Study finds there can be benefits for injured workers and insurers when a nurse case manager is assigned to a workers compensation case

A study performed by a workers compensation insurance company found that assigning a nurse case manager to a claim can be a benefit. According to the National Claims Journal, Helmsman Management Services, a division of Liberty Mutual Insurance Company evaluated over 42,000 workers compensation claims and found that WC claims with nurses sustained 18% lower future medical costs, 26% lower overall claim costs and 15% faster claim resolution. The report also found injured workers sometimes returned to work sooner if a nurse of assigned to a workers compensation case.

The study did point out that not all claims should have nurses assigned to the case. Claims that involved multiple injuries and employers that had positive relationships with their employers would not likely benefit from nurse case management. Based on the study, Liberty Mutual Insurance Company created a model to notify WC claims adjusters when nurses would have a good impact on cases. Some to the characteristics of the model included what body part was injured, the claimants motivation to return to work, and above average use of pain medications.

Injured workers who have valid workers compensation claims should realize they are NOT required to work with a Nurse that has been assigned to their case. Also, injured workers who do have nurses assigned to their case should be careful when dealing with an on-site nurse. You have a right NOT to allow the nurse go into the exam room when meeting with your doctor. A physical exam with your doctor should be a doctor/patient privilege and you should not have to allow a nurse who works for an insurance company to breach that confidential relationship. On the other hand, nurses assigned to workers compensation claims can be beneficial to an injured worker. Nurses sometimes have contacts and can schedule appointments with medical providers sooner than if the injured worker tries to schedule it on their own. Furthermore, nurses can sometimes speed up the process of getting the workers compensation insurance company to authorize necessary medical treatments.

If you have a valid workers compensation claim and the insurance company has assigned a nurse to your case, you should speak with an attorney that specializes in workers compensation matters to understand your rights. Attorney Michael Smith has been representing injured workers for over 15 years and will be able to counsel you regarding your rights.

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