurosurgeon go so mad that he has decided to issue the MMI rating and I am still having pain and weakness due to the injury to my back. Not just once but several times she has had the nurse for my neurosurgeon to put me back to full duty. Is anyone else having problems like this with their NCM? Also the first 2 appointments that I had with the Dr of the IME she talked her way into the room and was suggesting treatments to the DR. When she could not get the DR to try a placebo on a selective nerve root block, she tried to go over the doctors head and tried to go to the radiologist to have them do a placebo. Is this legal for the NCM to interfere like this? And are there any legal repercussions for her having my WC checks shut off on several occasions?

  2. #2
    Join Date
    Feb 2007

    Default Re: Nurse Case Manager Problems

    Doctors certify your eligibility for benefits, not NCM
    Radiologists don't do treatment, they read MRI, X ray, CT scans and interpret the findings.
    If your Dr Neuro is not strong enough to stand up to a "nurse"/NCM, it's probably time to consider a change in treating physician. And Dr who would simply dismiss any patient at MMI because a NCM interferred isn't a Dr I think I would be comfortable with.
    I am still having pain and weakness due to the injury to my back.
    Pain/weakness is not necessarily reason you cannot perform sedentary work, or light duty if your ER can provide the accommodation. 'Pain" in itself is not a ''disability''. If you are stable from the injury/treatment, you would be MMI/Max Medical Improvement has been reached.
    It would be appropriate to be rated for PD/impairment, and your return to gainful employment attempted.
    Not just once but several times she has had the nurse for my neurosurgeon to put me back to full duty.
    Nurses do not change your status...only 'doctors' can do that.

    If you don't have an attorney, might be a good time to consider consultation.
    And are there any legal repercussions for her having my WC checks shut off on several occasions
    Atty can answer that... "legal" repercussions are dependant upon the reason for benefits being delayed. If there is any Dr/medical report saying you no longer need wage loss benefits, they will stop. Apparently, the IME has said you are MMI and able to return to work in some capacity. So it's not necessarily the nurse who has caused this.

  3. #3
    Join Date
    Jul 2008

    Default Re: Nurse Case Manager Problems

    I hope you have a work comp attorney. If you have no one to CYA, they will take advantage of you!!! It will cost you nothing up front...
    Never doubt that a small group of thoughtful, committed citizens can change the world...indeed...its the only thing that ever has - Author Margaret Mead

  4. #4
    Join Date
    Oct 2010

    Default Re: Nurse Case Manager Problems

    This particular NCM kept telling my DR that they needed me returned to work. On 10/20/10 I found out that I had been terminated 13 days after my injury. I found out because I requested a document that had been dated on a Sunday that I had been terminated. But she sent it out a day before my last medical appointment. At that appointment she told me that they dis not know if I had been terminated. I have all this recorded! Buit when I requested my med record she told me that they do not have to follow HIPPA regulations. Is this true?

  5. #5
    Join Date
    Jan 2010

    Default Re: Nurse Case Manager Problems

    Yes, it's true...they do not have to follow HIPPA guidelines. Either way, you better look into FMLA a bit. They can not fire you until after you are out for 12 weeks. FMLA is a given. If you did not fill out the paperwork or request it, your employer has to. If they did not, they are in violation. FMLA is the ONLY job protection you have, but ONLY for 12 weeks from the date of notification (yours or theirs). Believe it or not, FMLA violations are taken pretty seriously by the EEOC (federal) or your state level Human/Labor Relations Commission. I had a cause to go to my state level Human Relations Commission about 7 years ago, when I injured myself at home (totally unrelated to this injury). My Employer at the time waited about 2 weeks and wrote me a letter of termination because I had run out of sick leave and did not come back. I kept them up to date on what was happening about every 3 days. They never mentioned FMLA nor did I. When I got the termination letter, I called them back and then requested my FMLA, in which they stated "too late, you are terminated." I promptly cut and paste the area on FMLA website and emailed it to the HR person (you KNOW they either thought I was stupid and tried to get one over on me or they didn't know THAT part existed) and again requested my FMLA papers be sent to me. I gave them about a week to respond. Then I called the Human Relations Commission. There was an investigation. They paid dearly for that, because if there is a complaint and they are found in violation of this one incidence, then the investigator is obligated to view all records company wide and report. There was a fine involved and restitution not only to me, but for who ever else there was a violation against. They went back as far as 5 years. So you can imagine.

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