The Virginia Workers’ Compensation Commission has many guidelines for the Nurse Case Manager counsel regarding the medical treatment of the employee. These guidelines hold that:
The Nurse Case Manager cannot dictate or control the employee’s medical treatment. This includes limiting treatment options, prescribing referrals or otherwise determining the treatment. The insurance carrier is under the same warning. The only exception is if the physician directly requests the opinion of the counselor or the carrier.
The Nurse Case Manager can monitor the treatment provided it doesn’t cross the line into management of the treatment. This means the counselor, with the consent of the doctor, can see the doctor outside of the employee’s view. The employee, though, is not required to consent to this arrangement. The carrier can get information from the doctor through proper discovery.
The employee has the right to see his/her doctor without the presence of the Nurse Case Manager.
The employer/insurance carrier does have the right to require that the employee submit to a functional capacity evaluation (FCE) to determine the employee’s work ability – but only if the employee’s treating doctor or an independent medical examiner approves and authorizes the evaluation.
