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Living With Fibromyalgia - Online Support Group

Need ADVICE urgently!

#1

Case managers? what are they ? what i have found in the internet is a bunch of horror story about social workers who come to your home and work for your insurance company and intimidate your doctors ... i was recently offered one, but If her only purpose is to coordinate because she cant legally give me advice and then a case manager would serve no purpose for me since I have a strong support system in place... so am I right? am i wrong? tell me before my appointment comes due this friday please

#2

Find out who this case manager works for. Is she from an independent agency, a place connected to behavioral/mental health/substance abuse/foster child follow up and psychiatric services, etc.?

Typically, what one will do on your first visit is evaluate (Q&A) your current situation, your support system, awareness of community resources, find out what kinds of things you may need help with, and really be a liason and an additional support person. If you need transportation, they can help arrange that or provide it for doctor/lawyer appointments. The one I had was a good sounding board while I was in between therapists and helped me make some calls that caused me severe anxiety.

So, my experience was good. Case managers, on the other hand, that are court ordered and are there to represent the courts to follow up with child placement/well being related situations, go into homes to evaluate living conditions to see if a childs' needs are being met - those people are going to give case workers more of a bad wrap, because they feel invaded, are being 'evaluated', and reports made by the caseworkers weigh heavily on if a child stays in the home.

There are so many different types of caseworkers. What you describe sounds to me as being more like an insurance rep. IDK., Hard to say without knowing exactly who they are working for and what 'her' goal is.

Hope that helped. Good luck!

#3

Insurance companies like to use them to contain costs, make sure services aren't duplicated, help patients navigate the "system", etc. It seems from what I've read that you are very aware of your physical problems, and you have strong support. You probably don't need this service. Someone is paying for it, so if you don't need it don't use it.

#4

Hello Vishq, Perhaps I can shed some light on this subject.

We hired a wonderful one for my son after he got run down by a hit and run driver. She attends every appointment with him, makes sure the paperwork gets to where it's supposed to, suggests aids that could be put in the house to help the my son or small renovations. We only had to get a ramp built for my son, but other things were suggested...just suggested, not forced in any way.

Ours has become very dear to us. She actually was suggested to us by our attorneys and will attend any court hearings, legal proceedings that we have. She is paid for by the insurance company so the attending doctor will write a script for case management for a period of time and then, if it's still needed, write another and so on and so forth. We also get reimbursed for replacement care for Patrick and he also has Transportation services...all these are written scripts from the Primary. We have had ours for a year and a half now. We can call her anytime with any questions and she will find them out if she doesn't already know. I want to make sure you understand...in our case, the insurance company "pays" for us to have her but she does in no way work for the ins company or the attorneys for that matter. The insurance co. that is taking care of your bills and the such are the ones who also pay for a case manager. Ask you Doctor if he/she thinks a case manager would benefit you and go deeper, ask why/how you would benefit...then ask for referrals.

Ours is also a RN. She has the charm and finesse to work with insurance companies to get what WE want, to speed things up when they're dragging along. She works for us, the contract is between us and we could fire her at any time and get another if needed.

My son has a TBI as well as massive injuries to his legs and cannot remember things from his appointments....I call Linda. If I'm not happy with the way some of his therapies are going, I call Linda...not the facility...they won't let me talk to anyone without my sons permission and he's not giving permission yet.

She makes copies of everything so if Patrick misplaces his, Lindas got it.

Our Caseworker is a Godsend. She works for a company called CareForward here in Michigan...they may be in other states, I don't know. We had our choice when selecting a case worker ad chose one with the most experience not only in case managing but with Nursing experience and knowledge in the kind of injuries and brain damage that my son has.

We have a household of 9 and we thought we had all his needs covered betwixed us but the work that had to be done for Lawyers and insurance companies on top of my sons health care...well, it would have been too much and the stress level might have had horrible consequences.

So, my friend. That's what a caseworker does...she will help you get other services that she might see that you need when she comes to the house...just things to maybe make life easier for you. Try not to take offense with suggestions...it's all about the patient. She has to ask a lot of questions to find out what other services she thinks you could benefit from...like transportation. That was huge for us with all Patricks appointments an hour or better away and his (still) deep fear of even riding in a vehicle. That service came highly recommended and now the drivers Patrick uses are dear friends...something else he needed after his previous so call friends pretty much deserted him...if he couldn't go out runnin the roads and hittin the bars then what fun was he gonna be?

She consoles Patrick as well...another set of ears to bounce things that are hard to talk about.

Can ya tell we love her. I am so glad she was suggested to us...came right up to the hospital to visit Patrick and us and introduced herself, then after he was out he said, lets call that case manager.

Well Alrighty Then!

Be sweet to yourself!

PeacenLove~Always~Laurel aka Northwoods G-Ma

#5

I have to admit that when someone answers me thats a silly question what do you mean who do i work for I work for you .. It sets my inner alarms off, then again I must be biased I dont want anyone outside my family having my medical records. I have a past relationship that has children and Id hate to give him ammunition, against me.I really dont like the idea of having someone that mingled in my medical processes thats the point behind having a medical power of attorney, and a durable power of attorney. I thought I had covered all my bases i dont want someone trying to "push me" off using or not using resources not good for me I saw someone today I dont see a purpose behind seeing a physical therapist who just so happens to be related to the nurse practitioner and an occupational therapist too 2 different rhematologists one for "regular care and the other for pain management" sounds like a scam to me and i dont want to get wrapped up in that kind of sh*t.. I went with the sole purpose of getting a second opinion for my mobility, pain and ibs ect and walked away with 7+ referrals .. and I walked away with my head spinning from the pain nothing got fixed and i feel like my spider sense is screaming this is a set up walk away... Am i losing it?

#6

I dont know i went to a counselor she recommended a rollator after she got frustrated with how long it took her to get me in the room, then we talked about my frustration with the doctor i see because she seems to wait until im at 'omg somethings gonna break if i move" before she blinks so she recommended an in house CNP and a case manager I saw the CNP today I had an appt at 1 I took my meds at 9 I should have been home by the time they wore off but they didnt bring me to the back til about 3 and I didnt leave until about 6 with 7+ referrals and i have to say I dont know that I will be going back to that CNP Id rather stick with the one that waits til Im on deaths door the other one straight told me im gonna refer you to my sister shes a Pt and her partner is an OT also very talented and im supposed to see both and then they wonder why i hesitate at getting a manager

#7

ok ty

#8

i think this all arises from the fact that they want me to GET on disability, but I want to salvage my mobility I'd like to work again some day maybe it has something to do with the confusing diagnoses I have, and I just dont know what to think about having a completely unrelated person have that much sensitive information i can manage my own affairs i will let them know when i cant and assign my own person who i can trust has a bested interest that i have a good turn out that is not necessarily cost instead of efficiency