Things that annoy the sh*t out of workcover case managers

In this article we cover yet another few “buzzwords” which are guaranteed to annoy the sh*t out of virtually any workcover case manager. The supposedly “lighthearted” (but true) content was provided to us via an informal interview with a former Allianz case manager… So here we go…

Things that annoy the sh*t out of workcover case managers

1. Fibbing about never having had an injury before

Apparently, according to the former Allianz workcover case manager, there is always some distrust between an injured worker and an insurance case manager at the beginning. The reason case managers are distrustful of a “claimant” is that they wrongfully believe that many injured workers are frauds and seeking nothing more than a “free holiday”. Many case managers also believe that quite a few injured workers “make a career of claiming workers compensation benefits”, “yes really”, says our insider!

Many “claimants” also get on off on the wrong foot with a case manager and this is understandable. Many are genuinely scared of the unknown and many injured workers have heard horror stories from other injured workers, and naturally worry that they will not be entitled to certain benefits or that their claim will be rejected.

The former Allianz case manager also thinks that “most people feel that all workcover insurers “share” information on people. That is true to a point”. Case managers will – always -run through the “motions” and do an “initial but thorough background check with just about every claim they receive”. The insurer does this to protect itself against “fear of the unknown” – so they say – but in actual fact they do so to find any way possible to reject liability and compensability for a workplace injury. “This is just part of the initial claim set up”, says the former case manager. “It’s about business”.

The former Allianz case manager also tells us that honesty is her best advice. “Just because you have had an injury that that particular body part, or that you happened to have had a previous workers compensation claim, does not necessarily mean that your claim will be doomed”. The problem is that “case managers are obliged and will snoop in your past medical history and conduct thorough background research on you”. “If they find injuries or claims in your background and you have not shared those with the case manager or the insurer, it will become a big beacon on the radar”.

“Rest assured that the case manager will go the distance in overturning every single rock they have to in order to feel they have completed a thorough investigation”.

Her advice is to be “honest” as best you can and to report all previous injuries, no matter how insignificant. That way, they can never ever “blame” the injured worker of “hiding something”.

“Case managers take it as a point of pride that the claims they pay are legitimate”, if you know what I mean, says the former case manager.
2. Sighing and grunting on the phone (WTF)
According to our insider, nothing more annoys the sh*t out of an Allianz case manager than to sign, groan or moan on the phone whilst talking to a case manager (WTF). She says that many [evil] case managers do not understand what PAIN is and for example do not understand that “a serious laceration or a broken leg” can make you groan on the phone, especially when the said case manager is asking you to move about and sift through some paper work, looking for “information” etc.
Many case managers will make fun of injured workers after a telephone call and state things such as “another one looking for an Oscar in pain performance”,

” Please do not drive the point home by being unable to complete a sentence without groaning in unbearable pain. I understand there is pain, but can a decent laceration, a bee sting, bruise, broken bone be that disabling? Sure everyone has their own pain threshold, and some people can deal with pain better than others deal, but again please just act f *cking normally. There are no Oscars for pain performance”!!!!!

What’s more, many case managers will deliberately sift through an injured worker’s medical reports to see whether a doctor or even an IME has in fact indicated that the pain is in proportion to the injury! If the notes indicate that the pain (as in groaning, moaning, etc) appears out of proportion (i.e the so called Waddel signs), the case managers will believe that the injured worker “is over the top” and will be less likely to believe an injured worker. You will then be flagged as a “malingerer”, she says!

3. Demanding 24/7 medical attendant care

Fact is that insurers and as such case managers prefer – at all cost – to use the husband or wife as a carer for assistance with activities of daily living. Even WorkSafe Vic has guidelines about the provision of, for example, home help, whereby it insists that the husband/wife must take care of the injured worker and for free! Obviously case managers will go to great lengths to exploit the use (abuse) of the spouse as a carer, instead of bringing in outside vendor and person to do this work for them, at a cost (labour).”Much cheaper that way”, says our insider.

Some injured workers will, understandably, argue that it is not up to their full time working spouses to care for them (as a free carer) and to undertake all the household work as well as the personal care for the injured worker. Especially, given that most injured workers were in fact doing those duties (or part thereof) prior to their injuries.

According to the former Allianz case manager, “nothing will irritate the case manager more than receiving an account for 24 hrs per day, 7 day per week attendant care”. Obviously this is not reasonable or acceptable. But, saying that we believe that the spouse should not be made responsible to be made the sole non-paid carer (cleaner + attendant) for an injured spouse!

Also, according to our insider, “some injured workers will demand more home help or attendant care than they should in the view of uneducated case managers”. “The more the issue is pushed, the more of a red flag the case manager will raise that there are some secondary gain issues going on”. WTF!!!

Most case managers believe that if you are not a quadriplegic, you should be able to “care for yourself” or “made to care for yourself” with things such as long handled toilet brushes, a light hoover and a long handled bathroom scrubber!

4. Lying about transport or kilometers to be reimbursed
Case managers will go ape when an injured worker is traveling 50 kilometers to go to a physio or rehab facility (whatever). Apparently, if an injured worker travels more than about 20 kilometers, the case manager will see that as a red flag and cause more surveillance – WTF!

We just wonder about those injured workers living in remote or rural areas, and even those who live in cities but who are in need of specialist centres of a decent doctor, therapist, etc! How sick to judge an injured worker on mileage traveled!

6. Being a “Google doctor”

More and more injure workers, understandably, will “Google” their injury and try and find out as much as they can about their type of injury, treatment and so forth.

Our insider tells us that case managers hate it when injured workers use medical terms or “talk shop” with the case manager (WTF!). Case managers feel very upset when injured workers do so, because “case managers have handled claims like yours for years and they think they know the time-frame and the improvement step to make and when they should be made” – wow, how SICK!

Any derivation from that timeline template raises the red flag and a watchful eye, says our former case manager!

So again instead of this helping the scenario, it is hurting it in the long run. … WTF!

No wonder I have being treated like sh*t the minute I have talked or written about my medical condition, complications or prognosis (and I am medically trained)! And as if my uneducated case manager would know anything about the injury I suffer, hell, even my upper limb specialists has not seen this before. One of the operations he performed on me had only been done once before!!!! And that bitch even had the guts to tell my upper limb specialists that “she did not believe him and that I needed an objective medical examination”! Guess what, the objective examination consisted of an 8o year old (at least) GENERAL surgeon’s old fashioned and clue-less opinion on a mangled arm. A limb that this geezer has never ever operated on either by the way, as he deals with gall bladders, warts and stuff like that. Still his honorable “opinion” was in my favour and a far much worse prognosis was given, inevitably, given that he knew nothing about bionics.

7. Other irritants

According to our insider, there are other important words that annoy the cr*p out of case managers, and these are so-called “risk” or “risk drivers”. These are the non-injury facts that can contribute to disability and include things like obesity, diabetes, having a young child at home (being off of work decreases daycare costs), not wanting to go back to work in general, pending layoffs at the employer of the injured, smoking, etc. (WTF).

Our insider tells us that for example, if an injured worker is “fat”, the case manager will go to great length to try and blame the injury and consequences on being “fat”, rather than the other way around (fact is many injured workers will gain weight because they loose their job, hobbies, activities etc). [See previous post: case manager tells injured worker she is fat to deny benefit ]. While some risk drivers may (MAY) have a bearing on a claim (i.e drug/alcohol use), most are RIDICULOUS.

So there it is, words, and issues that annoy the sh*t out of case managers. These will never go away, and will probably increase in use as time goes on,says the former Allianz case manager. The system is heavily biased, and that is why I chose to leave and ran as fast and as far as I possibly could.

 

 

Updated 19April 2012

The COS Daily Magazine published our article!

Thank you to The Cos Daily!!!

Shortlink: http://workcovervictimsdiary.com/?p=5710


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5 Responses to “Things that annoy the sh*t out of workcover case managers”

  1. how do they know what irratates them when they dont answer the phone calls and the emails

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    • You must have “irritated” them already in their “clairvoyant” pathetic pea-brain minds 🙁

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      workcovervictim3 April 18, 2012 at 12:06 pm
  2. We appealed via Twitter and are seeking  “rude” or inappropriate letters or emails sent (as a consequence of being de-humanised) and received by aggrieved injured workers. So far we have received a shocker from an injured worker who received a hellish letter from his/her case manager with regards to the injured worker having begged for taxi and home help and used substantive medical information (as in evidence, including recent IME reports the case manager ignored) to make a case that the case manager was deliberately denying him/her those services (i.e. taxi to an urgent scan) and in fact deliberately putting the severely injured worker at great risk of further injury and severe, life threatening complication! In that letter, folks, the case manager goes as far as threatening the injured worker with “police” intervention for begging for his life! We will publish this letter in part tomorrow – stay tuned.

    Please, please share any rude. inappropriate emails or letters you may have received from case managers because they drove you to insanity (i.e. you ended up swearing on the phone after they denied you something legit again), or just because they are intimidating you.

    It’s only through sharing and showing other injured workers and the public that we can begin to show that there is a real pattern of abuse here and that we can start our very real demands for a change.

    Come on guys, don’t be afraid. There is no need to be scared. Remember what Erin Brockovich has told us. Email us (via ‘info@workcovervictimsdiary.com’) or use the share your story page to send us your documents anonymously.

    You can hide your document’s ID’s by using basic imaging editing programs such as GIMP or even your very basic Microsoft office picture manager! You can take screenshots of your documents and convert them in images too (and then edit the images and remove your ID). You can also use pastebins and TOR.

    But rest assured that any document(s) you send us will be used in an extremely private and secure manner, any ID will never ever be disclosed and we will never ever publish your ID. As you know, many injured workers have already shared stories and documents with us, so that we can keep a database of evidence of wrongdoings by insurance companies, in the hope of hopes to take legal action. (read about what we’re planning here). We also have a lawyer on board and Erin Brockovich’s close and full support!

    So what are you waiting for – YELL!

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    workcovervictim April 18, 2012 at 5:46 pm
  3. To our surprise and great delight, the Canadian Occupational Health and Safety Magazine (The COS Magazine Daily) published our article today 19 April (yesterday 18 April in Canada)! Yohoo!

    Thank you so much to The Cos Daily for publishing very important matters 😉

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    workcovervitcim3 April 19, 2012 at 8:50 am
  4. I have annoyed the crap out of me monkey this morning – oolallaallaaaaa – ggggraaaaawwwww 🙁

    All I said was what my surgeon has said to me on my last appointment and that is that I need a 2nd back operation. I explained what had happened and as soon as I mentioned the “diagnosis”, my case manager said “I don’t believe anything you say, all medical information must come from your treaters. You spend too much time on internet instead of working on your CV” what the f*ck!

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