Workcover nurse case managers are not your friends

case-managers-are-not-your-friend

Some states use Nurse case managers, don’t be fooled as they – like ordinary case managers- are not your friends. They are hired by worker’s compensation insurance companies and routinely attend actual doctor visits with the injured worker

Workcover nurse case managers are not your friends

Know your rights when it comes to nurse case managers in a workcover case. Nurse case managers are hired by worker’s compensation insurance companies and routinely attend actual doctor visits with the injured worker. Most workers—who are unfamiliar with a workcover  injury and process—simply accept the insurance company nurse’s presence.

These nurse case managers generally pitch their services as easier navigation of medical care for the worker and facilitating communication with the insurance company. While some nurse case managers are helpful for injured workers not familiar with medical treatment and providers, most don’t have the injured worker’s best interests at heart.

An injured worker always should remember who pays the account.

A nurse case manager is hired by the insurance company. The insurance company wants to avoid payment of claims.

Thus, there is an incentive for a nurse case manager to push an early return to work or to question the severity of a doctor’s limitations.

We  have heard from many injured workers telling us how an aggressive nurse case manager was pushing for a premature return to work while the injured worker was – in fact- still recovering from an injury.

Injured workers also have seen nurse case managers argue with the treating doctor about  “loosening” restrictions for return to work and even about decreasing the percentage of impairment.

Also, anything a worker tells the nurse case manager can be shared with the worker’s compensation insurance case manager.

Even if the nurse acts as their best friend, potentially confidential information will be passed to the insurance company, with negative consequences on a worker’s claim and medical care.

 

[Article dictated by Workcovervictim and transcribed on her behalf]

5 Responses to “Workcover nurse case managers are not your friends”

  1. We are talking about privacy so can the insurer by Law contact my GP or my treating Psychologist and ask for a report without informing me?

    Xchangingvictim October 1, 2012 at 8:14 pm
    • As far as I know, in Vic, when you lodge a workcover claim, you automatically agree that workcover is allowed access to your medical information and allowed to make contact with your doctors (request reports etc, phone etc). It’s outrageous as far as I am concerned.

      • That’s right, you have to sign the forms to allow them access to your medical information….and they dredge everything they can, going way beyond what is pertinent to the workplace injury. They even got a report from a psychiatrist who I’d seen for six months in 1990 – twelve years before the workplace injury. I stopped seeing her because she wasn’t helping me and was extremely judgemental, telling me I had to give up my politics because that’s what was at the root of my problem! This shark got her snout in the Workover trough too.

  2. When it comes to a nurses involvement as a case manager the client needs to know the nurses role is to “empower” their client not their employer. Holding a nursing registration means their decision concerning your health can be put before a tribunal. Their nursing practice is based on a codes of ethics and a code of practice. Although consideration to their employer is necessary a nurse is classed as their ” own” practitioner and must be individually responsible to their clients health and well being. These codes of practice are all access able through: Codes of professional Conduct. http://www.nrgpn.org.au/index.php?element=ANMC+Code+of+Professional+Conduct (And)
    http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements.aspx

  3. This is so outrageous. The conflict of interest is extreme. Injured workers should take a friend/support person with them to all injury assessments. Apart from anything else, the presence of such a stranger at your medical appointment would limit the kind of discussion you could have with your doctor about the effects that the injury is having on your sex life, your personal relationships at home, your own personality etc.
    Personally I would find such intrusion into my “private health sphere” would exacerbate my sense of self and autonomy and hence my psychiatric injury.
    Know you are in the war once you have a workplace injury, trust nobody in the system their interests will always be opposed to yours.