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nurse case manager and workers compensation Indiana

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  • nurse case manager and workers compensation Indiana

    I have been on workers comp since April due to a back injury. All of a sudden I have been contacted by a nurse case manager. She told me that she will be here to help with my treatment and be able to obtain speedy approval for my needs. That part is fine. The problem I have is that she has decided to make my doctors appointments for me when it is inconvenient for me. I have always been able to make my own appointments for the time when I have transportation. This has never been a problem until now.

    For personal reasons I will not drive with a stranger to appointments (she said she could provide transportation). The time that I would be able to attend an appointment is within the same week, just a few days later. My last report from my doctor did not even indicate that I needed to make an appointment with him. I was told to call him and he would then let me know what my treatment would be.

    So basically.......I want to know if I am able to control my own appointment scheduling? Why am I am being forced into an appointment that was not requested by my doctor? Can I just call my doctor and reschedule for my convenience? Am I able to tell the doctor that I will be the only one allowed to schedule appointments from now on?

    I have become so stressed out because of this woman. I feel as if my options are being taken from me. I feel as if I am being bullied by my case manager and my adjustor. Could someone please give me some advice. I live in Indiana also.

    Thank you!!!

  • #2
    nurse case manager indiana

    i am unable to find the rules that my nurse case manager needs to follow in Indiana. Can someone help me with this?

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    • #3
      I am going to add this post to your original thread of 9-8.
      Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. Leo Buscaglia

      Live in peace with animals. Animals bring love to our hearts and warmth to our souls.

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      • #4
        I've never seen specific rules for NCM in any state. The employER/IC has the right to assign a NCM, and if they are willing to provide transportation, you would be expected to cooperate, or your benefits may be adversely affected.
        Meaning... stopped as you are not attending medically necessary appts reasonably expected to "cure or relieve from the effects of your injury".

        You are being paid wage replacement benefits while your Dr says you cannot work due to your injury, if/as during that time you would ordinarily be working, it's not about your convenience.

        When you are delayed, or denied benefits, or experience difficulty in a WC claim, you should consult with a WC attorney. Message boards are basically for generic help at best.

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        • #5
          If you aren't sure why you are being scheduled for an appointment, call the NCM. That is why you were assigned one.

          As for when they are scheduled, that isn't totally up to you as it is not necessarily reasonable to delay appointments by several days to allow you the transportation option of your choice. If you do not wish to use the transportation provided, you are welcome to arrange your own with a friend, taxi or other public transit service. This is also something you can discuss with your NCM but while you are off work and being paid benefits, the IC does have a certain degree of latitiude to call the shots as it were. You are being paid to heal and get treatment. They have a right to insist you do so in a timely manner and when it works for the doctor and NCM as well.

          You can certainly hire a lawyer if you wish but these facts will remain the same. Lawyer or not you can still be required to attend appointments when they are scheduled and as you are off work and transportation is being provided you really have no excuse not to go when asked. Same for having a NCM involved. If you have been off since April it is past time to have a NCM on the claim. It is not bullying. It is responsible case management.
          I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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          • #6
            The NCM is working for the insurance company, and not really working for you. Here in NC we have a set of rules they have to follow that constrains some of their more outrageous conduct, but I do not know if you have such rules in Indiana. A quick look at the state's workers' comp agency web site may reveal some rules for nurse case managers or rehabilitation professionals.

            You probably need to consult with a local work comp lawyer at this point. Things are unlikely improve for you without legal representation. Good luck.
            Bob Bollinger, Attorney
            Board Certified Specialist in NC Workers' Compensation Law
            Charlotte, NC

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