Have you been hurt at work and the insurance adjuster assigned a nurse case manager to accompany you to your medical appointments?
We represented a worker who had a nurse case manager attend all doctor’s appointments with him. A nurse case manager is a nurse who is supposed to take a look at a workers’ compensation claim from a broad view, considering both the medical and legal aspects of the case. Some of the duties of a nurse case manager include:
Before the nurse case manager’s involvement, the injured worker felt like he had a good relationship with the doctor that was treating him…until the nurse case manager came along.
Once the nurse got involved, the client felt that the doctor treated him differently and that the nurse controlled the medical visits. The doctor would defer to the nurse regarding treatment choices, such as authorizing an MRI and even the PPI.
The Indiana Workers’ Compensation Act does not currently regulate the conduct of nurse case managers. However, if a nurse acts improperly, that can result in sanctions being issued against the insurance company. We have seen nurse case managers that attempt to manipulate the medical care being given to our clients. Instead of helping the injured worker recover from his injuries, the nurse case manager is acting in the best interest of the insurance company to cut off your medical care and benefits.
If you have a situation where a nurse case manager is controlling your medical care, we can help. Call us at (317) 569-9644. Don’t let a nurse case manager impact your medical care, get the treatment and rehabilitation you deserve.
Question: What if I reported my injury and there is no written report made? I was sent to a doctor who would not even look at my hand because he said it was not due to some immediate accident or trauma. He said that the Indiana Workers’ Compensation law does not cover any injury that is gradual over time due to repetitive motion unless you are a secretary and typing. He told me it was not work related because of this and did not examine the hand. I have requested a second opinion. I also asked for a copy of the injury report and was told there isn’t one. The plant manager is out of town and is doing it over the phone.
Answer: The doctor told you wrong. I would be interested in knowing who your employer is and who the doctor is. Sometimes the doctor works very closely with the employer and their opinions are influenced by the employer.
You absolutely can have a condition that is a result of repetitive use or trauma. I suspect you are talking about carpel tunnel syndrome which is a very common condition in many professions, not just typists. For instance, truck drivers and factory line workers often develop carpel tunnel syndrome as a result of their employment. There can also be issues related to a condition called trigger finger or trigger thumb that can be work related and results from employment activities.
In Indiana, employers must pay the compensation and benefits provided under the Workers’ Compensation Act when the following four elements of a worker’s compensation claim are met. If the employer/carrier denies a worker’s compensation claim and the dispute is heard by the Board, the employee has the burden of proving each of the elements.
“Injury” and “personal injury” mean only injury by accident arising out of and in the course of employment and do not include a disease in any form except as it results from the injury.
“By accident” means that the injury was unexpected. To occur “by accident,” the injury may be either an “unexpected event” or an “unexpected result.” Under the “unexpected result” theory, the injury to the employee may be the combined injurious effect of repetitive motions. The definition of “by accident” as both an unexpected event and an unexpected result means that a broad range of injuries is potentially compensable in Indiana.
As to your employer’s refusal or failure to report your injury. Ind. Code §22-3-4-13(a) requires that employers file the Employer’s Report of Injury with the Workers’ Compensation Board if an injury results in the death of an employee or in the employee’s absence from work for more than one (1) day. Failure to comply with reporting provisions may subject the employer/carrier to a $50 civil penalty to be collected by the Board. This report must be filed with the employer’s insurance carrier. Sometimes, employers try to avoid reporting work conditions because they want to avoid increases in their premiums for workers’ compensation insurance because of the reports of injuries or work conditions.
If you have found yourself in this situation, you probably want to utilize the help of a lawyer to fight for what you’re owed. Contact our office at 317.569.9644 today.
Have a question for us? Send an email to rklezmer@klezmermaudlin.com for help.
Every case is different. Most workers’ compensation claims are settled without a hearing. The Workers’ Compensation Board of Indiana requires both parties to make attempts to settle their disputed issues on their own before bringing them in front of a Judge. Going through this process can take some time.
Hearings are scheduled in either the county where the injury occurred, the county where the employer is located, or a county nearby.
If you have a condition that significantly reduces or limits your ability to work, you may be considered disabled according to the Americans with Disabilities Act (ADA) and therefore protected by this federal law.
The ADA applies to any employer with 15 or more employees. The Act says that an employer cannot discriminate against workers with disabilities. This includes those who may be a candidate for a position as well as those who already hold a position, such as an injured worker who is left with a disability due to a work accident, but who wants to return to his or her place of employment.
An injured worker whose work abilities have been limited by a work accident will probably be evaluated by a doctor to find out how well he or she can perform the necessary duties of the job. If the worker’s condition limits him or her from performing job tasks that are not critical to the job, then the ADA would require these tasks be reassigned. In a similar manner, if the task that the worker is unable to do are critical to the job, then the ADA requires the employer to consider a reasonable accommodation that would help the worker to still complete this task. This might include special equipment or a device that relieves some of the physical nature of the worker’s job; however, the law does not clearly define this term.
Vocational rehabilitation may be available to you as an injured worker if you are not able to return to the job you were doing before the work accident. However, the Workers’ Compensation Act does not require the employer to pay for this additional treatment. The Office of Vocational Rehabilitation [(317) 232-1319] can assist you with questions regarding this process.
The Jones Act provides benefits to seamen who work on-board a vessel in navigation and who are injured on the job. A seaman is someone who spends a substantial amount of his or her time on-board the vessel. For example, riverboat casino employees may be treated as seamen under the Jones Act. Riverboat casino employees who have been injured on the job and are unsure of their rights should contact an attorney familiar with workers’ compensation and with the Jones Act.
Questions surrounding the Jones Act and whether employees falling under this law are eligible to receive Indiana workers’ compensation benefits have surfaced more recently. Some attorneys believe that employees under the Jones Act are still eligible for workers’ compensation benefits in Indiana. If your employer tells you otherwise, you should consult with an attorney about YOUR RIGHTS to workers’ compensation benefits.