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  1. #1

    Default Challenging a Nurse Case Manager's Orders

    My question involves Workers Compensation law for the state of: KY
    Back Injury 30 yrs. ago in Industrial Accident. After 13 yrs. in court gave up and accepted award of Medical Expenses paid for life in relation to injury. Have never been able to return to work. I've been under constant doctor's care since injured. I've now had 3 NCMs in 5 yrs. lost two physicians who said could not take constant paper work and sent me elsewhere.
    Newest NCM recently sent a letter requiring I appear in a Physiatrist's (Rehabilitation Specialist) office in two weeks for an Independent Medical Exam and bring all my medicines. The doctor is not an IME but a rehabilitation physician. WC Case Manager no help. Stated since my case was settled 20 some yrs. ago there are no rules and no one in WC Office who can help. WC Case Manager said I must do whatever Ins. Adj. says do.
    The doctor I must see does not have near the Medical Degrees of my doctor. The IC doctor has been known to hurt patients. I was warned to be very careful in his office. I am fragile and this situation makes me very nervous. My Ins. Adj. sent me a letter several months ago that said do what NCM says or risk loosing benefits. I ignored everything the NCM has tried to pull until now. I know there is a law that says I must go to doctor if mandated and the doctor must be a duly qualified physician. The NCM is from a Managed Health Network and has been trying to get me to sign release forms which I ignored. My employer did not have a Managed Health Network. I am in constant pain but I'm satisfied with where I'm at under my current physician’s care. I’ve been harassed for over five yrs. by the Ins. Adj. constant battle to get same treatments I've been getting for 35 yrs. It is rumored this doctor charges $2000 per visit. I'm told this will be paid out of KY Taxpayers dollars as my employer is no longer in business.
    Am I required to go this doctor's office even though my Ins. Adj. did not instruct me to go but rather the NCM sent me a letter that says she is working with my Ins. Adj? I cannot afford to have my medical cut off which I understand can happen. My attorney who handled my case originally no longer practices WC and he received max allowance at the time I settled so as I understand it I am not allowed to hire an attorney (I've tried). Advice appreciated.

  2. #2
    Join Date
    Sep 2011
    Posts
    154

    Default Re: Nurse Case Manager Orders Quetionable

    you can file an objection with the comp court.
    you can present your evidence as to why it should not allow the carrier this exam at their expense.
    you can contact the state bar and see if they can provide you with legal assistance.

  3. #3

    Default Re: Nurse Case Manager Orders Quetionable

    Thank you for your response. You note I can file an objection with the comp. court. Currently there is no pending or open case for my injury and as I understand it my only course of action with the comp. court is to file a Re Opening (which I have had to do several times) but this does not qualify there. How would I file an objection? I will contact the State bar. Thank you.

  4. #4
    Join Date
    Sep 2011
    Posts
    154

    Default Re: Nurse Case Manager Orders Quetionable

    i would contact the work comp ombudsman for legal help in filing for a hearing on the issue of the IME exam.
    http://www.labor.ky.gov/workersclaim...udsmen%29.aspx

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