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Workers' Compensation > Policyholders > About Claims > Managing the Claim

Managing the Claim

Role of the case manager


NYSIF case managers are professional workers' compensation specialists who oversee all aspects of the case, from injury to resolution, to maximize recovery and outcomes. The case manager provides a single point of contact for claimants and policyholders.


Role of the nurse case manager


NYSIF nurse case managers, also called medical care representatives, are registered professional nurses who oversee medical care, identify pre-existing medical conditions, negotiate fees for medical equipment, review and audit medical bills, and help coordinate return-to-work.


Role of the vocational case manager


NYSIF professional vocational rehabilitation counselors coordinate return-to-work by performing functional job analyses and recommending job modifications and ergonomic adaptations.


Role of the investigator


NYSIF investigators or private investigation firms hired by NYSIF verify the circumstances of a reported injury and ongoing validity of a claim.


Role of the hearing representative and attorney


NYSIF hearing representatives and attorneys represent the employer and NYSIF at Workers’ Compensation Board hearings. NYSIF attorneys also represent the employer and NYSIF in claim and third party litigation. These professionals work to limit the liability of the employer and NYSIF, and ensure the claimant is appropriately compensated.

 

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