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.
As an attorney, I see many cases where adjusters and employers are fair and try their best to follow the law. However, I see cases where adjusters and employers try to skirt the Indiana Workers’ Compensation Act laws at every turn.
The more I practice law, the more I feel like employers, in many cases, look for any reason to take advantage of injured workers. Two recent examples really make me wonder about what rights injured workers may have.
In a recent case, my client, an employee of a nursing home, was injured at work and offered light duty which consisted of remaining at the nursing home for a period of 13 hours a day and working three separate work shifts with 2-3 hour breaks in between. I truly feel that the employer designed this offer of light duty so that she would refuse it, then lose her job and not be paid workers’ compensation benefits. The employer later modified this offer of light duty to include only 3 hours a day of work. My client lives 25 minutes from this nursing home and to work 3 hours a day after taxes would put approximately $35 in her pocket a day. I assume gas money would probably cost 1/3rd of that amount.
Another scenario I saw recently, and I see all the time, is an insurance adjuster or an employer ignoring treatment recommendations of doctors they select. Under our Indiana Workers’ Compensation Act, an employer is allowed to select the physician, but is required to provide the treatment, medical services or supplies recommended by that physician. An adjuster or an employer is not free to pick or choose what it will authorize or what it will not.
The Indiana Court of Appeals determined that the estate of an independent contractor who died after falling off a ladder has been properly compensated through the state Workers’ Compensation Act. Therefore, the estate cannot claim at a later date that his injuries occurred outside the scope of employment.
The Indiana Court of Appeals has determined that the estate of an independent contractor who fell off a ladder and died was properly compensated through the state workers’ compensation act, and the man’s estate cannot later claim that his injuries occurred outside the scope of employment.
In The Estate of Donald Eugene Smith v. Joshua Stutzman d/b/a Keystone Builders, No. 43A01-1103-PL-136, an appellate panel affirmed the judgment of Kosciusko Superior Judge Duane Huffer in dismissing the estate’s lawsuit against Keystone Builders.
Eugene Smith, who worked for Keystone Builders, broke his neck and died when he fell 20 feet from a ladder in March 2010. Smith’s widow and estate agreed that Smith’s workers’ compensation claim would be settled for a lump-sum settlement of $100,000. In October 2010, however, the estate filed a complaint against Joshua Stutzman, alleging that Smith’s death was the result of Stutzman’s negligence in maintaining a safe workplace. Since Smith was an independent contractor and not an official employee, the estate argued that the claim was valid.
The trial court entered a default judgment against Stutzman, but ultimately dismissed the case in Stutzman’s favor because the Worker’s Compensation Board has exclusive jurisdiction.
Applying its own caselaw about workers’ compensation coverage, the appellate panel also relied on Sims v. U.S. Fidelity & Guar. Co., 782 N.E.2d 345, 349-350 (Ind. 2003), in which the act’s exclusivity provision bars a court from hearing any common law action brought by an employee for the same injury.
On the issue of whether Smith was an employee, the parties agreed to resolve those differences via a settlement agreement.