Do I Need A Nurse Case Manager?

Maybe. My general rule is that the more complex the injury, the more helpful a nurse case manager may be. For a simple rotator cuff injury or a back sprain that may only last a few months, a nurse case manager is probably not required. However, if there is a complicated surgery in which any claimant may need special accessories such as some type of a back brace, a hospital bed, or accommodations in the shower, then a nurse case manager may indeed facilitate the patient’s recovery.

If I allow a nurse case manager to participate in the care of a patient/claimant, I do so under very stringent guidelines which I make the nurse case manager agree to and sign before the nurse case manager can become involved in the case. If the nurse case manager will not adhere to these guidelines and sign, I will not allow him or her to participate in the case any further. For example, I do not allow the nurse case manager to be present in the examination room during the examination of the claimant. For one thing, this destroys the doctor/patient confidentiality. In addition, it is completely inappropriate.

If you decide allow the nurse case manager to participate in your case, you must always remember that the nurse case manager is a double agent. Anything that you relate to him or her is not confidential and you can assume that it will be conveyed to the adjuster. You should also remember that the nurse case manager’s ultimate allegiance is to the carrier since it is the carrier who pays the nurse case manager, not the claimant.

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