Michigan lawyer explains your legal rights when a workers’ comp nurse case manager has been assigned to the claim.
Many of the injured employees who contact our office want to know about the workers’ comp nurse case manager. Who is this person showing up at medical appointments? Is it necessary to give them a signed medical authorization? Should they be allowed into the examination room? Are they allowed to speak with the doctor alone?
Injured employees are entitled to medical treatment and lost wages regardless of fault. It is no secret that insurance companies want to save money on these claims. This is especially true if benefits have been paid for an extended period.
Watch out for the workers’ comp nurse case manager because they might not be on your side. Insurance companies use them as eyes and ears on the ground. Like everything else, there are good and bad ones. Our experience shows they can make a situation worse if allowed to interfere with medical treatment or manipulate restrictions.
An injured employee need not cooperate with the workers’ comp nurse case manager. Rules to follow include not allowing them into the examination room until after the physical examination is completed. It is also a good idea to make sure they not permitted to speak with the doctor alone.
Here are some guidelines published by the State of Michigan regarding medical case management. Use the following as a workers’comp nurse case manager checklist to make sure legal rights are not being abused. We recommend contacting an experienced workers’ comp lawyer if problems occur.
- Be inclusive of all parties involved in the medical recovery process, especially the injured employee and their family.
- Include goals and time-frames when creating the care plan, and allow for updates as needed.
- Determine if treatment is appropriate.
- Determine if funding for the workers’ comp nurse case manager services is secured before proceeding.
- Determine what is needed for successful return to work, especially from employer’s perspective.
- Provide client advocacy and support at all times, and provide input and guidance on treatment services…BE A LIAISON BETWEEN PARTIES.
- Use valid disability duration guidelines, and use them as GUIDELINES.
- Educate all parties, especially employer, whenever possible on the positive and cost-effective aspects of return to work programs and processes.
- Always obtain and maintain appropriate releases of information prior to beginning services with your workers’ comp nurse case manager.
- Understand that there are many players in the case management process, but that your main client should always be the injured employee.
- Always identify clearly your role as a case manager to the employee at the start of the relationship.
- Give legal advice at any time.
- Schedule IME appointments.
- Change employee’s doctor appointments just to fit YOUR schedule.
- Withhold information crucial to RTW success.
- Perpetuate disability by failing to address doctor recommendations, health concerns, or return-to-work issues in a timely fashion.
- Become personally and/or emotionally attached to the client.
- Assume that you have an absolute right to attend all doctors’ appointments despite client wishes against it.
- Interfere with due process between employee and employer.
- Initiate cost services prior to obtaining carrier authorization.
- Provide legal direction to the claims adjuster, or engage in claims investigative or adversarial activities.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.
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