Workcover isurance case manager are, in my opinion, for the most part, not very nice people in a tough job. They are caught in between the workcover insurance company that wants them to control the claim costs, and you, the claimant, who wants the best or most reasonable benefits you are entitled under the law.
But I’m not nearly as concerned about them as such, I mean, most case managers, as a disillusioned rehab provider observed are ” between the age of 35 – 50 and female… by their anger, frustration and sheer resentment I wouldn’t be surprised if they are also divorced and extremely bitter.” The thing is, If they don’t like their job, they can quit. Nobody is forcing them to be case managers, duh!
I’m mostly concerned about you, the “Worker”, the “claim number”, the injured person, and that includes me.
Let’s face facts here, workcover insurance companies play games and have scams that they use to delay claims and minimise payouts, medical and like treatments and settlements. Injured workers are usually placed under pretty severe financial hardship when they have a workcover claim, especially if the injury is severe and they are unable to return to work or at least for a long time.
Few of the injured people I’ve ever met who had orhave a workcoverclaim could or can afford their day to day living expenses, let alone their medical costs etc. out of their own bank account. Most of the time, people depend upon the benefits and eventual restitution they receive from the insurance company.
Workcover insurance companies know this, and rely upon it. They know that delays will place pressure on injured workers (and their families) and that makes them more willing to accept less benefits, fore-go certain entitlements (e.g physio, home help, special appliances etc) , pay for medical account themselves, accept lower settlements offers etc.
Yesterday I posted a blog about a nasty, most evil email my case manager sent me (probably by mistake, as it was addressed to the RTW coordinator). This blog post has been proven to be very popular (many many people have read it) and today, after having spent an entire night brooding about it, I want to put a spin on that article and make a more obvious point and that is: How can we best deal with a workcover case manager?
The following tips were emailed to me anonymously by an anonymous “insider”:
Dealing with workcover case manager
When you are dealing with a (nasty) workcover case manager, make sure that you are ALWAYS pleasant, well-mannered, and polite. You can’t control them, but you CAN control YOU.
You need to “nice them to death!” Make sure you are doing the following:
- If you have to deal with the case manager via phone, speak calmly whether in person or by phone, no matter what your level of frustration may be. Record the telephone conversation.
- It is best to avoid phone discussions where possible and ensure all is done in writing, that way you have evidence of what was ‘said’ and by ‘whom’.
- Make your requests for payment, documents or any other requests politely, and make them in writing.
- Be firm but respectful when you are using a claim strategy. Being demanding will only make the case manager feel threatened, and he will want to resist your demand to prove s/he cannot be controlled by you.
- When you write a letter, be sure that you are polite and respectful. Simply state what you want them to do and remember to say “please” and “thank you”…just like your mother taught you.
- Do not, under any circumstances, lose your temper! Words said in anger are impossible to retract. You can apologise as much as you want, but better to say things for which you will not have to apologise. Be in control. If you feel like blowing up at your adjuster, end the meeting or phone conversation and come back another time to finish your business.
Don’t bother dealing with them on the phone, assume they’re out to “put words in your mouth” and give yourself plenty of time to respond, think it over, get someone to proof read it, and demand they send all correspondance by letter also.
Take note of when you sent letters, and if they haven’t responded in a timely manner, send another letter requesting a prompt response to your previous letter.
Be super-organised. Have a file, have a spreadsheet, scan your receipts, and keep track of what’s been paid, by whom, when, how and the response from the insurance company in terms of reimbursement.
It’s a huge huge burden for people who should be focusing on getting better.
Ben.
It is a f*cking full time job, isn’t it! You should see the amount of files I have! Not to mention the amount of gigs on my hard drive… and the miserable amount of f*cking time I spend 1-handedly scanning all the paperwork into my computer and filing/labeling all the correspondence as to not “leave any stone unturned”. It shouldn’t have to be like that! It’s really like we ARE criminals and have to run our own DEFENSE 24/7. Terrible… considering the lives we lead. Yet, if you don’t keep meticulous track, the bloodsuckers will come and bite you down the track with some most outrageous lie.
Just like in yesterday’s vile email from my case manager, where she states that I never sent the account, well I did and thank God I kept the fax, scanned, filed. dated, f*cking stamped, sealed, whatever.
Private comment.
Surely hope she’s not my case manager’s identical twin! I have decided to up the ante formally and to get rid of mine! Good luck!
They’ll just rebrand her “Customer Adviser”
Nah, seriously, there’s no reason ANYONE should be scared of their case manager. They have a lot of rules to work within, you just need to find these rules and hold them to account.
The problem is that most people seem to be very scared of their case manager. Don’t be. Give them as good as they dish out.
It’s abusive of victims to require them to “give as good as they dish out” … the case manager is well supported, computer systems, managers, instructions, assistance, 9-5 style job with the clear intent to abuse the reasonably read intent of the law.
Victims often don’t have their time, their sanity, are usually affected mentally by drugs and pain…. Expecting them to be even able to compete wtih a case manager like that is medically unhealthy. Doctors really should be gonig into bat for victims here — they know outstanding claims and beaurocratics reduces peoples chances of healing due to the extra stresses, makes pain worse through that stress response, and so on. Doctors should be agressively fighting to insulate victims from said issues for medical reasons — yet they dont, because they’re also a cog in the machine, they need to feed their families, and they know making waves results in a variety of persecutions. Some doctors worse than others. But there’s no doctors that are agressively pro-victim, unlike the agressively pro-insurance IME’s. At best there are “balanced” victims doctors – and that’s at best – they’re usually scared of the politics and law involved, and so back down from fighting for victims health.
Getting things written on paper from even a good doctor is practically impossible — they know it can be used as evidence and expect to be able to run it past their lawyer, which means you get poor proof of needing the treatments prescribed, and the insurance gets another reason to deny treatement because you don’t have documentation to prove why you need the treatement. Lawyers can get it on paper from doctors, but doctors often charge a grand for each report. Sometimes much more. It’s an expense that victims should be liable for. But are.
Ben.
Most case managers have voice recorders, I agree with the points raised – a neutral co-operative voice control – repeat back to them their request and do not sign anything !! without consulting your legal advisor.
Make sure you have a certificate covering the weeks and months ahead and talk it over with a close friend – as the calls and threats are extremely upsetting and abusive – rang a solicitor on one call and said if a call was not placed to the offender other remedies would be applied – and was prepared to go all the way.