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  1. #1
    Join Date
    Mar 2021
    Posts
    2

    Default Nurse Case Manager Assigned

    Hi... so, I fell at work and injured my knee, have had an MRI, have issues with tearing. Was assigned a lost time adjuster and nurse case manager. I've tried to educate myself on my rights, and am kind of prepared for what I'm facing (I've already had a few unpleasant conversations with the original workers comp manager and the lost time adjuster that made me feel as though I need to protect myself). My question is this : I have just spoken to my nurse case manager, and while I realize I need to be very careful and make sure she really does advocate for me, she did seem very friendly and stated that she was with an independent contractor and not with either the hospital or the insurance company... is an independently contracted NCM more likely to advocate for you and be on your side?

    My goal is to get back to work at MY JOB asap bc it's in the healthcare field and is constantly changing (we are learning a new system as a speak... well, THEY are... I'm stuck at home)... so if I need surgery, I'm like let's hurry and do it so I can heal quickly, if I just need PT, let's get me back to where I can manage my job somehow. So I'm hoping this isn't a battle. She did say it looked like it probably will be surgery, but that the doctor I'm going to (a great ortho that almost all my coworkers and their families have seen under different circumstances) will read the MRI himself and determine that. So, do NCM that aren't directly working for the insurance company tend to be better for injured workers? What do I need to watch for in terms of protecting my rights?

  2. #2
    Join Date
    Oct 1971
    Posts
    5,189

    Default Re: Nurse Case Manager Assigned

    I realize I need to be very careful and make sure she really does advocate for me, she did seem very friendly and stated that she was with an independent contractor and not with either the hospital or the insurance company... is an independently contracted NCM more likely to advocate for you and be on your side?
    She isn't associated with the carrier but the company she works for is.

    The carrier contracted them to get you off the dough by any means available, she'll stop at nothing.
    Now's the time to lawyer up to act as a buffer between you and this so called "Nurse Case Manager"/ agent for the insurance.
    Be careful of what you do and say around this person, she feeds the P.I investigating your case with info to track you.

    Nurse Case Managers are not your friend, they're hired to close your case and limit exposure to the carrrier.
    Have as little contact as possible with this person until you lawyer up.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,809

    Default Re: Nurse Case Manager Assigned

    I agree with Tony. You cannot trust the nurse any more than you can trust the adjuster.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

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