Nurse case managers can be useful for employers and injured workers. Rehabilitative services are frequently used in accepted workers’ compensation cases to help document the medical treatment plan.
The term “rehabilitative services” falls under the “Medical Compensation” definition of North Carolina General Statute § 97-2(19). It is also defined under the Rehabilitation Professional Rules (Rule 103) as the “planning and coordination of health care services by a medical case manager or coordinator, with the goal of assisting an injured worker to be restored as nearly as possible to the worker’s pre-injury level of physical function.”
When a nurse case manager is assigned to an injured worker’s claim, s/he must comply with the requirements of the Rehabilitation Professional Rules. Specifically, s/he must: meet the requisite qualifications of Rule 105, file a Form 25N: Notice to the Commission of Assignment of Rehabilitation Professional and identify the purpose of the rehabilitation involvement (Rule 107), and, if requested by the injured worker’s attorney, meet with the injured worker and the attorney within 20 days of the request. There are many other rules regarding the nurse case manager’s conduct under Rules 107 (Communication), 108 (Interaction with Physicians), and 109 (Vocational Rehabilitation Services and Return to Work).
Despite the foregoing, occasionally an injured worker will receive a phone call indicating that a nurse is requesting permission to attend an upcoming medical appointment. Frequently, these requests are given with little notice and the nurse is unknown to the injured worker. To further confuse the situation, the nurse indicates that his/her involvement is merely a “task” assignment meaning that s/he anticipates popping into the injured worker’s appointment, asking critical questions of the doctor, reporting back to the insurance company and will assume no further role in the case.
It is the North Carolina Industrial Commission’s “long-standing position” that “rehabilitation professionals (‘RPs’) who are given one-time ‘task’ assignments do not have the privilege and protection afforded them under the NCIC Rehabilitation Rules because one-time assignments do not meet the definition of medical or vocational ‘rehabilitation.’” Accordingly, “. . . prior to any one-time ‘task’ activity that involves contact with the injured worker or, if represented, the injured worker’s attorney.” (See NCIC Minutes from February 2008).
Given the limitations of a “task” assignment and highly limited role of the nurse case manager in those situations, we do not consent to task assignments.