Should I let a rehabilitation nurse accompany me to visits to my physician?

The Pennsylvania Workers' Compensation Act does not give the insurer the right to have a rehabilitation nurse accompany you for visits to medical providers.  Furthermore, you have the legal right to explicitly prohibit your physicians, even company doctors, from talking with the rehabilitation nurse.  Though they are legally entitled to file with the insurance company medical report forms and records so that they may be paid for treatment rendered, otherwise physicians and other medical providers must respect the confidentiality of your relationship. Why, therefore, would you ever decide to cooperate with a rehabilitation nurse?
You may be receiving benefits pursuant to a Notice of Temporary Compensation Payable in which the insurance company has not yet accepted full legal responsibility for your injury.  In that situation, you may want to cooperate as much as you can with the insurance company, taking the risk that a rehabilitation nurse may not be helping you.  Why?  As a practical matter, insurance companies deny claims all the time, even when the claims are valid.  They do so because they know that they can "starve you out" and often force you to return to work, often long before it is appropriate for you to do so.  Thus, until the insurance company has accepted full legal responsibility for your work injury either by issuing a Notice of Compensation Payable, or paying wage loss benefits to you for a period of more than 90 days under a Notice of Temporary Compensation Payable, you may wish to cooperate.       

Furthermore, although the quality of rehabilitation nurses varies widely, there are many rehabilitation nurses, even those hired by the insurance company, who will support you, make sure that the medications you take are appropriate, and coordinate care with other medical providers.  Other rehabilitation nurses, however, are little better than spies for the insurance company.  It is often impossible to tell if a rehabilitation nurse falls into that category until it is too late.  

Thus, if the insurance company is using a rehabilitation nurse, you should be represented by an attorney.  Most good firms, including our firm, will monitor your claim at no charge under these circumstances and will charge fees only in the event of a dispute.  

If you have a good relationship with a rehabilitation nurse and wish to maintain that relationship, we usually place conditions on the continued interaction of the rehabilitation nurse with you or your physician. First, we insist that all conversations between the rehabilitation nurse and any medical provided be done in your presence.  Second, we require all communications with the insurance company by the rehabilitation nurse to be in writing with copies to our firm.  

It is our belief that you should not permit a rehabilitation nurse to speak privately with your physician.  You not only want to be present when a rehabilitation nurse, even one you trust, speaks with your physician, you also want to write down afterwards everything you hear. If you are suffering from a serious work injury, it is best to be safe than sorry.

Greg Boles
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