If you’ve suffered an Idaho work injury, you may be contacted by a Nurse Case Manager (NCM). While they may present themselves as part of your care team, it’s important to understand who they actually work for — and it isn’t you.
What Is a Nurse Case Manager?
A Nurse Case Manager is hired by the workers’ compensation insurance carrier to oversee your medical treatment. To justify their cost, they must save the insurance company money — and those savings often come directly out of your benefits.
Why You Should Be Cautious
Doctor Pressure. NCMs may attempt to influence your physician to clear you for work prematurely or to limit necessary treatments — even when you’re not medically ready.
Appointment Intrusions. Nurse Case Managers often try to attend your private medical appointments to monitor and influence the conversation between you and your doctor.
Information Sharing. Anything you say to an NCM is reported directly back to the insurance company and can be used to reduce or deny your benefits.
Your Rights
You are not legally required to speak with or be managed by a Nurse Case Manager. You have the right to see your doctor privately, without an insurance representative in the room. If an NCM is present at your appointments without your consent, or is pressuring your physician, contact an attorney immediately.
What to Do
- Politely decline to speak with the NCM beyond basic scheduling matters
- Never provide detailed statements about your condition, your job, or your daily activities to an NCM
- Follow your doctor’s medical advice — not the NCM’s recommendations
- Contact Goicoechea Law if you have concerns about how an NCM is affecting your care
If you believe an NCM is interfering with your medical treatment or your workers’ compensation benefits, call Michael Kessinger at Goicoechea Law for a free case review. 208.743.2313