Tom McCutcheon – Attorney at Law
Q: My husband was injured on the job. He went to a couple of doctor visits on his own but after undergoing an MRI, he was told he needs surgery. Now he has been assigned a nurse case manager (NCM) and she is coming to every appointment. She talks to the doctor when he is not around and although she is nice to his face, there is something about her I don’t trust. Recently, my husband went to a scheduled doctor’s appointment only to get there and be told that the appointment had been canceled because the NCM couldn’t be there. Is this legal?
Trisha, Killen
A. I hope your husband is doing well and I wish him a speedy recovery. Unfortunately, Alabama law does allow the use of nurse case managers. Furthermore, your woman’s “intuition” is exactly spot on, you should not trust this person. NCMs exist for one reason and one reason only, to get an injured worker back to work and off of the insurance company’s payroll as soon as possible regardless of whether they are fully recovered or not. I am sure all the NCMs will disagree with me but I have no problem calling a spade a spade. They may act like your best friend but always remember, they are hired by the insurance company.
When Alabama adopted the Worker’s Compensation Act, there were a couple of trade-offs. First, an injured employee could no longer sue an employer for negligence. In return, the employer, which is really the worker’s compensation insurance company, had to pay the injured employee’s cost of medical treatment, a percentage of his wage while he is out of work recovering, and any future loss of earning capacity. The employer, however, was granted the right to control the course of medical treatment which means the employer gets to choose the treating doctors.
Because the employer/worker’s compensation insurance carrier got to choose the injured worker’s treating doctor, the nurse case manager was born. The vast majority of doctors who treat our clients have the injured worker’s best interest at heart. The NCM, on the other hand, is there to control costs, push the doctor to return the injured employee to work whether they are ready or not, and basically do all they can to insure that the insurance company spends as little money as possible.
Tom and I have a very strict set of guidelines that the nurse case manager must follow when dealing with our clients. For example, we will not allow the NCM to meet with the doctor outside of our client’s presence. More than once I have called a NCM to the mat for violating these rules.
Trisha, after 22 years as a personal injury attorney I will tell you what I tell everyone who has been injured on the job, hire an attorney. Whether it’s my firm or another firm, the best thing you can do is hire an attorney who will protect you and your family during this time.
McCutcheon & Hamner, P.C.
2210 Helton Drive
Florence, Alabama 35630
Telephone: 256-764-0112
Facsimile: 256-349-2529
