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On workers' compensation? Beware the case manager's interventions

The big focus among workers' comp insurers today is reducing the expenses tied to "runaway" claims. However, they may now be targeting injured workers for "helpful" interventions by case managers whenever they decide a worker's attitude isn't conducive to healing.

In other words, if you're injured at work and you don't heal up quickly enough, you might get tagged for having an unhealthy attitude that insurers say is really driving your disability.

What type of injuries are most at risk of attracting the insurance company's attention? Insurers use the example of the "turned ankle" that evolves into full-blown disability. In reality, however, any claim that fails to resolve as quickly as an insurer thinks it should have could be targeted.

Once a claim is identified as a runaway claim, insurers are now looking at the injured worker's emotional state. What can identify you as someone in need of intervention by a case manager?

  • Catastrophic thinking (feeling like your injury is wrecking your life as you know it)
  • Lifestyle risks (which are whatever the insurer says they are)
  • A fear of further injury (no matter how rational)
  • A sense of being unfairly treated (even if justified)
  • A disability mind-set (believing you are disabled because of your condition)

Using these qualifications, almost anyone with a debilitating injury could be shoehorned into the targeted group.

Once an insurance company decides to target an injured employee, they often try to force the employee to accept alternative treatment. A case manager will often discourage ongoing pain management using medication in favor of cheaper alternatives -- like meditation.

Case managers don't tell patients that they are trying to manipulate them into forgoing real treatment for their pain. Instead, they masquerade as empowering the patient to cope with pain through mental controls.

This ultimately adds a new level of victimization to an injured worker's state of being. If he or she fails to get better once "empowered" with mental techniques to control his or her pain, his or her attitude is blamed -- instead of the injury.

You can't stop an insurance company for assigning a case manager -- but you can protect your right to compensation. Insist on private meetings with your doctor and never allow the case manager to change your care without your consent. Above all, watch what you say regarding your feelings -- it may be all the ammunition the company needs.

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