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Is the Insurance Company Using a Workers’ Comp Nurse to Watch Over Me?

When you're hurt on the job, experience has taught us that one of the insurance company's primary concerns is cost control.

If your injuries are serious, the insurance company will often assign a workers' comp nurse to closely monitor your medical treatment and the recommendations your doctors make.

It's important to know the purpose of the nurse's involvement - and how you can protect yourself if your rights are violated. Below are important things to know if a workers' comp nurse becomes involved.

Who Is a Workers' Comp Nurse?

Workers' comp nurses are case managers, coordinators, and rehabilitation nurses who do not provide direct medical care.

Contrary to your physical therapist or occupational therapist, a workers' comp nurse is more of an overseer.

How Does a Workers' Comp Nurse Become Involved in My Case?

Most frequently, workers' comp nurses become involved at the request of the insurance company. The insurance company selects the nurse and pays them.

Nurses are often brought in when serious injuries occur, or when medical costs begin to rise. You can also request that the Industrial Commission assign a nurse free of charge.

What's the Point of a Workers' Comp Nurse?

According to the Industrial Commission, workers' comp nurses are directed to coordinate and plan medical care with the goal of assisting you back to your pre-injury level of function. They are supposed to communicate with your doctor about your treatment plan and work capabilities.

However, in our experience, some workers' comp nurses have ended up becoming more of a mouthpiece for the insurance company, focusing more on costs rather than what is best for the injured worker. Workers' comp nurses should not:

  • Direct medical care (tell the doctor or you what treatment you should or shouldn't have)
  • Advocate for one type of treatment over another
  • Advocate for a change in your treatment plan
  • Advise you on any legal matters involving your workers' comp claim

Workers' comp nurses are allowed to come to your doctors' appointments, but you can request a private exam with your doctor, in which case the nurse will speak with your doctor after the appointment (with you present).

Nurses will often speak with your doctor about your work restrictions and ability to return to work. The nurse should not be pressuring your doctor to ease your restrictions or release you to your full duty of work.

If looking at alternative work you might be able to do, the nurse can only recommend you for, or direct you to, suitable employment - jobs that are within the restrictions assigned by your doctor.

What Are My Rights When a Workers' Comp Nurse Is Involved?

If you have a workers' comp nurse assigned to you, remember this:

  • You are entitled to a private exam with your doctor, outside the presence of the nurse
  • You are entitled to be present when the nurse talks with your doctor
  • You can request the nurse be removed from your case for advocating for the insurance company or for violating the rehabilitation rules

In our experience, some workers' comp nurses have focused more on costs instead of health.

NC Workers' Comp Lawyers Evaluate Your Case FREE

If you are having problems with a workers' comp nurse looking out for the insurance company and not for your health, click here to contact us or call 1-866-900-7078. We can file a claim and work to try to ensure the workers' comp nurse understands their limits, so you can focus on your recovery.

Brian Clemmons joined the Law Offices of James Scott Farrin in 2010.

Mr. Clemmons received his J.D. from the University of North Carolina School of Law. He received his B.A. in History from the University of North Carolina at Chapel Hill. He’s spoken at numerous continuing legal education courses and has more than 23 years of experience in a variety of practice areas, including: personal injury, Workers' Compensation and Social Security Disability. He also has a great deal of experience as a defense attorney for insurance firms, so he has seen personal injury law from both sides of the table.

Mr. Clemmons believes that honest communication is key to a successful case.

Contact Information

Asheville Law Office

300 Ridgefield Court Suite 309
Asheville, NC 28806
Phone: 828-552-8215
Toll Free: 1-866-900-7078

Charlotte Law Office

301 S McDowell St, Suite 900
Charlotte, NC 28204
Phone: 704-599-1078
Toll Free: 1-866-900-7078

Durham Law Office

280 South Mangum Street, Suite 400
Durham, NC 27701
Phone: 919-688-4991
Fax: 800-716-7881

Fayetteville Law Office

2915 Raeford Road, Suite 204
Fayetteville, NC 28303
Phone: 910-488-0611
Toll Free: 1-866-900-7078

Goldsboro Law Office

1308 Wayne Memorial Drive, Suite B
Goldsboro, NC 27534
Phone: 919-731-2581
Toll Free: 1-866-900-7078

Greensboro Law Office

300 N. Greene Street, Suite 850
Greensboro, North Carolina 27401
Phone: 336-665-7072
Toll Free: 1-866-900-7078

Greenville Law Office

702 Cromwell Dr. Suite G
Greenville, NC 27858
Phone: 252-355-5205
Toll Free: 1-866-780-3227

Henderson Law Office

514 Dabney Drive, Suite 200
Henderson, NC 27536
Phone: 252-492-4600
Toll Free: 1-866-900-7078

Morganton Law Office

216 N. Sterling Street, Suite B
Morganton, NC 28655
Phone: 828-219-3080
Toll Free: 1-844-520-2894

New Bern Law Office

1505 South Glenburnie Rd, Unit P
New Bern, NC 28562
Phone: 252-634-9010
Toll Free: 1-866-780-3422

Raleigh Law Office

4325 Lake Boone Trail, Suite 100
Raleigh, NC 27607
Phone: 919-834-1184
Toll Free: 1-866-900-7078

Roanoke Rapids Law Office

709 Julian R. Allsbrook Highway
Roanoke Rapids, NC 27870
Phone: 252-537-9670
Toll Free: 1-866-900-7078

Rocky Mount Law Office

144 Woodridge Court
Rocky Mount, NC 27804
Phone: 252-937-4730
Toll Free: 1-866-900-7078

Sanford Law Office

703-B South Horner Boulevard
Sanford, NC 27330
Phone: 919-775-1564
Toll Free: 1-866-900-7078

Wilson Law Office

2315 Airport Blvd Suite A
Wilson, North Carolina 27896
Phone: 252-246-9090
Toll Free: 1-866-900-7078

Winston-Salem Law Office

301 N. Main Street, Suite 2409-C
Winston-Salem, NC 27101
Toll Free: 1-866-900-7078