Who Is the Nurse Case Manager In A Workers’ Compensation Case?

The job of the nurse case manager is to work directly with the individual patient in order to coordinate patient care. The nurse case manager is a registered nurse employed by the insurance carrier. The nurse case manager will often coordinate treatments between multiple doctors, and also keep the insurance carrier up-to-date about ongoing treatments, as well as when you will be medically cleared to return to work.

Since the insurance company pays the nurse case manager it is important that you and your workers’ compensation attorney scrutinize their efforts on your behalf. Too often nurse case managers try to push a treating physician into releasing an injured employee before the doctor should release them. We have also seen them try to convince a doctor not to provide certain types of treatment due to the fear it would cost too much money for the insurance company.

To try an avoid any improper actions by the nurse case manager the North Carolina Industrial Commission has set up guideline and rules they are required to follow. The North Carolina Industrial Commission Rules for Utilization of Rehabilitation Professionals in Workers’ Compensation Claims guides the conduct of nurse case managers.

Because the nurse case manager is an employee of your insurance carrier, it is advisable to discuss any questions about the role of your nurse case manager with your workers’ compensation attorney.