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What is a Nurse Case Manager in a Workers’ Compensation Case?

The purpose of a nurse case manager is to manage the medical care for an injured worker. Generally, a nurse case manager is provided by the employer’s workers’ compensation insurance carrier to assist with medical management and the coordination of medical treatment of the injured person.

Usually, a nurse case manager is utilized by the employer’s insurer when the injury victim has serious injuries, such as broken bones, or where surgery is warranted.

A nurse case manager’s job is to not only coordinate medical treatment for the injured person; however, they also sometimes work as a liaison to the workers’ compensation insurance company to report back to the insurer with medical treatment recommendations and status reports. Regarding the claimant’s treatment status and assist the claimant with scheduling medical appointments.

A nurse case manager is also helpful in facilitating the issuance of benefits to the injured due to their continuous contact with the insurance company that employs them.

Nurse case managers generally act independently as independent contractors for the employer’s insurance. However, given the fact that they are sometimes seen as an extension of the employer’s insurer, it is wise to consult with a lawyer regarding putting stipulations and agreements in place with respect to what the case manager can and cannot due on behalf of the claimant, as well as to keep claimant’s counsel informed of the same.

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