StockSnap / Pixabay

Who is this Nurse Case Manager on my workers comp case?

After being injured on the job and receiving some medical treatment there may come a time when the adjuster or case manager assigns a nurse case manager (NCM) to your case.  You do have rights regarding this case manager and there are some boundaries that the nurse should be aware of.  If you are unfamiliar with case managers then it is important to further investigate these rights and not be afraid to ask for the nurse’s ethical obligations.  It is also a good idea to consider obtaining a Maryland workers compensation attorney when workers comp involves a nurse case manager.

The role of the nurse case manager in a Maryland workman’s compensation case.

A nurse case manager is often brought into a case by the adjuster in order to facilitate the progress of medical treatment.  The goal is to ensure the injured worker gets the treatment they need without undue delay.  Workers Compensation nurse case managers are often very good in this regard as they can quickly obtain the necessary authorization or approval from the adjuster and provide it to the treating physician.  In the event a treating provider orders an MRI the injured worker may have difficulty getting authorization, scheduling an appointment, and obtaining the test.  Sometimes getting a diagnostic test performed under Maryland workers compensation insurance can take weeks or a month.  When there is a nurse case manager involved it may happen within days.

While acting as the liaison between the workers comp adjuster and the doctors the nurses can often be helpful.  However on a regular basis the nurses seemingly cross the line of appropriateness and cause problems for the injured worker.

What rights does the injured worker have when dealing with a Maryland workers compensation Nurse Case Manager?

A workers compensation nurse case manager is still a licensed nurse and has to abide by the same ethical standards that an ER nurse or clinician would have to abide by.  The nurse case manager has taken an oath to a fundamental commitment to the patient.  The nurse must consider the injured workers interests first!  If this comes in question then the injured worker should not be afraid to question the nurse about this.  In the circumstance that the injured worker has difficulty doing so perhaps a Maryland workmans’ compensation attorney is needed to advocate for the claimant.  The workers comp nurse case manager must still treat the patient/injured worker with respect, dignity, and without prejudice.  Unfortunately some practitioners have a preconceived notion about workers comp recipients and these notions may, from time to time, interfere with acting respectful and dignified.  Perhaps most important is the nurses obligation to maintain the patients right to privacy!

Is the nurse case manager crossing the line?

At some point those injured workers in Maryland who have a nurse case manager assigned to their case may begin to feel that their interests are not being considered to the extent expected.  This presumable lack of consideration often comes in the form of the nurse attempting to rush the patients return to work.  The nurse may be approaching the treating provider or physician with statements as to when the worker can return to work, or perhaps when treatment should come to an end.  Regularly case managers have meetings with the treating physicians, without the patient being present, and discuss the injured workers return to work.   In Maryland the injured worker has the right to be involved in any communication the workers compensation nurse case manager has with the physician!

On occasion there may be some influence placed on the doctors to avoid prescribing certain treatment.  Instances when an NCM took it upon her/himself to influence the form of treatment prescribed which essentially materialized into the nurse taking over the treatment prescriptions.  This, under no circumstance, is ok! 

What can the injured worker and their doctor do if the Nurse Case Manager is overreaching?

First and foremost- the treating physician has the say as to what treatment is appropriate and at what point the hurt worker can return to work.  Accompanying this power is the power to refuse to speak with the nurse case manager.  The doctor can absolutely refuse to speak with the workers compensation nurse case manager.  Unfortunately many physicians in Maryland are not aware of this. 

The injured worker also has options under Maryland law as to how to handle a rowdy nurse case manager.  Under Maryland law the injured worker can refuse to let the nurse into the examination room.  The injured worker maintains their right to privacy.  He or she may also request the doctor not speak with the nurse.  It is best to explain to the doctor that conversations with the workers comp nurse case manager may affect the physicians impartiality as well as their judgment.  In some of the more egregious cases it is necessary for the injured worker to request the nurse have no involvement in their case.  While the nurse will limit their involvement to a minimum, often they continue to act as a liaison by requesting medical records and appointment dates from the physicians office.  Ultimately the decision falls with the doctor as to providing the medical records and appointment dates and they are limited by Maryland workers compensation laws as to what they can refuse to provide.  Requested medical records must be provided to the case manager.

For a no cost consultation with Anne Arundel County workers comp Attorney Andrew M. Rodabaugh call  +1 (410) 937-1659  , Email ,  or fill out the form at the bottom of this page.

My experience with the law firm of Cohen and Dwin was very professional. Mr Rodabaugh was very kind and easy to talk to in a very professional manner. The receptionists were helpful in guiding me through the procedures. I would definitely recommend Mr Rodabaugh in the future.
David B.CosmotologistBaltimore



Maryland workers compensation attorney Andrew M. Rodabaugh and his office offers information about Personal Injury law and Workers’ Compensation for informational purposes only. Nothing contained herein constitutes formal legal advice. If you need the advice of a Maryland workers compensation lawyer, please contact him today. He has offices throughout the state and various convenient meeting locations.  Each and every case needs to be evaluated before legal advice can be provided.  Under no circumstance should the information on this website be considered medical advice. This is an attorney’s website and is not affiliated with any government agency or government entity of any kind.
We are pleased to communicate with you concerning legal matters.  However if you communicate with us through this website regarding a matter for which our firm DOES NOT ALREADY REPRESENT YOU, your communication may NOT be treated as priveleged or confidential, and shall not be deemed to create an attorney/client relationship.  Furthermore you should NOT provide confidential information to anyone at our law firm in an email inquire or otherwise unless we have FIRST entered into a representation agreement.  By continuing on to our website you are deemed to have agreed to these terms and conditions.



Tags: , , , ,