This is called a “Nurse Case Manager.” You do not have to allow this person to be in the room at medical appointments, and you can instruct the nurse case manager to only communicate with your doctors in writing. You also do not have to tell the nurse case manager any of the details of your visit with the doctor. Taking this step may anger the claims adjuster, however, and result in  a denial of benefits.

The Nurse Case Manager is basically a paid spy for the claims adjuster. Their job is to report back to the claims adjuster regarding  your treatment and try to influence you and your doctors. Some are helpful to you and your treatment, while others are definitely not. If the nurse case manager tells you that you must seek a certain type of medical care or see a certain doctor, you have the right to say “no,” unless the doctor they want you to see is an “Independent Medical Examiner.”  Remember, however, that an Independent Medical Examiner only evaluates your condition, he or she does not provide you with any medical treatment.  Contact us if you are sent for an independent medical examination and the doctor performing the examination recommends treatment, tries to treat you, or otherwise makes you feel uncomfortable or unsettled.