You Are Not Required to Have a Nurse Case Manager in Most Georgia Workers’ Comp Claims

If you are injured on the job in Augusta and file a workers’ compensation claim, your employer’s insurance company may want you to work with a nurse case manager. Under a rule implemented by the Georgia State Board of Workers’ Compensation in 2016, you are not required to agree to the help of a nurse case manager if you suffered a non-catastrophic injury. It is important to understand what a nurse case manager does and your legal options so that you make the right decision for your situation.

What Does a Nurse Case Manager Do?

A nurse case manager is hired and paid for by the workers’ compensation insurance company. Her role is to act as a liaison between the insurance company and the doctor treating the worker. She is usually a registered nurse. Some of the duties she may perform include:

• Provide telephone or in-the-field case management services
• Coordinate appointments with multiple physicians and other medical care providers
• Obtain information and documents needed to process a claim
• Answer the injured person’s questions
• Develop a plan to enable the worker to return to his job
• Conduct in-home visits to ensure that the individual is following his doctor’s instructions
• Meet with the person’s supervisor to evaluate the worker’s ability to return to work and discuss needed modifications of job duties

Because the nurse case manager works for the insurance company, he or she may not make decisions that are in the best interest of the worker, so you should consult your attorney about whether or not you want to use one.

When Consent Is—and Isn’t—Required for Use of a Nurse Case Manager

If you suffered a catastrophic injury, you are required to have a rehabilitation supplier, who will coordinate medical care, develop an individual rehabilitation plan, provide vocational services, and analyze potential jobs. When your injury is non-catastrophic, you are not required to have a nurse case manager. However, an employer has the right to hire a nurse case manager to perform certain services—whether or not you agree to this.

The rule that governs the use of nurse case managers in non-catastrophic injury cases is Rule 200.2. Your rights under this rule include:

• You or your attorney must consent to a nursing case manager working with you.
• In order for the nurse case manager to attend your doctor’s appointments, written consent must be obtained.
• You have the right to withdraw any consent given, and the nurse case manager must advise you of this right.
• Your consent is not required for the insurance company to hire a nurse case manager to contact your physician to assess, plan, implement, and evaluate options and services that are necessary for your medical treatment.

Have You Been Injured At Work?

If you’ve been injured on the job you need to speak with an experienced workers’ compensation lawyer as soon as possible. Contact us online or call our Augusta office directly at 706.863.6600 to schedule your free consultation.