Beware of Insurance Company Tactics: Nurse Case Manager, Recorded Statements and Surveillance

A. Workers’ compensation insurance carriers frequently request that an injured worker give a recorded statement by telephone prior to accepting his claim. It is inadvisable to consent to a recorded statement without first obtaining the services of a workers’ compensation attorney. A workers’ compensation attorney can best prepare you for the sorts of questions that will be asked and can advise you on how to properly answer. Remember, the workers’ compensation insurance adjuster is trained to solicit info from you that can be prejudicial to your claim. If you agree to give a recorded statement without the assistance of an attorney, there is a greater risk that the workers’ compensation insurer will deny benefits to you. The questions generally asked at a recorded statement are similar to the questions asked at deposition, but a deposition is only given once the injured worker has requested court. A recorded statement however, can be given prior to requesting court for your benefits. B. Workers’ comp insurance companies frequently conduct surveillance on injured workers after they have filed their claim. This is not illegal. The insurer can obtain the services of a private investigator who will follow you in your day to day activities and record same on video. Insurers conduct surveillance when they believe there is a possibility of fraud. It is illegal to simultaneously receive indemnity benefits for your workers’ compensation claim and work for remuneration. If you have any questions or concerns, or you believe you may be surveilled, it is urgent that you contact our office for a free consultation C. Insurance companies will frequently assign a nurse case manager to a workers’ compensation claim. The nurse case manager is supposed to maintain all medical appointments , schedule any transportation and/or interpretation needs of the injured worker, ensure that all prescriptions medicine are properly and timely filled, and gather all medical reports. In addition, nurse case managers may attend medical appointment and may even communicate with your treating physicians. Sometimes, nurse case managers are helpful in coordinating an injured worker’s medical care. HOWEVER, in some cases, a nurse case manager can harm your claim by attempting to persuade your treating physicians that you are ready to return to work and need no further medical care. An experienced w c attorney will monitor the services provided by the nurse case manager and determine whether it is harmful or helpful to your claim. Your attorney has the right to terminate the services of the nurse case manager, with the exception of “catastrophic claims” The job of the insurance company is to save themselves thousands and millions of dollars in medical cost and benefits. Often times, an adjuster will assign a case manager to your claim to “help you manage your medical appointments and records”. Now he or she may seem friendly, but they are there on behalf of the insurance company. You want to be careful what you tell the nurse case manager because she can directly speak with the adjuster on your case. We have heard from clients over the years that they have overheard the case managers tell the doctor to lower the disability rating and ask the doctors to lift the work restrictions they have. Speak with us or your attorney to help you navigate through this


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