Insurance company going with to my Dr appointment?

[s_family]

I injured my elbow last year at work. The doctor put me in physical therapy and I have been on work restrictions for the past nine months or so. The injury has been improving, and at my last appointment the doctor indicated that he anticipated lifting all the restrictions at my next appointment. That appointment is now about 2 weeks away and the elbow seems ok. However, I had a voicemail from a nurse working for the insurance company stating that she wanted to schedule a visit at my home to do her own evaluation. I have two issues with this: 1) I don't think a nurse is qualified to do any sort of evaluation and 2) I'm not comfortable with a stranger coming to my home. I hadn't even returned the call yet, and the following day I found another message from her stating that she had decided she wants to accompany me to my next appointment and that she had called the clinic to change my appointment to a date/time that was convenient to her. I immediately called the clinic and changed it back. The scheduler at the clinic was the same person who changed it when the nurse called and said she thought that is was very odd that they would change my appointment and had never heard of anything like that happening before. Does anyone know if any of this is customary or have any advice? Thanks.

[AQA]

The nurse you are speaking of is known as a "nurse case manager". You DO NOT have to allow them in your home. YES, they can go to your appointment. You DO NOT have to allow them in the exam room with you. YES, they will speak with your doctor about your medical care.

Just like any profession there are good ones and bad ones. They work for the ic. I find that the ic brings in a ncm. when they have questions about the medical care. Some people have had good experiences with a ncm and some had not.

You may want to be pro-active and call her. The only reason I see that she changed your appointment was to be able to meet you. I say that because she can speak with the dr. at any time in reference to your claim. If your dr. is like mine, the dr. will not be swayed from his/her oppinion by a ncm.

Take Care

[queenbee]

I told my NCM that she was not welcome to my home.
I could make an appt to come to her home if she wanted to meet with me- she didn't like that.
She tried to make my appt for her convenience I resheduled them to my conveniencee and to the convenience of the people driving me .
My NCM is always in the waiting room when I get there but my attorney told the insurance co that I do not want to be bothered by her .
She is not even allowed to speak to me .
My doctors are not impressed with her and laugh and roll thier eyes when discussing her.

[stiffnecked]

I had the NCM meet me at Starbucks. From day one she was not allowed into the exam room with me. After a couple of months she quit coming....

[lfoster21]

I also met my NCM at a coffee shop. I like the idea of asking to go to their house. As far as comming in with me to the appointments, she always gives me the choice to have her in the room (only when I am talking to the Dr. and not during any physicals, procedures etc.) or she could talk with the Dr. later. I have always chosen for her to come in when I am there talking to the Dr. I decided I would rather be in the room while she asked any questions. She rarely actually asks questions, but takes notes when the Dr. is talking. I had a friend who chose not to have her worker in the room with her and her case manager came back and asked the Dr. if she would be allowed to do a certain job, lying about what it would consist of and the Dr. agreed. By doing this job for a couple of weeks, she reinjured herself. So, I want to make sure I am in the room when my NCM is with my Dr. Just my thought on the subject.

[sparkey]

I too met my NCM at Mc Donald's far from my home. I had to sign paperwork for her to get my medical records also. I do not have a lawyer so I am doing all this on my own. My NCM went to every appt. I had after i met her. I would always see her in the waiting room at my doctor's appts. and would allow her to come in the room with me also as i wanted to make sure we all were on the same page. I did not want her in the room after me asking questions or making my appts. longer by having to wait for her to go in after me.

I had nothing to hide so i allowed her in. Once i was put at MMI she disappeared. That is what they are there for. To get you back to work and even if it is light duty. They also hear what meds you are on and keep in touch with your adjuster. They are the direct link to what your adjuster gets for info. They may be evil people, but I found once that when i was not paid for 3 months of my mileage reimbursement, that i mentioned it to her that i was going to contact someone higher up in the WC system and she then made a phone call to the adjuster and i got all 3 months payment in the mail two days later.

Just be VERY careful what you talk about with this person. They listen to everything you have to say, and can twist things around for your case. If they try to become your best friend ( like mine did ) keep in mind that they are NOT. They work for the IC not for you. Good luck. They will go away once you are back to work. Also my NCM tried to change my appts. and thank god i had a wc advocate that was assigned to me at DMHC and she stopped the NCM from changing my appt. I would make the earliest appts. which my NCM could not stand..LOL She would always comment on why do you want to go to the doctors so darn early...LOL This frustrated her.

[e3mrk]

Hi.
I have never even spoken to My NCM as all contact must be made with My Attorney.

[Timothy Belt]

e3mrk Wrote:Hi.
I have never even spoken to My NCM as all contact must be made with My Attorney.

I can't speak for any other state, but in PA the IC does not have a right to assign a NCM, you can refuse to have any contact with them, and you can refuse to allow your doctor to have any direct contact with them. With my clients, I always get rid of the NCM. They are nothing but bad news for the injured worker.

[jayne]

Mine was evil....constantly trying to change my appts and trying to tell the doc what he could and could not do...Doc refused to talk with her ....he and I called my lawyer and she disappeared....

[Deb]

I spoke to my NCM when I first was injured. I haven't seen or heard from her since. At the beginning the company nurse called me daily to see how I was doing and tried to "help" me make decisions as to my care and also kept me informed in the different procedures, medicines and effects, etc. Since I was forced out of my job because I could not return to work I have not heard from any of them. Now it is just me and my doctors. I like it better and it is less confusing.

Deb