The Railroad As Big Brother


Employee Control Through The Use of Medical Exams, Rehab Nurses & Medical Case Managers

Nearly three years have passed since we first discussed the issue of rehabilitation personnel informing the railroad of private patient information and the tactic of using medical exams to control occupationally disabled railroaders. (See Straight Track - Why Do Re-Hab Nurses Wear Fish Net Stockings? Because You're The Catch!, and Straight Track - Medical Examinations & Occupational Disability)

Unfortunately, during this period, these underhanded practices developed by the railroads’ legal departments have only gotten worse. While attending railroad union meetings throughout the country, Hoey & Farina has repeatedly heard from railroad workers that claim agents are cross-checking employee files with the medical files from the rehab clinics, the railroads are harassing occupational disabled railroaders by sending them to medical exam after medical exam, and rehab nurses continue to inform the railroad claims department -- in a shocking breach of confidentiality – of patients’ personal medical information learned during the course of treatment.

Just last week, a client called to tell me that a “medical case manager” told him to expect to see him at the next appointment with his own doctor. I told my client:

  • The case manager has a right to updated information about his medical condition, but under no circumstances is the case manager to be involved in the medical decisions made by him and his doctor;
  • To inform his doctor that the case manager can be heard from after the exam is over but is not to be allowed in the examining room while the exam is going on; and
  • To remind the doctor that the railroad does not pay the doctor’s bills.

At the end of the exam, the case manager received the doctor’s verbal report on the client’s condition, and immediately started to harangue the doctor to change the medicine that he prescribed to his own patient. The case manager then demanded that my client change his physical therapist to someone who the doctor had never heard of before. To his credit, the doctor stood firm and refused to change his course of treatment in the face of such pressure from the railroad.


These tactics, used under the pretext of the railroad’s medical department, are ways a railroad’s legal department can exercise control over an injured employee.

The requirement to submit to a medical examination is just another pretense for the railroad to exercise control over its employee. There is no deep concern for the employee by the railroad’s medical department. It is critical that you contact Hoey & Farina, your FELA Designated Legal Counsel, to determine your rights and obligations concerning medical examinations in order to protect yourself and your family.

Railroaders must remember that the job of a rehab nurse isn’t in the best interest of the railroader patient. If you or someone you know suffered a work injury and a rehab nurse / case manager is assigned to your case, remember these helpful hints:

  • The rehab nurse / case manager works for the railroad and wants to please his or her employer.
  • Never get visibly angry with the rehab nurse (think of them as snitches!).
  • Always be courteous to the rehab nurse.
  • Be truthful when providing the rehab nurse with information.
  • Contact the rehab nurse ASAP if you need to cancel an appointment.
  • Never allow your rehab nurse to dictate your treatment or interfere with the relationship you have with your doctor.
  • Follow your doctor’s medical advice and not the opinion of the rehab nurse.

If you ever have any questions regarding something the rehab nurse or railroad medical case manager is doing or asking you to do, call Hoey & Farina for assistance. We are available 24 hours a day 7 days a week at 1-888- 425-1212 to help you.

If you or a loved one have suffered a work injury or wrongful death on the railroad, call an experienced FELA lawyer / railroad injury attorney at Hoey & Farina, P.C. at 1-888-425-1212, or complete this form, for your FREE CONSULTATION. Hoey & Farina represents clients throughout the United States.


542 South Dearborn Street
Suite 200
Chicago, Illinois 60605
Main: (312) 939-1212
Toll Free: (888) 425-1212
Fax: (312) 939-7842
Representing clients throughout the United States.


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