Nurse Case Managers and Illinois Work Injuries
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When you open an Illinois workers' compensation claim, your employer's insurance company may assign a nurse case manager to your claim. This doesn't happen in every case, but it's common in cases involving a serious injury. The main purpose of a nurse case manager is to save the insurance company money. In other words, they're not usually on your side.
Nurse case managers use many different tactics to try and influence your case in the insurance company's favor. They may try to talk to your doctor, suggest less expensive treatments, try to close your case early, or try to get your work restrictions lifted so the insurer doesn't have to pay as many benefits. An Illinois worker's compensation attorney can put a stop to this.
A nurse case manager may even try to attend your doctor visits. They may try to schedule the appointment for you based on their schedule. They may show up without your permission, or try to go into the exam room with you and your doctor. Sometimes they wait around and try to talk to the doctor after your appointment. What they don't tell you is that you have the right to say no to all of this and stop the nurse case manager's involvement.
The insurance company and case manager may seem like they're trying to help you. For this reason, many injured workers allow the nurse case manager to invade their privacy and attend doctor's appointments. Other times, the insurance company will try to bully a worker by telling them that their treatment won't be approved if they don't allow the nurse case manager to attend the appointment, talk to the doctor, etc. None of this is allowed under Illinois workers' compensation law.
The only reason the insurance company or case manager is allowed to contact your medical provider is if they need copies of your records or bills. Any other communication without your permission is against the rules. Of course, the nurse case manager can do these things if you give them permission, but we wouldn't suggest doing so.
Experienced workers' compensation attorneys are familiar with these tactics. They know what to look for, and how to prevent injured workers from being taken advantage of by the insurance company. We can't stress this enough – the best way to ensure that you are getting all the benefits to which you're entitled is to hire an Illinois workers' compensation attorney to look out for you. It simply makes sense because there are no up front costs and it levels the playing field.
If you have concerns about what your nurse case manager is asking you to do, or if you have questions about the benefits available to you, contact us. We'll help you sort things out, answer your questions and if needed refer you to an attorney with a track record of success in standing up to insurance companies on behalf of injured workers. Contacting our office is completely free and always confidential.