Who Are Nurse Case Managers?
Nurse case managers are registered nurses hired by workers’ compensation insurance companies to coordinate and monitor the medical care of injured workers. They serve as intermediaries between injured employees, healthcare providers, and insurance carriers. Their primary goal is to ensure that appropriate medical treatment is provided efficiently, which can also help reduce costs for the insurer.
What Do Nurse Case Managers Do?
In a Mississippi workers' comp claim, nurse case managers often:
- Coordinate Medical Care: Arrange appointments, ensure compliance with treatment plans, and facilitate communication between doctors and the insurer.
- Attend Medical Appointments: With your consent, NCMs may attend your appointments to stay informed about your condition.
- Monitor Progress: Track your recovery to ensure timely treatment and return-to-work planning.
- Report to the Insurance Carrier: Provide updates on your medical status and treatment outcomes.
Your Rights When Dealing with a Nurse Case Manager
While nurse case managers play a critical role, it’s important to remember they are hired by the insurance company and may prioritize their employer’s interests over yours. Here’s what you need to know about your rights:
- You Control Access to Your Medical Appointments:
NCMs cannot attend your appointments without your permission. If you’re uncomfortable with their presence, you have the right to refuse. - You Can Choose Your Treating Physician:
Under Mississippi law, injured workers are entitled to select one physician of their choice for treatment, in addition to the employer's initially chosen provider​. - Protect Your Privacy:
While NCMs are allowed to communicate with your doctors, they must respect your privacy. Be cautious about sharing sensitive information directly with them. - You Can Have an Attorney Present:
If you're unsure about an NCM's role or feel pressured, consulting with an experienced workers' compensation attorney can provide clarity and advocacy.
When to Be Cautious
Although nurse case managers can help streamline your medical care, potential issues may arise:
- Conflicts of Interest: Their primary allegiance is often to the insurance company, which could influence their recommendations.
- Pressure to Return to Work: NCMs may push for an early return to work, even if your recovery isn’t complete.
- Influence on Medical Decisions: Some NCMs might try to sway doctors’ opinions to align with the insurer’s interests.
How an Attorney Can Help
Navigating workers’ comp claims can be daunting, especially when dealing with a nurse case manager. An experienced Mississippi workers’ compensation lawyer, like Jennie Eichelberger, can:
- Advocate for your best interests.
- Ensure your rights to medical privacy and appropriate care are upheld.
- Address any concerns about undue pressure from the insurance company or its representatives.
For personalized assistance, contact Eichelberger Law Firm to schedule a consultation. Protect your rights, focus on recovery, and let us handle the rest.