Under NC Workers Compensation law, employers and their insurance carriers are allowed to hire nurse case managers to assist in coordinating medical treatment. Although the nurse case manager is paid by your employer, take comfort in knowing that they are expected to be impartial and exercise independent judgment. In fact, nurse case managers are required to adhere to the NC Industrial Commission Rules for Utilization of Rehabilitation Professionals in Workers Compensation Claims.
When working with a nurse case manager, make sure you know your rights. Here are a few key things to keep in mind:
- A nurse case manager is allowed to attend an injured worker’s doctor appointments; however, the worker has the right to a private exam. Usually the nurse case manager will join the injured worker and doctor after the examination to discuss treatment options.
- A nurse case manager is also required to prepare regular written reports on the injured worker’s treatment. These notes must be provided at the same time to all parties. You have a right to insist on this.
- Know that your communications with the nurse case manager are not protected and that they will likely will be reported back to the insurance carrier. Remember this every time you communicate with him or her.
- A nurse case manager is responsible for helping coordinate your medical treatment—but he or she should not attempt to direct medical treatment or influence your treatment in any way. Furthermore, a nurse case manager is not to be used as an investigator for your claim and may not give legal advice.