The games they play

[Bummer Knees]

I have posted on another thread about my friend a RN and floor nurse at a local hospital whom was injured at work. My friend has 3 ruptured disc and was schedule to have surgery last Sept although the surgery was cancelled due to wc not approving the surgery.

Recently my friend has been having a difficult time with mobility issues and many high pain days.

After hiring an attorney (mine) she had court today with the Ins Co attorney being present.

At court today my friend learned the wc ins co had approved surgery months ago but the wc case mgr has been telling the doctor and employer that surgery had not been approved.

When the wc attorney learned of the problems with the case manager, well I am told everyone in the room could hear him yelling in the phone.

While he was on the phone my friend’s attorney went before the judge and got the surgery approved. I am told the judge wasn’t to happy today.

[red1030]

I would like to be a fly on the wall when this was all happening...lol Red

[tweety00]

Like trump says You're fired !!

[monster]

Who in the hell do these case managers think they are to override a decision like that???? I would love to meet that B***h to her face and have a little talk with her if you get my drift!!!!

Bummer - thanks for letting us know of a positive outcome, I only hope that the surgery wasn't delayed so long that she will forever have problems or other issues. Please tell her we said congrats on the victory and also PLEASE, pat your attorney on the back as he sounds like a good one to have in your corner

Red - that's a good one, I would have liked to have been there too

[Bummer Knees]

Monster

The wc case manager is the reason why I hired an attorney.
After not being able to do the walking required to visit my sister while in the hospital.

I contacted the case manager and told her this isn't working, I need to see the doctor again. The case manager refused and said because I have a pre-existing condition my treatment had ended. I feel the case manager largly made the decision on her own.

Earlier that month the doctor released me with no restrictions and no rating.

I do wonder about the many problems IW's have and how much of it is due to case managers.

[Still in Limbo]

Bummer, although I'm Sure there are some Good CM's out there, I haven't Heard of Too Many! The Very First thing My Attorney did when I Retained Him was Draft a Letter to the NCM, Stating to have no more Contact with me, and All Correspondence was to go through Him!! He made their Life so Miserable, that they dropped a NCM from My Case! Now it's just My Attorney against Theirs, Head to Head, with No Middle-Man!! I Surely Wish the Best for Your Friend, and as Always for You also Bummer! Have a Great Day!!

[ksgirl]

I just don't understand how some people can live with themselves. Why, after the ins. co. itself had approved it, did this person feel like they could be a God and over ride someone else's decision? You know what, I really don't want to understand people anymore.
Bummer, I am like you. I didn't hire an attorney until the adjuster stopped my checks and I couldn't get a hold of her to find out why. I am so happy to say that she has since been fired.

I wish your friend the best of luck!

[Bummer Knees]

I spoke to my friend today and learned she had an interesting day at work.
She is still working but not as a floor nurse due to her restrictions, she put doctor's orders in the computer and work a shortened day.

At the hospital where she works one of the case managers works the staff's work comp for the hospital. This is the individual that finds work for the IW within their restrictions and communicated with the case manager for the insurance company.

The hospital case manager told my friend today, we will see what options to surgery the doctor comes up with. My friend told the case manager that the judge approved treatment for surgery in court yesterday. The case manager got mad and left.

This leaves my friend with the impression that the case manger from work and the insursance company's case manager have been working together.

The executive director for the hospital has questioned several times why my friend hasn't had surgery yet. I told her to take it to the hospital board.

[nurse83]

WOW!!!! Scary; what nerve that CM has to deny surgery when it's been approved. Who does she think she is; does she have MD behind her name or any other authorization to veto decisions? I hope she gets fired; she certainly needs to be! Would she want someone to do her or her family that way?

Hope your friend makes a full recovery.

[Lilly]

Hi,
My first case manager was the reason I got a lawyer!
She was horrible...one could NOT even have a conversation with her on the phone as she was soooo defensive and accusitory. No other word could describe her....she was a ROYAL B**** ! After I lawyered up...I got a new CM
Take care, and good luck, Lilly