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What is a Nurse Case Manager?

Please understand, this is by no means a knock on nurses. My mom is a nurse and I believe nurses are heroic. However, in a workers’ comp case the insurance company paying for treatment sometimes hires what is called a Nurse Case Manager, or NCM, to monitor claims.


The NCM will be tasked with talking to you about your injury, reading your medical records, talking to your doctor, and sometimes sitting with you during your doctor’s appointments and procedures. Is this a good thing?


The answer is, it could be if the NCM were acting solely as your advocate, like your attorney will be. Unless they were appointed as a neutral NCM by the commission, there is a glaring conflict. They are hired by, paid by, and reporting to the insurance company.


Do you have to allow the Nurse Case Manager to be involved in your claim? Absolutely not. You have privacy rights when it comes to your treatment. Our policy is to advise clients not to allow a Nurse Case Manager to do anything more than obtain records and help schedule treatments. Sometimes we don’t even allow the latter.


Let me know if you have any questions and have a great day!


Kevin

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